Clinical Characteristics and Prehospital care in Prehospital Cardiac Arrest Patients by Paramedic's Reports

Abstract

In order to report characteristics of out-of-hospital cardiac arrest patient in whom 119 rescuers used prehospital care by Paramedic's Reports. 1,016 out-of-hospital cardiac arrest patients were transferred to hospitals by 119 rescuers between January 1st and December 31st, 2008. Prehospital reports of 983 cardiac arrest patients by 119 were analyzed. Shockable rhythm with AED use was 20.3%(VF 18.4%, VT 1.9%), then 66.5% of shockable cardiac arrest patients was resuscitated by AED. Bystander basic life support was 14.8%. There were significant differences in the recurrent survival rates between shockable rhythm and non-shockable rhythm(13.0% vs 2.0%,7.4%, p=0.000). There was also significant differences in the recurrent survival rates between adequacy rate of AED(21.6% vs 2.4%, p=0.000). But there was no significant differences in the recurrent survival rates between done bystander CPR and none(9.0% vs 5.5%, p=0.10). The performance of bystander CPR and usage of AED, and appropriate CPR done by 119 rescuers were unsatisfactory by paramedic's reports. To improve the adequacy of Basic life Support and to increase the performance on Advanced Life Suppport, we must challenge to develop the emergency medical systems.

A Case Report of ROSC for Out-of Hospital Cardiopulmonary Resuscitation: Based on one Area Heart Saver

“…전국적으로 심정지 환자에 대한 심폐소생술 시행률은 대전 85 %, 광주 83 %, 충북 66 %를 보이고 있으며, 제세동기 적용률은 울산 22 %, 강 원 18 %, 인천 5 % 등으로 차이를 보였다 (10) . (15) . 이 연구에서는 심폐소생술과 자동제세동기를 함께 사용한 후 회복된 환자는 7례(87.5 %)였고, 심폐소생술만 시행한 후 회복된 환자는 1례(12.5 %)였다.…”

“…제세동의 적응증이 되 는 심실세동 환자에서는 100 % 제세동이 시행되었으며, 제세동 시 최초 에너지 사용량은 200 J 4례(57.1 %), 150 J 3례(42.9 %)를 보였다. 현장에서 의료지도를 위한 연계성을 살펴보면 3.1 %를 보였으며 (8,15) , 구급대원의 응급처치 시행률이 낮아 의료지 도를 받을 필요가 적고 전문적인 지도의사가 부족한 점 등 에 기인한 것으로 지적되고 있기도 하지만 (8,19) 를 보였고, 1급응급구조사 자격을 소지한 구급대원이 출동한 경우가 27.7 % (9) , 29.9 % (21) , 51.0 % …”