자살기도로 응급센터에 내원한 내국인과 외국인의 비교

성민국,최현영,강구현,장용수,옥택근,김우준,김영용,이영재,박승민,조영석 대한응급의학회 2014 大韓應急醫學會誌 Vol.25 No.6

Purpose: In an effort to determine the characteristics of foreignsuicides who visit an emergency center, this studyanalyzed suicidal attempt between natives and foreigners. Methods: We conducted a retrospective analysis of 1,218Korean and 149 foreign suicidal attempters who visited aregional emergency center from January 1, 2009 toDecember 31, 2013. We compared two groups accordingto age, sex, selected suicidal methods, past psychiatric history,medical examination and treatment acceptance,elapsed time to visit an emergency center after suicidalattempt, emergency center residence time, and hospitalizationperiod. Results: No difference in medical exam acceptance andtetanus vaccination was observed between the two groups. However, we found a difference in hospitalization acceptance. The prevalence rate of psychiatric disorders waslower in foreign suicides, and the refusal rate of psychiatrictreatment was higher in foreign patients. Conclusion: In foreign suicides, social support includingfinance is required for easy access to health care service. Inaddition, more active interdisciplinary cooperation with thedepartment of psychiatry and close observation is needed.

표준화 환자를 이용한 전문심장처치술 교육 이수자들의 심율동전환과 경피심박조율처치 능력 평가

김우준,강구현,장용수,옥택근,최현영,성민국,최한주,박현경,김경용,방성환 대한응급의학회 2015 大韓應急醫學會誌 Vol.26 No.1

Purpose: The aim of this study was to analyze the ability of Advanced Cardiac Life Support (ACLS) providers in performing cardioversion and transcutaneous pacing (TCP) in standardized patients. Methods: In 19 ACLS providers, an observational study was conducted in order to examine their abilities in performing cardioversion and TCP. We conducted this study using a defibrillator not producing electric current and standardized patients. Primary outcomes were the completeness in carrying out a task when performing cardioversion or TCP. Results: Completeness rates reached 100% for “Power on” and “Mental status evaluation” regarding both cardioversion and TCP. Regarding both cardioversion and TCP, the completeness rate was less than 50% for “Saturation identification”. In cardioversion, ACLS providers showed good performance for electrical therapies but not for reassessment. In contrast, they showed good performance for reassessment not for electrical therapies. Conclusion: Simulation using a defibrillator not producing electric current for standardized patients was useful in assessing the ability of ACLS providers when performing cardioversion and TCP. This could be helpful to ACLS providers in performing electrical therapies.

일반의약품과 전문의약품 수면제 중독에서 심전도 QTc 간격의 차이

이복자,강구현,옥택근,조규종,서정열,박승민,이성곤,성민국,김우준,장용수 대한응급의학회 2013 대한응급의학회지 Vol.24 No.6

Purpose: This study analyzed QTc prolongation in patients intoxicated from over the counter (OTC) hypnotics compared with prescription hypnotics. Methods: The medical records of intoxicated patients presented to four emergency centers from January 1, 2010 to December 31, 2010 were retrospectively reviewed. The records of hypnotics overdose patients were selected and investigated for several features: general characteristics,vital signs, past history, ECG findings, treatment methods,ED stay time, drug category and amount, and final results. Results: There were 134 patient cases of OTC hypnotic intoxication (36.9±15.1yrs, M:F=37:97), and 270 patient cases of prescription hypnotic intoxication (47.9±18.1yrs,M:F=58:212). The ECG QTc upon emergency center admission was 468.4±34.8 msec in the OTC hypnotic intoxication group and 449.48±26.2 msec in the prescription hypnotic intoxication group (p<0.05). QTc prolongation was noted in 81.3% of patients in the OTC hypnotic intoxication group and 64.1% of patients in the prescription hypnotic intoxication group (p<0.05). Conclusion: ECG QTc prolongation was more common from OTC hypnotic intoxication than prescription hypnotics. Close monitoring is therefore recommended for patients who have ingested and overdosed from OTC hypnotics to prevent potentially lethal cardiac toxicity.

