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J Korean Soc Emerg Med > Volume 31(2); 2020 > Article
Journal of The Korean Society of Emergency Medicine 2020;31(2): 135-145.
병원전 외상성 심정지 환자의 심폐소생술 결과: 강원도를 중심으로
임창우1, 이태헌1 , 옥택근2 , 김오현3 , 정상구4, 김윤성5, 마범석6, 안무업1 , 서정열1, 김동원1
1한림대학교 춘천성심병원 응급의학과
2강원대학교병원 응급의학과
3연세대학교 원주의과대학 응급의학교실
4울산대학교 의과대학 강릉아산병원 응급의학과
5강원도 삼척의료원 응급의학과
6강원도 속초의료원 응급의학과
Outcome of cardiopulmonary resuscitation for prehospital traumatic cardiac arrest: focused on Gangwon province
Chang Woo Im1, Taehun Lee1 , Taek Geun Ohk2 , Oh Hyun Kim3 , Sang Ku Jung4, Yunsung Kim5, Bum Sug Ma6, Moo Eob Ahn1 , Jeong Yeol Seo1, Dong Won Kim1
1Department of Emergency Medicine, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea
2Department of Emergency Medicine, Kangwon National University College of Medicine, Chuncheon, Korea
3Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
4Department of Emergency Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
5Department of Emergency Medicine, Samcheok Medical Center, Samcheok, Korea
6Department of Emergency Medicine, Sokcho Medical Center, Sokcho, Korea
Correspondence  Taehun Lee ,Tel: 033-240-5220, Fax: 033-240-5446, Email: ion2674@naver.com,
Received: July 11, 2019; Revised: October 24, 2019   Accepted: November 14, 2019.  Published online: April 30, 2020.
This aim examined the outcomes of resuscitation and the clinical characteristics of patients with pre-hospital traumatic cardiac arrests (TCA).
The charts of patients with pre-hospital TCA who visited the various emergency department (ED) in Gangwondo from January 2013 to December 2017 were reviewed retrospectively.
TCA patients comprised 0.3% of patients transferred by 119. A total of 367 patients were enrolled in the study. Traffic accidents were the leading cause of the arrest. The initial field and ED rhythm were mostly asystole (field, 79.6%; ED, 82.3%). It took 11.24±9.95 minutes from the call to the field. From the field to ED, it took 22.87±15.37 minutes. The total CPR time before ED arrival was 21.62±15.29 minutes. The causes of TCA were brain injury (35.7%), hypovolemic shock (29.2%), and severe lung injury (16.3%). Seventy TCA patients experienced at least one return of spontaneous circulation (ROSC). Twenty-six patients (7.14%) were admitted to the ward, and their average injury severity score was 38.96. Eight patients expired before 12 hours after transient ROSC. Four more patients expired before 24 hours. Four patients were discharged alive among patients who lived for more than 24 hours.
In this study, 1.5% of patients were discharged alive. The possibility of ROSC was higher as the time to ED, and the cardiopulmonary resuscitation time of 119 was shorter. Pulseless electrical activity rather than asystole tends to promote ROSC. The survival rate increased when ROSC occurred before arriving at the ED.
Key words: Prehospital; Cardiopulmonary resuscitation; Survival rate; Traumatic cardiac arrest
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