Seong-Woo Yun

The effect of inclined step stool on the quality of chest compression during in-hospital cardiopulmonary resuscitation

PURPOSE A step stool is an ordinary device to improve the quality of chest compression (CC) during in-hospital cardiopulmonary resuscitation (CPR). We investigated the effect of an inclined step stool on the quality of CC during CPR on a hospital bed. METHODS We conducted a randomized crossover study of simulation using a manikin. Two different methods of CC were performed and compared: CC using a flat stool and CC using an inclined (20°) stool. Each session of CC was performed for 2 minutes using a metronome at a rate of 110 beats per minute. The primary outcome was the depth of CC. The adequate CC rate, duty cycle, rate of incomplete recoil, and the angle between the arm of the participants and the bed were also measured. RESULTS The median value of the mean depth of CC was 50.5 mm (45.0-57.0 mm) in the flat stool group and 54.5 mm (47.0-58.3 mm) in the inclined stool group (P = .014). The adequate CC rate was significantly higher in the inclined stool group (84.2% [37.6%-99.1%] vs 57.0% [15.2%-95.0%]; P = .016). The duty cycle and the rate of incomplete recoil were comparable between the 2 groups. The angles between the arm of the participants and the bed were more vertical in the inclined stool group (84.0° ± 5.2° vs 81.0° ± 4.8°; P = .014). CONCLUSION Using an inclined stool resulted in an improvement in the depth of CC and the adequate CC rate without increasing the rate of incomplete chest recoil.

Emergency Medical Technology Students` Awareness and Performance of Standard Precautions in Hospital Infection Control

This study was to provide the basic data to raise the efficient practices that can reduce the Infection Prevention and Exposure by understanding the awareness, Performance degree of the Administrative Standard Guideline of Nosocomial Infection Control for Emergency Medical Technician students who are exposed to hospital infections while conducting clinical practice. After the study, the performance degree was lower than the awareness of the Performance degree of the Administrative Standard Guideline of Nosocomial Infection Control. And awareness and performance degree are have significant positive correlation, significant differences statistically(r

Disseminated intravascular coagulation is associated with the neurologic outcome of cardiac arrest survivors

Purpose: We aimed to examine the serial changes in coagulofibrinolytic markers that occurred after the restoration of spontaneous circulation (ROSC) in cardiac arrest patients, who were treated with targeted temperature management (TTM). We also evaluated the association between the disseminated intravascular coagulation (DIC) score and clinical outcomes. Methods: This was a single‐centre, retrospective observational study that included cardiac arrest patients who were treated with TTM from May 2012 to December 2015. The prothrombin time (PT) and partial thromboplastin time (PTT), along with the levels of fibrinogen, fibrin degradation products (FDP), and D‐dimer were obtained after ROSC and on day 1, 2, and 3. The DIC score was calculated after ROSC. The primary outcome was the neurologic outcome at discharge and the secondary outcome was the 6‐month mortality. Results: This study included 317 patients. Of these, 222 (70.0%) and 194 (61.2%) patients had a poor neurologic outcome at discharge and 6‐month mortality, respectively. The PT, PTT, and fibrinogen level significantly increased over time, while the FDP and D‐dimer levels decreased during first three days after ROSC. Multivariate logistic analyses revealed that the DIC score remained a significant predictor for poor neurologic outcome (odds ratio [OR], 1.800; 95% confidence interval [CI], 1.323–2.451) and 6‐month mortality (OR, 1.773; 95% CI, 1.307–2.405). Conclusion: The activity of coagulation and fibrinolysis decreased over time. An increased DIC score was an independent prognostic factor for poor neurologic outcome and 6‐month mortality.

The Relationship between Advanced Airway Management and Self-Efficacy by Level 1 Emergency Medical Technicians(EMT) in 119 Emergency Medical Service

This study was to identify the frequency and related factors of advanced airway management for patients with cardiac arrest by the Level 1 emergency medical technicians in the 119 Emergency medical service. 95 level-1 medical technicians belonging to Gwangju Fire Service Headquarter were surveyed with structured questionnaire composed of general and job-related characteristics, self-efficacy, barrier factors to performing the advanced airway for patients with cardiac arrest. From January 1, 2010 to June 30, 2011, data obtained from the Gwangju Fire Service Headquarter by performance of advanced airway. Self-efficacy toward the necessity of advanced airway revealed positive correlation with self-confidence. The barrier factor to advanced airway performance had negative correlation with the frequency of performance. The most important factor of advanced airway performance was necessity and self-efficacy. In conclusion, it is necessary to develop the field-based practice education program and to improve self-efficacy.

A Study on the Patients Who Attempted Suicide with Drug Intoxication

Abstract The purpose of this study is when the cases will be found, used as a basic data for clinical severity prediction, and research on suicide prevention. By classifying the group of survival and death about the patients who visit the Emergency Medical Center by attempt suicide by drug addiction, identifying the condition when visiting and results of the treatment after visiting. From June 2009 to May 2011, last two years data that among the drug abusers who visited the Emergency Medical Center in C-University Hospital in Gwang-Ju, only suicidal patients, except with unintentional accidents were collected. The findings, among the drug addiction patients who high age, lower level of education and living alone were the mortality rate was higher. And if who drunk the agricultural chemicals, the convalescence was not good. If the causes of suicide were economic problems and depression, the mortality rate was higher. And when visit hospital, if the consciousness was stupor and semi-coma / coma, the convalescence was not good. As grasp the risk for suicide patients of drug addiction, help on the Prediction of clinical severity, also stamp the appropriate drug education with psychological support is more important on them.

Back strength and relevance of CPR chest compression

Purpose : The purpose of the study is to investigate the quality and relevance of back strength or chest compression which is applied by isotonic exercise of hip joint. Methods : Subjects were 37 students who participated in the BLS course and accepted the informed consent from December 7 to 8, 2012. During CPR performance, back strength was measured by the researcher. CPR was used the manikin for practical training with using PC, conducted by standard CPR for 2 minutes, Quality of chest compressions included average chest compression depth, rate, and recoil ratio. Results : Back strength (kg) is related to the chest compression depth (mm) (r