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병원전 외상성 심정지 환자의 심폐소생술 결과: 강원도를 중심으로

Outcome of cardiopulmonary resuscitation for prehospital traumatic cardiac arrest: focused on Gangwon province

대한응급의학회지 2020년 31권 2호 p.135 ~ 145
임창우 ( Im Chang-Woo ) - Hallym University College of Medicine Chuncheon Sacred Heart Hospital Department of Emergency Medicine

이태헌 ( Lee Tae-Hun ) - Hallym University College of Medicine Chuncheon Sacred Heart Hospital Department of Emergency Medicine
옥택근 ( Ohk Taek-Geun ) - Kangwon National University School of Medicine Department of Emergency Medicin
김오현 ( Kim Oh-Hyun ) - Yonsei University Wonju College of Medicine Department of Emergency Medicine
정상구 ( Jung Sang-Ku ) - University of Ulsan College of Medicine Gangneung Asan Hospital Department of Emergency Medicine
김윤성 ( Kim Yun-Sung ) - Samcheok Medical Center Department of Emergency Medicine
마범석 ( Ma Bum-Sug ) - Sokcho Medical Center Department of Emergency Medicine
안무업 ( Ahn Moo-Eob ) - Hallym University College of Medicine Chuncheon Sacred Heart Hospital Department of Emergency Medicine
서정열 ( Seo Jeong-Yeol ) - Hallym University College of Medicine Chuncheon Sacred Heart Hospital Department of Emergency Medicine
김동원 ( Kim Dong-Won ) - Hallym University College of Medicine Chuncheon Sacred Heart Hospital Department of Emergency Medicine

Abstract


Objective: This aim examined the outcomes of resuscitation and the clinical characteristics of patients with pre-hospital traumatic cardiac arrests (TCA).

Method: 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.

Results: 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.

Conclusion: 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.

키워드

Prehospital; Cardiopulmonary resuscitation; Survival rate; Traumatic cardiac arrest
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