병원 전 전문심장소생술을 위한 기계적 가슴압박기의 효과
The Effect of a Mechanical Chest Compressions for Out-of-hospital Advanced Cardiac Life Support
0
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
본 연구는 병원 전 환경에서 기계식 가슴압박기(LUCAS)와 수기심폐소생술의 비교실험을 통해 가슴압박의 질을 평가하고 기계적 가슴압박기를 사용한 효과적인 전문심장소생술을 제안하는데 그 목적이 있다. 병원 전 심정지상황을 가정하고 구급대원이 3인 1조로 현장에서 수기심폐소생술과 LUCAS를 이용한 심폐소생술을 적용하고, 구급차로 이송하며 수기심폐소생술과 LUCAS를 이용한 심폐소생술을 시행하였다. 연구결과는 다음과 같다. 첫째, 현장과 이송중의 수기심폐소생술의 비교결과 현장에서 수기심폐소생술이 평균압박깊이와 압박률, 이완율에서 유의한 차이가 나타났다(p<.001). 둘째, 현장에서 수기심폐소생술과 LUCAS를 비교한 결과 LUCAS가 압박률, 이완율에서 유의한 차이가 나타났다(p<.001). 셋째, 구급차로 이송중 수기심폐소생술과 LUCAS를 비교한 결과 평균압박깊이, 압박률, 분당압박횟수에서 유의한 차이를 보였다(p<.001). 위와 같은 결과로 보아 LUCAS는 적절한 압력으로 가슴압박을 수행할 수 있고, 그 동안 구급대원의 전문기도기 삽입, 정맥로 확보 등의 전문심장소생술을 추가적으로 수행할 수 있으며 환자의 소생률을 높이는데 기여할 것이다.
Abstract
The purpose of this study is to evaluate the quality of chest compression by conducting comparison research between mechanical chest compressor(LUCAS) and manuale cardiopulmonary resuscitation(CPR) in a out-of-hospital environment and suggest effective advanced cardiac life support using mechanical chest compressors. For this, a out-of-hospital cardiac arrest was simulated with a team of 3 ambulance workers, and manuale CPR and CPR using LUCAS were performed on site and during transport in an ambulance. The research results are as follows: the comparison of manuale CPR between on site and in an ambulance revealed that on-site manuale CPR showed significant differences in the average compression depth, compression rate, and relaxation rate. Second, the comparison between manuale CPR and LUCAS in an ambulance showed significant differences in the average compression depth, compression rate, the number of compression per minute.
참고문헌 (26)
- 이경열, "119 구급대원의 비외상성 심정지 환자의 병원전 처치실태 및 전문 처치율 향상을 위한 개선 방안", 한국화재소방학회 논문지, 25(5), pp.21~31 (2011), 한국화재소방학회
- J. Mosier, "Cardiocerebral Resuscitation is Associated with Improved Survival and Neurologic Outcome from Out-of-hospital Cardiac Arrest in Elders", Academic Emergency Medicine, 17(3), pp.269~275 (2010)
- C. Axelsson, "Clinical consequences of the introduction of mechanical chest compression in the EMS system for treatment of out-of-hospital cardiac arrest—A pilot study", Resuscitation, 71(1), pp.47~55 (2006)
- Q. He, "Random control trial of the efficacy of cardiopump on pre-hospital cardiac arrest", Zhongguo Wei Zhong Bing Ji Jiu Yi Xue, 15(5), pp.292~294 (2003)
- Robert A. Gyory, "The Efficacy of LUCAS in Prehospital Cardiac Arrest Scenarios: A Crossover Mannequin Study", Western Journal of Emergency Medicine, 18(3), pp.437~445 (2017), Western Journal of Emergency Medicine[DOI]
- Gavin D Perkins, "Mechanical versus manual chest compression for out-of-hospital cardiac arrest (PARAMEDIC): a pragmatic, cluster randomised controlled trial", The Lancet, 385(9972), pp.947~955 (2015), Elsevier BV[DOI]
- N. H. Krarup, "Quality of cardiopulmonary resuscitation in out-of-hospital cardiac arrest is hampered by interruptions in chest compressions—a nationwide prospective feasibility study", Resuscitation, 82, pp.263~269 (2011)
- Ching-Kuo Lin, "Effectiveness of mechanical chest compression for out-of-hospital cardiac arrest patients in an emergency department", Journal of the Chinese Medical Association, 78(6), pp.360~363 (2015), Ovid Technologies (Wolters Kluwer Health)[DOI]
