3차 의료기관에 내원한 병원전 심정지 환자에게 시행된 119 응급처치에 대한 평가 (Evaluation of Pre-hospital Care Provided by 119 Rescuers in Out-of-Hospital Cardiac Arrests Transported to Tertiary Emergency Department Covering a Rural Area)

서지정보

· 발행기관 : 대한응급의학회
· 수록지 정보 : 대한응급의학회지 / 22권 / 5호 / 391 ~ 399페이지
· 저자명 : 전용규, 윤재철, 조시온, 정태오, 진영호, 이재백, 김진회, 이현경

초록

Purpose: The large disparity in outcomes of out-of-hospital cardiac arrest (OHCA) between communities makes it important determine pre-hospital factors associated with outcome of OHCA. The study evaluated pre-hospital care performed by 119 rescuers in OHCA and investigated pre-hospital factors that influenced return of spontaneous circulation (ROSC) and automated external defibrillator (AED) use.
Methods: We retrospectively analyzed 119 OHCA patients with presumed cardiac origin admitted to our emergency department transported by 119 rescuers from May 2007 to April 2010. Patients were divided according to achievement of ROSC and AED use prior to comparative analysis.
Results: Twenty six patients (21.8%) experienced ROSC and only five patients (4.2%) survived to discharge. In the study area, scene-to-hospital arrival time was significantly shorter in the ROSC group (15.0±5.8 minutes) than the non-ROSC group (19.4±9.1 minutes) (p=0.02) and electrocardiography (ECG) application was associated with non-AED use.
Conclusion: Cooperation of emergency medical services and hospitals in the community to reduce hospital arrival time is needed to improve ROSC in OHCA patients. AED use on scene prior to ECG application will be encouraged and higher level training and continuous education of 119 rescuers for AED use will be needed to enhance AED application.

영어초록

Purpose: The large disparity in outcomes of out-of-hospital cardiac arrest (OHCA) between communities makes it important determine pre-hospital factors associated with outcome of OHCA. The study evaluated pre-hospital care performed by 119 rescuers in OHCA and investigated pre-hospital factors that influenced return of spontaneous circulation (ROSC) and automated external defibrillator (AED) use.
Methods: We retrospectively analyzed 119 OHCA patients with presumed cardiac origin admitted to our emergency department transported by 119 rescuers from May 2007 to April 2010. Patients were divided according to achievement of ROSC and AED use prior to comparative analysis.
Results: Twenty six patients (21.8%) experienced ROSC and only five patients (4.2%) survived to discharge. In the study area, scene-to-hospital arrival time was significantly shorter in the ROSC group (15.0±5.8 minutes) than the non-ROSC group (19.4±9.1 minutes) (p=0.02) and electrocardiography (ECG) application was associated with non-AED use.
Conclusion: Cooperation of emergency medical services and hospitals in the community to reduce hospital arrival time is needed to improve ROSC in OHCA patients. AED use on scene prior to ECG application will be encouraged and higher level training and continuous education of 119 rescuers for AED use will be needed to enhance AED application.

참고자료

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