일반인에 의한 완전자동형과 반자동형 자동제세동기의 사용능력 비교: 시뮬레이션 연구

고찬영,김주현 대한응급의학회 2013 大韓應急醫學會誌 Vol.24 No.4

Purpose: This study compared the performance between the fully-automated external defibrillator (F-AED) and the semi-automated external defibrillator (S-AED) when used by laypersons. Methods: Thirty-three laypersons participated in a mannequin simulation study as part of Cardio-Pulmonary Resuscitation (CPR) training courses. After 30 minutes of didactic education for the Automated External Defibrillator (AED), they watched a video on how to use the fully-automated external defibrillator (F-AED) and a semi-automated external defibrillator (S-AED) instead of a hands-on education. Laypersons performed the S-AED first, then the FAED. Performances and shock delivery time intervals were recorded and evaluated. Results: The performances in shock delivery were better with the F-AED, although the overall performance was statistically insignificant. In terms of shock delivery interval, the F-AED was shorter than the S-AED (54.48±2.84 sec vs. 64.76±3.57 sec, respectively, p<0.01). In the post survey,F-AED had a higher preference (F-AED vs. S-AED 23(70%) vs. 5(15%), respectively, p<0.001). Conclusion: The F-AED had a better performance and shorter shock delivery time interval than the S-AED. The FAED should thus be considered for use, outside of the hospital,on cardiac arrest patients for early defibrillation.

자동 제세동기(Automated External Difibrillator)교육결과의 분석

이부수,이강현,임종천,김현,김성환,이진웅,황성오,강구현,김옥준 대한응급의학회 1997 대한응급의학회지 Vol.8 No.4

Background: Automated external defibrillator(AED) represent a major breakdown to permit more widespread application of the principle of early defibrillation. Many recent efforts to improve emergency medical services(EMS) and increase survival rates are simply efforts to get defibrillation to patients as rapidly as possible. AED is major innovation for the prehospital care of ventricular fibrillation cardiac arrest patients. The purpose of this study is to evaluate the course of initial training to three different groups(nurses, firefighters, and EMT trainee) to use AED. Method: We studies the efficacy of education of AED to 33 nurses, 15 EMT trainee, and 16 firefighters. Training lasted 75 mins and included 45 mins an overview of defibrillation, protocols for using the AED, and operation of the AED(Laerdal Heartstart 3000), 15 mins demonstration. A check list was used to grade the performance of cardiopulmonary resuscitation, operation of the AED, and the time required to deliver the first three defibrillations. Result: There were no statistically significant differences in performance and time required to deliver an electrical countershock among the groups(p=0.4). To the second test, 92% of all group completed all steps successfully. The step most often failed was the preparing of the AED for defibrillation. Conclusion: In nurses, EMT trainee, and firefighters, it is both feasible effective to train AED use irrespective of the degree of the trainee.

전기장판이 자동제세동기 정확도에 미치는 연구

구재은,유제성,주영선,정현수,이한식,정성필 대한응급의학회 2013 大韓應急醫學會誌 Vol.24 No.5

Purpose: The accuracy of the automated external defibrillator (AED) is susceptible to environmental factors such as vibration, motion artifacts, and electromagnetic interference (EMI). The purpose of this study was to evaluate whether the EMI produced by an electric mattress can affect the performance of AEDs. Methods: Four commercially available AEDs were evaluated under four ECG rhythm settings (normal sinus rhythm,asystole, ventricular fibrillation, and ventricular tachycardia)with or without an electric mattress. The sensitivity, specificity,positive predictable value, negative predictable value,and accuracy of AEDs were calculated to differentiate shockable from nonshockable rhythms. Times required to interpret the ECGs were checked with and without an electric mattress. Results: A total of 320 tests were recorded, and each AED was tested a total of 80 times. Depending on the AED model used on an electric mattress, sensitivity ranged from 55% to 90% with a specificity of 100%, and accuracy ranged from 77.5% to 95%. For some AEDs, sensitivity was reduced compared to the control. Although there was no significant difference in times required to interpret ECG signals with or without an electric mattress, some AEDs detected a relatively small interference as motion artifacts when an electric mattress was used. All recorded ECG rhythms on an electric mattress showed baseline artifacts and these artifacts lessened with increasing distance from an electric mattress. Conclusion: This study suggests that an electric mattress could affect the shockable rhythm performance of some AEDs. Electromagnetic interference generated by an electric mattress could interfere with the ability of some commercial AEDs to correctly interpret stimulated ECG rhythms and provide appropriate defibrillation.

