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Advanced airway management for the prehospital traumatic patient

병원 전 환경의 외상성 응급환자를 위한 전문기도관리

  • Shim, Gyu-Sik (Dept. of Emergency Medical Technology, Korea Nazarene University) ;
  • Kim, Eun-Mee (Dept. of Emergency Medical Technology, Korea Nazarene University)
  • 심규식 (나사렛대학교 응급구조학과) ;
  • 김은미 (나사렛대학교 응급구조학과)
  • Received : 2013.04.10
  • Accepted : 2013.05.09
  • Published : 2013.05.31

Abstract

The purpose of this study was to improve the paramedics skills to manage advanced airway by comparing speed and success rate between endotracheal intubation and laryngeal mask airway(LMA) insertion in a moving ambulance. Sixty subjects were randomly recruited and samely divided into control group and experimental group. And they were asked to join a practical experiment using dummy model. Data analysis was done by SPSS WIN 14.0 Version. As a result of this research, in terms of difference in speed according to patient's intubation posture, the speed of control group was indicated to be good in sniffing position(t=-4.038, p<.001). There was no difference in speed between two groups in neutral position. In the neutral posture given the endotracheal intubation, tooth fracture occurred in 16 people(53.3%). There was no difference in success rate between two groups. As for a change in self-confidence before and after experiment, the post self-confidence was indicated to have been enhanced in both groups. In conclusion, it is effective to use LMA in the traumatic patient who is unable to receive endotracheal intubation in sniffing position. It is very important for the paramedics to receive the continuous training of the airway management skills.

본 연구의 목적은 주행 중인 구급차에서 기관내 삽관과 후두마스크(LMA) 삽입의 신속성과 성공률을 비교하여 구급대원의 전문기도관리 능력을 향상시키는 데 있다. 연구방법은 C 지역 구급대원 중 1급 응급구조사 60명(대조군 30명, 실험군 30명)을 편의추출 하여 마네킹을 대상으로 측정을 하였다. 자료 분석은 SPSS WIN 14.0 Version을 사용하였다. 연구결과 기관내 삽관이 냄새맡기 자세에서 신속성이 좋은 것으로 나타났고(t=-4.038, p<.001), 중립자세에서 그룹 간 신속성 차이는 없었으나 기관내 삽관 시 16명(53.3%)에게 치아파절이 발생했다. 또한, 그룹 간 성공률 차이는 없었고 두 그룹 모두 실험 후 자신감이 향상된 것으로 나타났다. 결론적으로 냄새맡기 자세가 불가능한 외상성 환자는 후두마스크(LMA)의 사용이 효과적이고 구급대원의 기도관리 능력을 향상시키기 위하여 지속적인 교육이 필요할 것으로 사료된다.

Keywords

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