The Effect and Appropriateness of CPR Training in Elementary School Children

PURPOSE: We undertook this study to evaluate the effects and the appropriateness of CPR training for elementary school children. METHODS: The Kangwon National University developed a "Human Body Explorer Program", where local fifth and sixth grade students would learn about the human body. The 72 students who participated in this program were used in this study. The subjects were evaluated by comparing CPR data collected from nurses working at Kangwon National University Hospital. The education sessions consisted of a 30 minute video tape and slides; then, under the supervision of their teacher, the subjects were asked to practice what they had seen. Ten criteria were used to evaluate the subject's CPR proficiency. The CPR skill sessions used Laerdal's HeartSim(R) 4000, and the data stored from the HeartSim(R) 4000 were collected for further analysis. A statistical analysis was done using the SPSS statistical software package. A pvalue< 0.05 was considered to statistically significant. RESULTS: A total of 72 subjects were evaluated. Their average age was 13.2+/-0.5 years. The subjects had very little experience with CPR education(0.17) prior to this study. The data gathered were compared to the evaluation table and yielded an average score of 20.53. The criteria used in the study had the following results: The assessing responsiveness(2.0/2.0), activating the EMS (calling for help) (1.99/2.0), checking for breathing(3.47/4.0), and compression to ventilation ratio of 15:2(1.6/2.0) showed to be at the 80 percentile. However the follow criteria showed a less than 80 percentile: opening the airway(1.54/2.0), mouth-to-mouth breathing(2.04/4.0), checking the carotid pulse(2.0/4.0), chest compression(1.88/4.0), chest compression velocity(1.02/4.0), and reassessment(1.44/2.0). The data from the manikin was extrapolated, and upon examination, we found the following: Correct ventilation was 25+/-31%, insufficient ventilation was 67+/-38% and excessive ventilation was 3+/-10%. Correct chest compression was 9+/-23% and insufficient compression was 91+/-23%, and excessive compression was absent. We compared these scores to the score from nurses of Kangwon University Hospital and found that elementary school children scored higher in all variables except in rate of chest compression. The scores were statistically significant (p<0.05) in total score, check for breathing, and reassessment. The skills evaluation showed that the adults scored higher than the elementary school children. All variables were significant (p<0.05). CONCLUSION: We found that elementary school children were superior to adult counterparts in understanding the CPR scheme. An expansion of CPR training to elementary school children is needed.

Consideration of Ultrasonographic Examination about an Abdominal Aortic Diameter of An Old Man Visited in the Emergency Center

BACKGROUND: This study was investigated risk factors of abdominal aortic aneurysm that correlation with an aortic diameter and necessity of ultrasonographic screening program through ultrasonographic examination of the aorta, additionally investigated prevalence of abdominal aortic aneurysm. METHODS: We conducted a prospective study of an aorta-proximal part, middle part, distal part with using abdominal ultrasography with 246 subjects more than 65 years old who visited the emergency department of chuncheon sacred hospital without symptoms during the period March 2004-February 2005. Also, examined risk factors (age, sex, smoking, hypertension, vascular disease) and did comparative analysis of relation between an aortic diameter and risk factors. RESULTS: The abdominal aortic diameter of them was 2.08+/-0.37cm in proximal part, 1.78+/-0.31cm in middle part, 1.55+/-0.31cm in distal part. The difference between male and female group was regarded(proximal part 2.20+/-0.35cm vs 1.99+/-0.36cm, the middle part 1.88+/-0.30cm vs 1.69+/-0.31cm, distal part 1.66+/-0.30cm vs 1.48+/-0.29cm). The difference of diameter in distal part was regarded in comparison of young old man and old old man (1.58+/-0.31cm vs 1.91+/-0.27cm). The difference of middle and distal aortic diameter between a smoking and non-smoking group was regarded (1.88+/-0.31cm vs 1.74+/-0.31cm, 1.62+/-0.32cm vs 1.53+/-0.30cm). The difference of distal aortic diameter between a hypertensive and non-hypertensive group(1.58+/-0.36cm vs 1.54+/-0.28cm) and between the groups which had a vascular disease or not(1.78+/-0.36cm vs 1.54+/-0.30cm) was regarded. There was no abdominal aortic aneurysm among them. CONCLUSION: The diameter of distal part increased with more ages, in male, smoker, and person with hypertension and vascular disease. In this study, abdominal aortic aneurysm wasn't found.

Aspects of Patients Injured While Attending Street Rallies in Seoul During the Period of the 2002 World Cup

PURPOSE: An appropriate emergency medical support system is required at sites of large-scale congregations because different kinds of emergencies may be encountered. My colleagues and I initiated this project to present the information required for the process of devising an onsite plan for large crowds. The basic structure is based on an analysis of patients who were injured while attending large scale street-cheering demonstrations in Seoul during the period of the 2002 World Cup. METHOD: The analysis concentrated on the period from May 31, 2002, to June 30, 2002, during the 2002 Korean-Japan World Cup. Seven soccer games involving the Korean team and 8.91 million people from 116 places were considered. The following report was generated from the supporting schedules and the activity reports of emergency rescue crews from fire departments. It is largely based on rescue activity journals and transportation records. RESULT: There were 796 patients among the in 8.91 million people. Male patients were 383 (42.8%) and female 413 (51.2%). Patients in their 20's were 267, and that was the largest age group. In Korean game against Germany, 183 patients were treated, and that was the largest among the seven games involving Korean's team. There was one patient in every 10,000 people on average. Sicknesses were not that serious, and most of them were headaches, stomachaches and exhaustion. CONCLUSION: The frequency and pattern of generation of patients were affected by the scale of the cheering crowd, the sex and age composition of the crowd, and the weather. In planning future medical support for similar events, the structure of the plan should be based on the site and the size of the crowd, after which the plan can be finalized by considering details such as the importance of the game and the weather.

