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J Korean Soc Emerg Med > Volume 29(5); 2018 > Article
Journal of The Korean Society of Emergency Medicine 2018;29(5): 485-492.
병원 내 심정지 상황에서 응급의학과 이외 전공의에 의해 시행된 전문 심장소생술의 현황
조현우1 , 우재혁1 , 임용수1 , 장재호1 , 조진성1 , 최재연1 , 양혁준1 , 현성열2
1가천대학교 의과대학 길병원 응급의학과
2가천대학교 의과대학 길병원 외상외과
The status of advanced cardiac life support performance by resident belonging to other department except for department of emergency medicine in in-hospital cardiac arrest
Hyun-Woo Cho1 , Jae-Hyug Woo1 , Yong-Su Lim1 , Jae-Ho Jang1 , Jin-Seong Cho1 , Jea-Yeon Choi1 , Hyuk-Jun Yang1 , Sung-Youl Hyun2
1Department of Emergency and Critical Care Medicine, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
2Department of Trauma Surgery, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
Correspondence  Jae-Hyug Woo ,Tel: 032-460-3901, Fax: 032-460-3019, Email: emmetalkiller@gilhospital.com,
Received: June 28, 2018; Revised: August 20, 2018   Accepted: September 4, 2018.  Published online: October 31, 2018.
ABSTRACT
Objective:
This paper reports the status of the advanced cardiac life support (ACLS) according to the guidelines by residents belonging to other departments other than the department of emergency medicine. The differences in status between the junior group and senior group was also investigated according to grades of residents.
Method:
The ACLS performance for in-hospital cardiac arrest cases of one academic hospital, except for the cases occurring in intensive care unit between November 2015 and October 2017, were analyzed retrospectively. Data included the characteristics of residents, patients’ outcomes, ACLS performance, and conventional treatment having discordance with the ACLS guidelines. Leaders during cardiopulmonary resuscitation (CPR) were divided into a junior group and senior group.
Results:
A total of 152 cases were enrolled in this study. Of these, 131 cases (86.2%) showed at least one treatment with inconsistency from the guidelines and the incidence of discordant treatment was similar in the two groups (55 [85.9%] vs. 76 [88.4%], P=0.657). Implicit use of sodium bicarbonate was more frequent in the senior residents group (odds ratio [OR], 3.04; 95% confidence interval [CI], 1.36-6.81). On the other hand, no use of a defibrillator was less frequent in the senior residents group (OR, 0.14; 95% CI, 0.03-0.81).
Conclusion:
In both groups, the rate of discordance with the ACLS guidelines during CPR were high. The rate of implicit use of sodium bicarbonate and no use of defibrillator were significantly different in the two groups. A customized education strategy for ACLS is needed for each group.
Key words: Heart arrest; Cardiopulmonary resuscitation; Advanced cardiac life support; Education
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