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The Korean Journal of Critical Care Medicine > Volume 26(2); 2011 > Article
The Korean Journal of Critical Care Medicine 2011;26(2): 69-77.
doi: http://dx.doi.org/10.4266/kjccm.2011.26.2.69
응급실에서 실시된 전문심혈관소생술동안 에피네프린의 사용: 현재의 심폐소생술 지침에 부합하는가?
이승준ㆍ이병국ㆍ정경운ㆍ이형연ㆍ허 탁ㆍ민용일ㆍ윤종근*ㆍ임재훈†
전남대학교 의과대학 응급의학교실, *동강대학 응급구조과, †전남대학교병원 응급의료센터
Adequacy of Epinephrine Administration during Advanced Cardiovascular Life Support in terms of Dosing and Intervals between Doses
Seung Joon Lee, Byung Kook Lee, Kyung Woon Jeung, Hyoung Youn Lee, Tag Heo, Yong Il Min, Jong Geun Yun, Jae Hoon Lim
1Department of Emergency Medicine, School of Medicine, Chonnam National University, Gwangju, Korea. neoneti@hanmail.net
2Department of Emergency Medical Technician, Dongkang College, Gwangju, Korea.
3Emergency Medical Center, Chonnam National University Hospital, Gwangju, Korea.
ABSTRACT
BACKGROUND: Consensus guidelines clearly define how epinephrine is administered during cardiopulmonary resuscitation (CPR). In South Korea, it is not known whether epinephrine is administered in accordance with the current advanced cardiovascular life support (ACLS) guidelines during actual practice. We sought to investigate adherence to ACLS guidelines during actual CPR in terms of the dose of epinephrine and the interval between doses. METHODS: A retrospective review of medical records was performed on 394 adult cardiac arrest patients who received CPR at an emergency room. Data including the duration of CPR, the dose of epinephrine, and the interval between doses was collected from CPR records. RESULTS: Standard-dose epinephrine (1 mg) was used in 166 of 394 patients (42.1%). In 58.8% of patients, the average between-dose interval was within the 3-5 min recommended in the guidelines, whereas it was shorter than 3 min in 31.4% of patients. As a whole, epinephrine was administered in accordance with the current ACLS guidelines in only 96 of 394 patients (24.4%). Logistic regression analysis revealed the duration of CPR to be an independent factor affecting the use of standard-dose epinephrine and the adequate between-dose interval. CONCLUSIONS: Epinephrine was not administered according to the ACLS guideline in most patients. A national multi-center study is required to determine whether the poor adherence to the ACLS guideline is a widespread problem. In addition, efforts to improve adherence to the ACLS guideline are required.
Key Words: cardiopulmonary resuscitation; compliance; epinephrine; guideline
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