Earticle

연구 목적: 본 연구에서는 심근경색 쥐 모델에서 심장정지를 유발시킨 후 심폐소생술을 수행하는 과정에서 조기 저체온 치료를 적용하여 심장근육의 기능회복과 생존율에 미치는 효과를 조사하고자 하였다. 연구 방법: 본 연구를 위하여 체중 450-550g의 수컷 Sprague Dawley 쥐 10 마리에 개흉을 실시하였다. 왼내림심장동맥을 묶어서 심근경색을 유발시켰다. 왼내림심장동맥을 묶은 후 90분 동안 심실세동을 유도하고, 심폐소생술과 제세동을 실시하였다. 대조군(정상체온군)은 회복과정에 정상체온으로 유지한 군이며, 실험군(저체온군)은 회복과정에 32 ℃ 4시간 저체온을 유지한 군이다. 연구 결과: 심박출량, 좌심실박출률, 심근수행지수는 심폐소생술 후 첫 4시간 동안 대조군보다 실험군에서 더 양호하게 나타났다. 실험군의 생존시간은 대조군보다 더 길게 나타났다(p<.050). 결 론: 본 연구를 통하여 조기 저체온 치료의 적용이 급성심근경색의 심폐소생술 후 심장 기능을 개선하는 데 탁월한 효과가 있으며, 치료법의 새로운 기준이 될 것이다.

Purpose: To investigate the effect of early hypothermia on post-resuscitation myocardial recovery and survival time after cardiac arrest and resuscitation in a rat model of myocardial infarction(MI). Methods: Thoracotomies were performed in 10 male Sprague Dawley rats weighing 450-455g. Myocardial infarction was induced by ligation of the left anterior descending coronary artery. Ninety minutes after arterial ligation, ventricular fibrillation was induced, cardiopulmonary resuscitation was subsequently performed before defibrillation was attempted. Animals were randomized to control group and experimental group(acute MI-normothermia)(32 ℃ for 4 hours). Duration of survival was recorded. Myocardial functions, including cardiac output, left ventricular ejection fraction, and myocardial performance index were measured using echocardiography. Results: Myocardial function was significantly better in hypothermia group than the control group during the first 4 hours post-resuscitation. The survival time of the experimental group was greater than that of the control group(p<.050). Conclusion: This study suggests that early hypothermia can attenuate post-resuscitation myocardial dysfunction after acute myocardial function, and may be a useful strategy in post-resuscitation care.

Purpose: This study aims to investigate awareness and performance of infection control during ambulance attendant training, and to provide basic data for infection control. Methods: The subjects were 235 paramedic students who completed ambulance attendant training. There were 51 questions. The infection control dimension was divided into hand washing, personal protective equipment use, and environmental management, for each sub-dimension, awareness and performance were measured by a 4-point scale. The collected data were analyzed using SPSS statistics ver. 22.0. Results: A total of 95.3%, of the subjects completed an orientation for ambulance attendant training and 71.7% received education on infection. In all three sub-dimensions, hand- washing (p<.001), personal protective equipment use (p<.001), and environmental management (p<.001), awareness scored higher than performance. The awareness of infection control showed a significantly positive correlation(r=.394) with performance. Conclusion: In order to improve performance of infection control, education to improve awareness should be provided, and paramedics with higher performance levels in hand washing, and use of gloves and masks wearing should be assigned as training advisors.

Purpose: This study investigated the current status of post-traumatic stress and related factors among safety managers in Korea National Parks. Methods: The study subjects were 109 safety managers working in Korea National Parks. General characteristics, job-related characteristics, experience of traumatic events and post-traumatic stress were collected by self-reported questionnaires through the mail. The associated factors with post-traumatic stress was analyzed by t-test, ANOVA and multiple linear regression. Results: Overall score of post-traumatic stress was 10.32±11.37 and 12.8% was the high-risk group of post-traumatic stress disorder. In simple analysis, score of post-traumatic stress was associated with drinking frequency, disease history, duration of career, delay of rescue, provided the break, rest space and the number of experiences of traumatic events. Finally, the score of post-traumatic stress was significantly higher in subjects who experienced 3 (B=9.141, SE=3.538) or more than 4 (B=11.367, SE=3.063) traumatic events compared to subjects without experience of traumatic event. Conclusion: The score of post-traumatic stress was 10.32±11.37 and 12.8% was the high-risk group among safety managers in Korea National Parks. Post-traumatic stress was associated with the experience of traumatic events. Management of safety managers after mobilization or experience of traumatic events will be helpful to decrease of post-traumatic stress.

