일개 대도시에서의 119 구급대가 자동제세동기를 사용한 병원 전 심정지 환자들에 대한 연구

Abstract

Purpose: To report characteristics of out-of-hospital cardiac arrest (OHCA) patients in whom 119 rescuers used an automated external defibrillator (AED) in the metropolitan area. Methods: 1,689 OHCA patients were transferred to hospitals by 119 rescuers between 1 January and 31 December, 2006. Among them, 106 OHCA patients for whom 119 rescuers used an AED were enrolled retrospectively. Results: Shockable rhythm with AED use was 70.8%, witnessed arrest was 46.2%, and bystander cardiopulmonary resuscitation (CPR) was 6.6%. The most common location of cardiac arrest was in the home, at 74.5%. Response time was 7.1(±3.9) minutes. Chest compression during transport was done by 119 rescuers in 87.7% of cases, and assisted ventilations such as advanced airway management and bag valve mask ventilation were performed by 119 rescuers in 17.0%. Initial ECG findings at ED were asystole(59.4%), PEA(25.5%), VF/pulseless VT(8.5%), sinus rhythm(4.7%), and others(1.9%). The most common etiology of cardiac arrest was presumed cardiac origin in 68.9% of cases. Sustained return of spontaneous circulation (ROSC) was 26.4%. The proportion of patients discharged alive was 11.3%. Conclusion: The performance of bystander CPR and usage of AED, and appropriate CPR done by 119 rescuers were unsatisfactory in metropolitan Daegu. There is a marked need to establish basic life support education in the areas of bystander CPR, and a quantitative and qualitative development of 119 rescue capability.