보건계열 대학생의 자동제세동기의 태도와 지식이 자동제세동기와 심폐소생술 수행능력에 미치는 영향

박윤희,김정이,조미숙 대한고령친화산업학회 2023 대한고령친화산업학회지 Vol.15 No.1

Objective : The purpose of this study was to investigate the perception, attitude, and knowledge of AEDs and their effects on AEDs and cardiopulmonary resuscitation (CPR) performance of college health students Methods : t-test, one-way ANOVA, correlation, and regression analysis were conducted using the SPSS 23.0 program for 315 third-year college students in the health students Results : The degree of attitude and knowledge of AEDs and CPR performance of college health students was 4.21, 2.65, and 4.01 points, and the most influential factor on AED and CPR performance was attitude toward AED, followed by AED. It was the knowledge of an automated external defibrillator. The explanatory power to explain the dependent variable was 45.0%. Conclusion : Through this study, it is proposed to develop a curriculum and continue education to improve knowledge and attitude, such as participating in the BLS provider program every year, in order to improve the AED and CPR performance of health-related college students. 연구목적: 본 연구는 보건계열 대학생의 자동제세동기의 태도와 지식이 자동제세동기와 심폐소생술 수행능력에 미치는 영향요인을 확인하고자 하는 탐색적 조사연구이다. 연구방법: 보건계열 대학생 3학년 315명을 대상으로 SPSS 23.0 프로그램을 이용하여 t-test, One-way ANOVA, 상관관계 및 회귀분석 하였다. 연구결과: 대학생의 자동제세동기의 태도와 지식이 자동제세동기와 심폐소생술 수행능력 정도는 4.21점, 2.65점, 4.01점이고, 자동제세동기와 심폐소생술 수행능력에 가장 영향을 미치는 요인은 자동제세동기에 대한 태도이고 다음으로 자동제세동기에 대한 지식이었다. 종속변수를 설명하는 설명력은 45.0%이었다. 결론: 본 연구를 통해 보건계열 대학생의 자동제세동기와 심폐소생술 수행능력을 높이기 위해 매년 BLS provider 프로그램 참여 등 지식과 태도를 높일 수 있도록 교육과정 개발과 지속적인 교육이 이뤄질 수 있도록 제언한다.

1개 3차 병원의 응급의료센터에 내원한 병원전 심정지 환자에서 119 구급대에 의한 자동제세동기 사용 실태 및 효과

정시영,배현아,어은경 이화여자대학교 의과대학 2009 EMJ (Ewha medical journal) Vol.32 No.1

Objective:The objective of this study was to evaluate the use and the effect of an automated external defibrillator(AEDs) by emergency medical technicians(EMTs) in prehospital cardiac arrest. Methods:After application of exclusion criteria, 293 patients who transported to emergency center of our hospital after cardiac arrest in consecutive 36 months from Jan, 1, 2003 to Dec, 31, 2005 were included in this study. We reviewed the 119 rescue service records and the hospital chart of the patients including, demographic data, types of eletrocardiogram(ECG) rhythms, witness of arrest, cause of arrest, basic life support(BLS), use of AED, transport time, time intervals from cardiac arrest to the advanced cardiac life support(ACLS), and return of spontaneous circulation(ROSC). Results:The mean age was 56.1±21.8 years with 185 males and 108 females. Time intervals from cardiac arrest to ACLS were 27.2±18.1 minutes and 259 patients(88.4%) were transported by EMTs. AEDs were used by EMTs in 119 patients(45.9%) and 20 patients(8.6%) were defibrillated. After ACLS, 17 patients experienced ROSC and 2 patients survived until discharge. There were no statistical differences in the ROSC rate between the patients transported by EMTs and those by non-EMTs(p=0.067), between the group of AED used and of no-AED used(p=0.116). Conclusion:The use of AEDs by EMTs was still low and the effect of AEDs and BLS by EMTs were not significant in ROSC.