- 변준섭, "병원전 심정지 환자에게 심폐소생술 시 AutoPulse와 LUCAS를 이용한 심폐소생술의 예후 비교", 대한응급의학회지, 30(1), pp.16~21 (2019), 대한응급의학회
- S. Steen, "Evaluation of LUCAS, a new device for automatic mechanical compression and active decompression resuscitation", Resuscitation, 55(3), pp.285~299 (2002)
- K. Couper, "Mechanical devices for chest compression : to use or not to use?", Current Opinion in Critical Care, 2(1), pp.88~94 (2015)
- P. A. Meaney, "Cardiopulmonary Resuscitation Quality:Improving Cardiac Resuscitation Outcomes Both Inside and Outside the Hospital A Consensus Statement From the American Heart Association", Circulation, 128, pp.417~435 (2013)
- 홍성기, "구급차내 심폐소생술시 흉부압박의 정확도에 영향을 미치는 요인", 대한응급의학회지, 20(4), pp.343~354 (2009), 대한응급의학회
- 이재국, "가상실현 기반 구급차에서 루카스와 수기에 의한 가슴압박과 인공호흡 비교 -마네킨 연구-", 한국응급구조학회지, 22(3), pp.67~76 (2018), 사단법인 한국응급구조학회[DOI]
- G. Putzer, "Manual versus Mechanical Chest Compressions on Surfaces of Varying Softness with or without Backboards : A Randomized, Crossover Manikin Study", The Journal of Emergency Medicine, 50(4), pp.594~600 (2016)
- 이효주, "The changes of symptom, EKG and hemodynamic in healty firefighters after delivering multiple cycles of cardiopulmonary resuscitation", 한국산학기술학회논문지, 18(6), pp.381~388 (2017), 한국산학기술학회[DOI]
- D. Smekal, "A pilot study of mechanical chest compressions with the LUCAS™ device in cardiopulmonary resuscitation", Resuscitation, 82(6), pp.702~706 (2011)
- C. Ji, "Post-admission outcomes of participants in the PARAMEDIC trial: A cluster randomised trial of mechanical or manual chest compressions", Resuscitation, 118, pp.82~88 (2017), Elsevier BV[DOI]
- D. Smekal, "CPR-related injuries after manual or mechanical chest compressions with the LUCAS™ device: A multicentre study of victims after unsuccessful resuscitation", Resuscitation, 85(12), pp.1708~1712 (2014)
- R. Baumeister, "Forensic imaging findings by post-mortem computed tomography after manual versus mechanical chest compression", Journal of Forensic Radiology and Imaging, 3(3), pp.167~173 (2015)
- T. H. Kim, "Quality between mechanical compression on reducible stretcher versus manual compression on standard stretcher in small elevator", The American Journal of Emergency Medicine, 34(8), pp.1604~1609 (2016)
- F. J. Ochoa, "The effect of rescuer fatigue on the quality of chest compressions", Resuscitation, 37(3), pp.149~152 (1998)
- 조영신, "시뮬레이션된 병원전 심정지에서 구급대원에 의한 가슴압박과 기계압박의 비교", 대한응급의학회지, 23(4), pp.486~492 (2012), 대한응급의학회
- M. Levy, "A quality improvement initiative to optimize use of a mechanical chest compression device within a high-performance CPR approach to out-of-hospital cardiac arrest resuscitation", Resuscitation, 92, pp.32~37 (2015)
- G. Putzer, "LUCAS compared to manual cardiopulmonary resuscitation is more effective during helicopter rescue—a prospective, randomized, cross-over manikin study", The American Journal of Emergency Medicine, 31(2), pp.384~389 (2012)
- C. K. Lin, "Effectiveness of mechanical chest compression for out-of-hospital cardiac arrest patients in an emergency department", Journal of the Chinese Medical Association, 78(6), pp.360~363 (2015)