심정지 대응팀의 운영이 병원 내 심정지 환자의 치료에 미치는 영향
The Effects of the Establishment of Code-Blue Team on In-Hospital Care of Patients with Cardiac Arrest
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초록
병원 내 심정지는 그 생존률이 병원 외에서 발생하는 심정지 환자의 예후와 비교할 때 높지 않으며, 초기 심정지 리듬, 제세동 가능 여부, 시간 지연, 소생술의 수준, 심정지 발생 전 환자 감시 여부, 소생 후 치료 등 다양한 요소들이 환자의 경과와 관련된다. 저자들은 심정지 대응팀의 구성과 활동이 병원내 심정지 환자의 치료에 어떠한 영향을 미치는지 분석하였다. 연구 기간 2년 동안 531명의병원 내 심정지 환자가 발생하였다 (이 중 289명은 심정지 대응팀 구성 전 의료진에 의하여 심폐소생술을 시행 받았다). 연구 자료는 전향적으로 수집하고 후향적으로 분석되었다. 심정지 대응팀 구성의료진에 대한 팀으로서의 심폐소생술 교육과 함께 원내 심정지 상황 전파체계를 재정비하여 대응한결과, 심정지 인지까지 걸린 시간 (9.9±8.2 대 11.0±8.1 minute), 현장 도착까지 걸린 시간 4.1±2.6 대12.4±10.3 minute) 그리고 심정지 인지로부터 흉부압박까지 걸린 시간 (15.6±7.2 대 20.6±10.6 minute) 은 비교육군보다 교육군에서 훨씬 빨라졌다 (모두 p<0.05). 생존율도 교육군이 비교육군 보다 높았으나 유의하지 않았다 (9.09% 대 8.33%). 본 연구의 수행 결과, 교육된 심정지 대응팀의 소생술 수행도는 더 좋아졌으나, 병원 내 심정지 환자의 생존율은 심정지 대응팀의 수행도에 의하여 영향을 받지않았다.
Abstract
We sought to evaluate the effect of the performance of the Code-Blue Team on survival of patients with in-hospital cardiac arrest. This study was performed as a retrospective analysis of a detailed cardiac arrest registry containing prospectively collected data during two years (from January 2010 to December 2011). We compared Code-Blue Team performance and patient survival in 2011 (Education Group) with those in 2010 (Pre-education Group). A total of 531 cases, including 289 cases in the Pre-education group, were included in the study. Time to arrest recognition (9.9±8.2 vs 11.0±8.1 minute), time to scene arrival (4.1±2.6 vs 12.4±10.3 minute), recognition to chest compression (15.6±7.2 vs 20.6±10.6 minute) were much shorter in the Education group than in the Pre-education group (all p<0.05). Although the Code-Blue team showed a better performance, the survival rate of in-hospital cardiac arrest was not influenced by the performance of the Code-Blue team.
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