Purpose: To investigate disaster safety education and the safety awareness of Korean high school students following the Sewol ferry incident. Methods: A self-reported questionnaire was completed by 1022 high school students in Korea from September 7 to 26, 2015. The questionnaire comprised questions pertaining to the general characteristics of the subjects, disaster safety education, and safety awareness, which were measured on a four-point Likert. Results: The majority of the students recognized the necessity of disaster safety education (3.12±0.61); however, most did not know where safety devices were located. After the Sewol ferry incident, awareness of disaster safety education was 2.11±0.64, and the necessity of education was relatively low. More than half the students (53.5%) responded that disaster safety education must be conducted in professional education facilities. Conclusion: It is important to develop and implement regular disaster safety education for high school students in professional education facilities.

Purpose: This study was performed to evaluate the influence of field practice on subjective well-being and domains of life satisfaction in paramedic students. Methods: A self-reported questionnaire was completed by 143 paramedic students from March 5 to 31, 2016. The questionnaire consisted of subjective wellbeing, openness to experience, and domains of life satisfaction. The statistical analysis was done with SPSS/WIN 22.0. Results: The number of field practice had a lesser influence on degree of life satisfaction and positive emotions. Field practice did not influence negative emotions. Those who were open to experience tended to have higher degrees of personal satisfaction and competence irrespective of field practice. Conclusion: Openness to experience can enhance the life satisfaction and competence against the stressful conditions paramedic students experience in field practice.

Purpose: This study aimed to investigate the awareness and direction of paramedics work and image in hospitals. Methods: From April 16 to May 5, 2015, data were collected through structured questionnaires from 45 paramedics and 81 nurses working in emergency medical institutions. The data were analyzed using SPSS version 18.0. Results: The work of paramedics is evaluated to be highly worthy at the in-hospital level rather than at the injury first-aid treatment level. It appears that paramedics are often forced to do what their hospitals tell them to do concerning matters related to conflicts with them and nurses. Paramedics stated that they experienced greater mental stress than those engaging in other professions, a finding similar to those of other studies. There was no statistically significant difference in opinions between the two groups about a desirable direction for the development of first-aid services at hospitals. More than two thirds of the respondents said that paramedics should be given the right to enter acting check for patients. Conclusion: Paramedics work is shown to differ in the opinions of paramedics themselves and nurses. Paramedics need for reform is associated with expanding the work of the law.

Purpose: The purpose of this study is to investigate the effects of flipped learning on self-directed learning and academic achievement in national competence standards (NCS) based physical assistant skills in the emergency medical technology(EMT) students. Methods: One-group pretest-post test design was used. Flipped learning was carried out for 2 hours per week for 16 weeks. A self-reported questionnaire was completed by 56 EMT students from March 3 to June 16, 2016. Data were analyzed by paired t-test and Pearson correlation coefficient using SPSS 18.0 program. Results: After completion of flipped learning, significant improvement was found in self-directed learning(t= 6.04, 𝑝< .001), academic achievement(3.25±.79) and academic achievement((t = 6.41, 𝑝< .001). There was a significant positive correlation among self-directed learning and academic achievement. Conclusion: Flipped learning is useful teaching and learning method to the EMT students.

Purpose: The purpose of this study was to investigate factors influencing severity of occupational fall injury. Methods: A self-reported questionnaire was completed by 105 patients sustaining occupational fall injury between July 2010 and January 2013. The study instruments were developed by the National Traumatic Occupational Fatalities and National Electronic Injury Surveillance System. The questionnaire consisted of general characteristics of the subjects (30 items), workplace characteristics (12 items) and disaster characteristic (13 items). Results: Demographic factors, except age, did not affect the severity of injury. Injured patients aged 50-59 years tended to have more severe injuries than those aged 39 years. Type of transport vehicles, conditions, and the circumstances of the fall influenced injury severity. Patients transported by 119 ambulance suffered more severe fall injuries than those who were not. Electrical workers did not receive safety education wihin a year. Critical height in severe injuries was > 6 meters. Conclusion: Occupational fall injuries were influenced by patient age, types of transport vehicles, fall height, size of workplace, and safety education experience.

Purpose: The purpose of this study was to investigate the drinking behavior of university students in Jeju for the safe campus life. Methods: A self-reported questionnaire was completed by 549 students in 4 universities in Jeju. The data were analyzed by t-test, one way ANOVA, and multiple regression using SPSS Win 19.0 program. The questionnaire instruments consisted of Alcohol Use Disorders of Identification Test-Korea (AUDIT-K) and Life Stress Scale for College Students adapted by Chon. Results: The alcohol consumption rate of participants accounted for 96.2%. The binge drinking rate in female students were 33.9% and that in male students was 29.5%. The result by scoring AUDIT showed that 30.7% of participants were normal drinking group, 36.0% were hazardous drinking group, and 33.3% were estimated alcohol abuse group. The average score of stress was 1.45 by Likert 4 point scale. The female students tended to have more stresses than male. The most important influencing factors on drinking behavior were the first alcohol drinking(β= -.250, p < .001), gender(β= .202, p < .001), and relationship problem(β= .116, p < .05). Conclusion: The drinking rate of university students revealed higher than that in other age groups. So the early systematic education is strongly recommended to prevent the physical and mental side effects.