일반인 심정지 목격자의 고품질 가슴압박을 위한 언어 지도 방법

이성곤,장용수,옥택근,최기훈,안정환,이복자,성민국,김우준,강구현 대한응급의학회 2013 대한응급의학회지 Vol.24 No.6

Purpose: Dispatcher-assisted telephone instruction during cardiopulmonary resuscitation (CPR) improves the quality of CPR performed by laypersons. However, in Korea, CPR instruction guidelines for bystanders have not made. We therefore studied the effects of verbal instruction on the quality of chest compression. Methods: Data from two randomized, double-blinded, controlled trials using identical methodology were combined to obtain 175 records for analysis. Subjects were randomized into either a “push as hard as you can and fast” (n=87) or “push down 5~6 cm, 100~120 rate/min” (n=88), verbal instructions in the 2011 Korea Guidelines for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC). Data were recorded via a Resusci Anne SkillReporterTM, Laerdal Medical mannequin. Primary outcome measures included chest compression depth and chest compression rate per minute. Results: The average compression depth and speed of chest compressions did not significantly differ between the two verbal instructions. Conclusion: The verbal istructions provided by telephone based on the 2011 Korean Guidelines for CPR and ECC are not effective. The instructions for high quality CPR of layperson should therefore be studied.

표준화 환자를 이용한 전문심장처치술 교육 이수자들의 심율동전환과 경피심박조율 처치 능력 평가

김우준 ( Woo Jun Kim ),강구현 ( Gu Hyun Kang ),장용수 ( Yong Soo Jang ),옥택근 ( Taek Geun Ohk ),최현영 ( Hyun Young Choi ),성민국 ( Min Kuk Sung ),최한주 ( Han Joo Choi ),박현경 ( Hyun Kyung Park ),김경용 ( Gyoung Yong Kim ),방 대한응급의학회 2015 대한응급의학회지 Vol.26 No.1

Purpose: The aim of this study was to analyze the ability of Advanced Cardiac Life Support (ACLS) providers in per-forming cardioversion and transcutaneous pacing (TCP) in standardized patients. Methods: In 19 ACLS providers, an observational study was conducted in order to examine their abilities in perform-ing cardioversion and TCP. We conducted this study using a defibrillator not producing electric current and standard-ized patients. Primary outcomes were the completeness in carrying out a task when performing cardioversion or TCP. Results: Completeness rates reached 100% for “Power on” and “Mental status evaluation” regarding both car-dioversion and TCP. Regarding both cardioversion and TCP, the completeness rate was less than 50% for “Satura-tion identification”. In cardioversion, ACLS providers showed good performance for electrical therapies but not for reassessment. In contrast, they showed good perfor-mance for reassessment not for electrical therapies. Conclusion: Simulation using a defibrillator not producing electric current for standardized patients was useful in assessing the ability of ACLS providers when performing cardioversion and TCP. This could be helpful to ACLS providers in performing electrical therapies.

일반의약품과 전문의약품 수면제 중독에서 심전도 QTc 간격의 차이

이복자 ( Bok Ja Lee ),장용수 ( Yong Soo Jang ),강구현 ( Gu Hyun Kang ),옥택근 ( Taek Geun Ohk ),조규종 ( Gyu Chong Cho ),서정열 ( Jeong Yeul Seo ),박승민 ( Seung Min Park ),이성곤 ( Sung Gon Lee ),성민국 ( Min Kuk Sung ),김우준 ( 대한응급의학회 2013 대한응급의학회지 Vol.24 No.6

Purpose: This study analyzed QTc prolongation in patients intoxicated from over the counter (OTC) hypnotics compared with prescription hypnotics. Methods: The medical records of intoxicated patients presented to four emergency centers from January 1, 2010 to December 31, 2010 were retrospectively reviewed. The records of hypnotics overdose patients were selected and investigated for several features: general characteristics, vital signs, past history, ECG findings, treatment methods, ED stay time, drug category and amount, and final results. Results: There were 134 patient cases of OTC hypnotic intoxication (36.9±15.1yrs, M:F=37:97), and 270 patient cases of prescription hypnotic intoxication (47.9±18.1yrs, M:F=58:212). The ECG QTc upon emergency center admission was 468.4±34.8 msec in the OTC hypnotic intoxication group and 449.48±26.2 msec in the prescription hypnotic intoxication group (p<0.05). QTc prolongation was noted in 81.3% of patients in the OTC hypnotic intoxication group and 64.1% of patients in the prescription hypnotic intoxication group (p<0.05). Conclusion: ECG QTc prolongation was more common from OTC hypnotic intoxication than prescription hypnotics. Close monitoring is therefore recommended for patients who have ingested and overdosed from OTC hypnotics to prevent potentially lethal cardiac toxicity.