ABSTRACT
Objective@#This aim examined the outcomes of resuscitation and the clinical characteristics of patients with pre-hospitaltraumatic cardiac arrests (TCA). @*Methods@#The charts of patients with pre-hospital TCA who visited the various emergency department (ED) in Gangwondofrom 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. Thetotal CPR time before ED arrival was 21.62±15.29 minutes. The causes of TCA were brain injury (35.7%), hypovolemicshock (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 was38.96. Eight patients expired before 12 hours after transient ROSC. Four more patients expired before 24 hours. Fourpatients 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 topromote ROSC. The survival rate increased when ROSC occurred before arriving at the ED.
ABSTRACT
PURPOSE: Malposition of an endotracheal tube tip may induce several complications. Prediction of the depth of the endotracheal tube is important and should be individualized. Here we propose a topographic method to predict the proper depth of the endotracheal tube and compare it with a conventional method (CM). METHODS: We enrolled 127 patients who were intubated in the ED or the ICU. To measure tube depth, we used 3 topographic methods: method 1 (M1): length from lateral side of lip to mandible angle + length from mandible angle to sternal angle; Method 2 (M2): sternum length; Method 3 (M3): length from the acromioclavicular joint to the nipple level on an anterior axillary line. Correlations between the ideal depth of the endotracheal tube and the length measured by topographic methods were studied and the ratio of the actual depth to the targeted (ideal) depth was calculated. We compared ratios between CM and topographic methods. RESULTS: Correlation coefficients between ideal depth and topographic measurement were 0.558 (M1), 0.469 (M2), and 0.301 (M3). Targeted intubation depth in the total group was 91(71.7%) for CM, 101(79.5%) for M1, 95(74.8%) for M2, and 90(70.9%) for M3. Among females, targeted intubation depth was 38(66.7%) for CM, 49(86%, p<0.05) for M1, 43(75.4%) for M2, and 44(77.2%) for M3. CONCLUSION: The topographic method is simple and rapid, and may be useful for individualizing measurement to each patient. Using a topographic method is expected to reduce complications during intubation in the ED, especially in women and when Method 1 is used.