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.

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.

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.

Accuracy of the automatic external defibrillator on an electric mattress: Simulation study

구재은,유제성,주영선,정현수,정성필,이한식 대한응급의학회 2013 대한응급의학회 학술대회초록집 Vol.2013 No.2

Background: Accuracy of the automated external defibrillator (AED) is susceptible to environmental factors such as vibration, motion artifact and electromagnetic interference (EMI). The purpose of this study was to evaluate whether EMI produced by the electric mattress can affect on performance of AEDs. Methods: Four commercially available AEDs were evaluated in the setting of four ECG rhythms (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 for differentiating shockable from nonshockable rhythms. Time to interpret ECG was checked between control and 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 on an electric mattress, sensitivity ranged from 55% to 90% and specificity 100%, representing accuracy from 77.5% to 95%. In some AED, sensitivity was reduced compared to control. Although there was no significant difference in time to interpret ECG signal with or without an electric mattress, some AED interpreted the relatively small interference as motion artifacts on an electric mattress (Fig. 1). All recorded ECG rhythms on an electric mattress showed baseline artifacts. According to farther distance from electric mattress, the artifacts were smaller (Fig. 2). Conclusion: This study suggests that an electric mattress could affect on performance of some AEDs in shockable rhythm. Electromagnetic interference generated by an electric mattress could interfere with the ability of some commercial AEDs to correctly interpret stimulated ECG rhythms and recommend appropriate defibrillation.

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.

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.

스포츠 시설에서의 자동제세동기(AED)운영에 대한 고찰 -헬스/피트니스 클럽을 중심으로-

박찬민 한국스포츠엔터테인먼트법학회 2013 스포츠와 법 Vol.16 No.4

Sudden Cardiac Arrest(SCA), a true medical emergency, signifies the cession of the heartbeat and breathing, and loss of consciousness. As a global health problem, more than 25,000 persons suffer SCA each year in South Korea. Since the chance of survival from SCA decreases by 7% to 10% each minute after unconsciousness, high survival rates are typically only found when the time from collapse to defibrillation is short. The use of Automated External Defibrillator(AED), which deliver an electrical shock to victims of SCA, has contributed to increased survival rates of SCA victims. The increased number of accessible AEDs in public settings, including ariports, shopping malls, schools, and sport arenas has led to significant increases in SCA survival rates. In the sport setting, many SCA cases have occurred among professional, collegiate, and recreational athletes, and teenagers with otherwise healthy hearts. SCA cases have occurred at sport venues such as health/fitness clubs, aquatic facilities, sport stadia/arenas, and golf courses. Health/fitness facilities, in particular, have been recognized as higher risk locations that may benefit from the implementation of AEDs. To address SCA issues in South Korea, the government of South Korea amended the Emergency Medical Service Act in 2008. During this revision, several sub-paragraphs regading AED implementation were inserted. In the 2011 revision, laws related the Good Samaritan Act (Article 5-2 and 63 of the Emergency Medical Service Act) states that even though an AED is a medical device, it can be used by trained laypersons in a medical emergency. Currently, however, legislation and guidelines do not exist in a medical emergency mandating or recommending the use of AEDs in health/fitness clubs. The purpose of this study was to examine current AED legislations in South Korea and United States. Regulations and guidelines regarding health/fitness facilities in United States, also, was examined. Moreover, current implementation of AED in South Korean health/fitness facilities and manager's relevant legal knowledge and certifications (i.e., CPR, AED) were investigated to understand current status of AED implementation. The results of this study suggest the low level of AED implementation in health/fitness facilities in South Korea and the low level of manager's knowledge regarding relevant AED laws, resulting primarily from a lack of exactly related AED legislation to health/fitness facilities. Also, staff certification and training of CPR/AED and protection from liability are other considerable issues. The findings contribute to the body of knowledge of AED implementation in South Korean health/fitness facility specifically. It may contribute to future enactment of additional AED regulatory laws for sport venues in South Korea. 급성심정지(Sudden Cardiac Arrest, SCA)는 심장박동과 호흡이 멈추고 의식이 없는 응급의료상황이다. 전 세계적인 건강문제로서, 대한민국에서만 매년 2만5천 명 이상의 환자들이 급성심정지를 경험하고 있다. 급성심정지 환자의 생존율은 환자가 쓰러진 순간부터 제세동을 실시하는 시간이 짧아질수록 높아지며, 매 1분마다 7%에서 10% 씩 환자의 생존율이 떨어진다. 자동제세동기(Automated External Defibrillator, AED)의 사용은 급성심정지 환자의 생존율을 높이는데 중요한 역할을 한다. 이러한 이유로, 자동제세동기(AED)는 급성심정지 환자의 생존율을 높이기 위하여 각종 공공기관, 공항, 쇼핑몰, 학교 및 스포츠시설등 많은 사람들이 밀집되는 장소에서 배치·운영되고 있다. 한편, 스포츠/신체 운동 측면에서 살펴보면, 급성심정지(SCA) 사건들은 전문 운동선수, 학생선수, 청소년등 건강한 심장을 가졌다고 여겨지는 사람들에게서도 일어나며, 이런 부류의 사람들에게 일어나는 급성심정지(SCA) 사건들은 사회적으로 더욱 커다란 파장을 일으킨다. 또한, 헬스/피트니스 클럽, 수영장, 스포츠 경기장/운동장, 골프장등에서 많은 급성심정지 사고가 발생하며, 특히, 헬스/피트니스 클럽은 급성심정지(SCA)사고가 많이 발생하는 장소로서, 자동제세동기(AED)의 운영이 매우 필요한 곳으로 인식되고 있다. 대한민국에서는 2008년 「응급의료에 관한 법률」의 개정안에서 자동제세동기(AED)의 활용에 대한 조항들이 개정되었으며, 2011년 개정안에서는 「선한 사마리안 법」과 관련된 조항들이 추가됨으로서, 급성심정지 환자의 응급처치에 대하여, 일반인들도 민·형사상의 책임으로부터의 부담을 덜고, 적극적으로 환자를 도울 수 있도록 법률로 독려하고 있다. 하지만, 스포츠/운동 시설과 관련하여, 헬스/피트니스 클럽에서의 자동제세동기의 의무적 배치 및 운영에 대한 관련법률이 없다. 본 연구에서는 현대인들이 운동을 하는 동안에 발생할 수 있는 급성심정지(SCA)에 대한 응급 상황을 돕기 위한 제도적 장치로서 대한민국 자동제세동기(AED)의 활용에 대한 현행 법률를 살피고, 아울러 미국의 헬스/피트니스 클럽에서의 자동제세동기(AED) 활용에 관련된 법령과 가이드라인을 살펴본다. 또한, 현행 대한민국의 헬스/피트니스 클럽에서의 자동제세동기(AED) 운영과 관련된 자료를 분석하여, 차후에 대한민국의 헬스/피트니스 클럽에서의 자동제세동기(AED) 활용 방안에 대한 법률의 발전에 필요한 중요한 기초이해자료를 제공하려 한다. 연구 결과에서 알 수 있듯이, 현재 헬스/피트니스 클럽에서는 자동제세동기의 운영상태가 매우 저조하며, 클럽의 관리자(급) 직원들의 자동제세동기에 관련된 법률적 내용의 지식상태도 낮으며, 심폐소생술과 자동제세동기 운영과 관련된 자격증의 취득여부 또한 만족스럽지 못한 실정이다. 이러한 결과는 현행 헬스/피트니스 클럽의 자동제세동기 운영의 이해를 돕는데 도움을 주며, 관련된 추가 법령의 도입이 시급함을 알림에 도움을 준다.