A Study of the Effectiveness of CPR Training to the Personnels of Nursing Department in the Hospital

PURPOSE: We undertook this study to evaluate the pertinence of yearly CPR training for three years in hospital. METHODS: We evaluated 106 participants (79 registered nurses, 17 assistant nurses, 10 medical technicians who were not emergency medical technicians). We performed the education once a year for three years. We used color slides and videos for the lecture. We used a CPR training manikin for training in the CPR skills. For the evaluation, we used a list involving 10 items about understanding the CPR scheme and the CPR training program. We divided the 106 participants based on frequency of training, occupation and career. RESULTS: The mean number of points for understanding the CPR scheme was 17.5 points out of 28. The mean number of points for check for breathing, rescue breathing, pulse check, and chest compression were 2.5, 2.3, 1.7, and 1.7, respectively out of 4 points. In CPR skills, appropriate rescue breathing was 37+/-31%, and appropriate chest compression was 62+/-39%. There were no significant statistical differences based on frequency of CPR training or career. There were significant statistical differences based on occupation. CONCLUSION: Our yearly CPR training in the hospital was not pertinent in improving the ability to perform CPR. Different CPR training methods are needed for different occupation. We think that further study are needed to develope effective CPR training methods and to identify the appropriate re-training interval.

Clinical Investigation of an Acute Allergic Reaction in a Patient Admitted to the Emergency Department of a College Hospital in a Small City

PURPOSE: Emergency department visits for acute allergic reactions are common. However, relatively little is known about the characteristics of patients who visit the emergency department for such reactions. We undertook this study to evaluate the frequency, the cause, the severity, the treatment and the prognosis of patients admitted for allergic reactions to a college hospital in a city. METHODS: We studied 724 patients visiting two emergency departments of college hospitals during the years 2002-2003. Clinical symptoms involved pruritus, dyspnea, hoarseness, nausea, vomiting, abdominal pain, diarrhea, dizziness, and seizure. Physical examinations involved vital signs, urticaria, rash, local edema, angioedema, rhinitis/conjunctivitis, wheezing, stridor, cyanosis, and laryngeal edema. We divided the causative agents into drugs, insects, foods, and others. We classified the treatments of the allergic reaction as antihistamines, corticosteroids, epinephrine, oxygen, and hydration. We divided patients into mild, moderate, and severe acute hypersensitivity groups. RESULTS: In order of frequency, clinical symptoms were pruritus (88.1%), urticaria (72.4%), rash (68.9%), local edema (11.7%), etc. The causative agents were foods (53.0%), unknown origin (29.1%), insects (11.0%), and drugs (6.8%). Antihistamine, corticosteroid, epinephrine were injected in 93.4%, 89.1%, 2.3% of the patients, respectively. The mild, moderate, and severe groups were 87%, 9.8%, and 3.2% of the patients, respectively. CONCLUSION: For patients with allergic symptoms visiting to the university-affiliated teaching hospitals in a small city, foods were the major causative agent, but drugs and insects provoked more severe allergic reactions.

Cardiac Tamponade from Chest Trauma During Snowboarding

As snowboarding has become one of the most popular winter sports, lots of young people enjoy it and they have become the center of this winter sports. However, this increased number of snowboarding lovers results in raising the number of injuries. In the case of severe chest injury caused by snowboarding can be a source of a serious injury such as cardiac tamponade. The development of cardiac tamponade is an acute, life-threatening emergency. To test a cardiac tamponade, a patient with chest trauma should be diagnosed from the information given by a physical examination and simple chest radiography. If the heart is doubted to be wounded, an emergency echocardiography has to be executed. An emergency treatment for the cardiac tamponade patient is to normal saline infusion quickly to augment the capacity of a blood vessel. Extremely, surgeries such as pericardiocentesis or pericardiotomy can be applied to ease the pressure inside the heart. Some patients with chest blunt trauma while snowboarding developed cardiac tamponade and they were successfully recovered through pericardiocentesis. This precedent is reported here with the consideration of the references.

Rhabdomyolysis after SCUBA Diving: A Case Report

Recently, self-contained underwater breathing apparatus (SCUBA) diving's popularity has been increasing tremendously. Most diving injuries are related to the behavior of the gas and to pressure changes during descent and ascent. A scuba diver at depths greater than 7 m may accumulate a tissue partial presure of nitrogen large enough that, on ascent to the surface, nitrogen exist the tissues rapidly, forming bubbles in the blood and other organs, which is known as decompression sickness (DCS). Although both of these bubble disorders can, in theory, cause injury to skeletal muscles (rhabdomyolysis), the case are report here demonstrates the potential for massive muscle necrosis after scuba diving. We report a case of rhabdomyolysis presented with general weakness after scuba diving.