전국 설문조사를 통한 자동심장충격기 교육현황과 저해요인 분석

최승필,이미진 대한응급의학회 2019 대한응급의학회지 Vol.30 No.4

Objective: Public concerns and awareness of automated external defibrillators (AEDs) are essential for improving the survival outcomes of out-of-hospital cardiac arrest (OHCA) in the community. On the other hand, the proportion of OHCA, in which AED is used in a prehospital setting, is very low in Korea. The aim of this study was to identify the barriers and training issues of AEDs. Methods: A nationwide population-based survey was conducted to analyze the current public trends in AED awareness, training, and intention to use in 2017 (n=506). The barriers and training issues of AEDs were then documented. For trend analysis, previous tri-temporal surveys were obtained in 2007, 2011, and 2015. Results: Public awareness of AEDs has increased: from 5.8% in 2007, to 30.6% in 2011, 82.6% in 2015, and 79.4% in 2017 (P<0.001). The training experience of AEDs has increased over time: from 0.5% in 2007 to 8.2% in 2011 and 33.2% in 2017. Thirty-two percent of respondents knew how and where to find the AEDs, but only 12.5% were able to certainly locate their public-access AED near their residency or work places. The reasons for being unwilling to use the AED included not knowing how to use (65.0%), fear of causing harm to the victim (21.3%), and legal liability (11.7%). Conclusion: Not knowing the location of AED and how to use it, and being unaware of the Good Samaritan Law were the major barriers to public access defibrillation. Further research is urgently needed if AEDs are to be increased and more lives saved.

South Korean and Japanese intention to use automated external defibrillators in out-of-hospital cardiac arrest situations

임승환 사단법인 한국응급구조학회 2014 한국응급구조학회지 Vol.18 No.1

Purpose : The purpose of the study is to investigate the factors influencing using AED use in South Korea and Japan. Methods : I conducted a questionnaire survey from February 25 to March 4, 2013, receiving responses from 517 people in Korea and 520 people in Japan. The questionnaire included sociodemographic factors, history of heart disease, AED knowledge, and other variables. A logistic regression analysis was conducted. Results : Among the 517 Korean respondents, 220 (42.6%) intended to use AEDs. Among the 520 Japanese respondents, 384 (74.4%) had similar intentions. Multiple logistic regression analysis found the following significant predictors of intent to use AEDs: gender (odds ratio [OR] = 0.419), household income (OR= 0.991), and AED knowledge (OR= 2.833) in Korea; and gender (OR = 0.582), age (OR = 0.968), cardiac disease history (OR = 2.099), and AED knowledge (OR = 2.984) in Japan. Conclusion : It would be helpful to teach AED use to encourage performing public access defibrillation. In addition, it is necessary to design AED education programs based on country-specific factors.

공공기관 종사자들의 자동제세동기에 대한 인식과 시행의도 및 교육경험에 관한 연구

김무늬(Mu-Nui Kim),이현지(Hyeon-Ji Lee) 한국산학기술학회 2017 한국산학기술학회논문지 Vol.18 No.11

본 연구는 공공기관 종사자들의 자동제세동기에 대한 인식과 시행의도 및 교육경험을 조사하고 그를 통해 효율적인 교육과 응급상황 시 자동제세동기의 실제 시행률을 높이는데 그 목적이 있다. 이러한 목적을 달성하기 위하여 2016년 6월 13일부터 8월 21일까지 강원도 공공기관에 근무하는 성인 남녀 243명을 연구대상으로 조사하였다. 수집된 자료는 빈도분석과 χ²-test로 분석하였다. 연구결과는 다음과 같다. 첫째, 공공기관 종사자들의 일반적 특성에 따른 자동제세동기 사용방법에 대한 인식의 차이에 대한 결과, 성별(X²=6.32, p<.05), 최종학력(X²=5.91, p<.05)에서 유의미한 인식의 차이가 있었다. 둘째, 공공기관 종사자들의 일반적 특성에 따른 자동제세동기 시행의도 차이에 대한 결과, 최종학력(X²=5.70, p<.05)에서 시행의도에 유의미한 차이가 있는 것으로 나타났다. 셋째, 공공기관 종사자들의 자동제세동기 시행의도가 없는 경우의 원인은 ‘자동제세동기 사용법을 몰라서’가 31.5%로 가장 높게 나타났다. 넷째, 공공기관 종자사의 일반적 특성에 따른 자동제세동기 교육경험은 연령(X²=6.15, p<.05), 최종학력(X²=11.56, p<.01), 근무경력(X²=11.92, p<.01)에서 유의하게 나타났다. 다섯째, 공공기관 내 종사자들 자동제세동기 교육의 형태는 이론과 실습의 병행교육이 55.9%로 가장 높게 나타났다. 이러한 결과들로 보아 많이 사람들이 이용하는 공공기관의 종사자들은 표준화된 자동제세동기 교육을 필수적으로 이수하고 실제 응급상황 시 심정지환자의 소생률을 높일 수 있도록 노력해야 할 것으로 사료된다. This study was conducted to examine the awareness of workers in public institutions of automated external defibrillators, their usage intention and related educational experience in an effort to increase the efficiency of education and the rate of automated external defibrillator usage in emergency situations. The subjects in this study were 243 selected. male and female adults who worked in public institutions in Gangwon Province. A survey was conducted from June 13 to August 21, 2016. The statistical analysis was based on the frequency analysis and the X²-test. There were significant differences among the public institution workers awareness of how to use an automated external defibrillator according to gender (χ²=6.32, p<0.05) and academic credentials (χ²=5.91, p<0.05). Additionally, there were significant differences in usage intention according to academic background (χ²=5.70, p<0.05). The most common reason for having no intention to use an automated external defibrillator for patients with cardiac arrest was that the respondents did not know how to use it (31.5%). There were also significant differences in educational experience with automated external defibrillators according to age (χ²=6.15, p<0.05), academic credentials (χ²=11.56, p<0.01) and career (χ²=11.92, p<0.01). The most common form of education that the workers received pertaining to automated external defibrillators was a combination of theoretical and practical education, which represented 55.9%. The findings of the study seem to suggest that workers in public institutions used by many people must receive compulsory standard education regarding automated external defibrillators and try to boost the revival rate of patients with cardiac arrest in real emergency situations.

일반대학생에 의한 자동제세동기 사용 능력 연구

양현모,권찬양,Yang, Hyun-Mo,Kwon, Chan-Yang 한국응급구조학회 2017 한국응급구조학회지 Vol.21 No.2

Purpose: The purpose of the study was to compare the ability of college students to use automated external defibrillators (AED) and to provide a basic data for helping laypersons easily apply the AED. Methods: The subjects were randomly assigned to instruction groups. One group was instructed by pictures (group P), one by videos (group M), and one by telephone dispatchers (group D), Without employing cardiopulmonary resuscitation, a single rescuer was asked to apply defibrillation to a mannequin for practice in accordance with the instructions assigned to each group. Results: Regarding the proper pad attachment of the AED, group P followed the instruction $0.31{\pm}0.47times$, group M, $0.81{\pm}0.40times$, and group D $0.69{\pm}0.47times$. Regarding the instruction of taking the hand off a patient for analyzing cardiac rhythm and the instruction of taking the hand off a patient before defibrillation, group P did not follow the instruction; group M followed the instructions $0.50{\pm}0.51times$; and group D followed all instructions at all times. Conclusion: If a dispatcher gives real-time instructions for using an AED to laypersons wtih no experience at the time of AED use, the quality of laypersons' AED use will greatly improve.

Association between bystander cardiopulmonary resuscitation with and without automated external defibrillator use and neurologic outcomes after out-of-hospital cardiac arrest

김상훈,송경준,홍기정,노영선,정주,박정호,신상도 대한응급의학회 2022 대한응급의학회 학술대회초록집 Vol.2022 No.2