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Á¦¸ñ ºÎ·Ï - 2015 Çѱ¹½ÅÆó¼Ò»ý¼ú °¡À̵å¶óÀÎ
ÀÛ¼ºÀÏÀÚ 2016-03-23
2015 ½ÉÆó¼Ò»ý¼ú °¡À̵å¶óÀÎ
2015 Korean Guidelines for Cardiopulmonary Resuscitation and
Emergency Cardiovascular Care
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°¡À̵å¶óÀÎ °³¹ß ÃÑ°ý¿î¿µÀ§¿øȸ
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(¹é¼®´ë), À±³²½Ä(Àü³²ÀÇ´ë), ÀÌâÈñ(³²¼­¿ï´ë), Àå¿ë¼ö(ÇѸ²ÀÇ´ë), Á¶±ÔÁ¾(ÇѸ²ÀÇ´ë), ÃÖ´ëÁ¾(´ëÇÑÀû
½ÊÀÚ»ç)
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ÀÌÁ¾È­(¿¬¼¼ÀÇ´ë), À§Áø(¿¬¼¼ÀÇ´ë), Á¦»ó¸ð(Â÷ÀÇ´ë)
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(¿¬¼¼ÀÇ´ë), ±èÁöÈÆ(°¡Å縯ÀÇ´ë), ¹Ú°æÀÏ(µ¿¾ÆÀÇ´ë), À̺´±¹(Àü³²ÀÇ´ë), ÀÌÁÖ¿µ(¼­¿ï¼­¸ðº´¿ø), Çѹ®±¸
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III
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(¼º±Õ°üÀÇ´ë), Àü¿ëÈÆ(ÀÎÇÏÀÇ´ë), Ãֿ뼺(°æÈñÀÇ´ë)
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ÀÇ´ë), ¹Ú½Â¹Î(ÇѸ²ÀÇ´ë), ¹ÚÀº¿µ(´ëÇÑÀû½ÊÀÚ»ç), ¹ÚÀÎö(¿¬¼¼ÀÇ´ë), ½ÅÁ¾È¯(¼­¿ïÀÇ´ë), ¿ÀÀ±Èñ(¼­¿ï¾Æ
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ÀÇ´ë), ¹Ú±Ô³²(°¡Å縯ÀÇ´ë), ¹ÚÁص¿(¼­¿ïÀÇ´ë), ±è¾Ö¶õ(¿ï»êÀÇ´ë), ¾çÇõÁØ(°¡ÃµÀÇ´ë), Á¤¼ºÇÊ(¿¬¼¼ÀÇ
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Á¦ 1ºÎ 2015 ½ÉÆó¼Ò»ý¼ú °¡À̵å¶óÀÎ °³Á¤°úÁ¤°ú °³Á¤ °¡À̵å¶óÀÎÀÇ ÁÖ¿ä ³»¿ë: Ȳ¼º¿À(¿øÁÖÀÇ´ë),
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¼±¿µ(¹é¼®´ë), ÀÌâÈñ(³²¼­¿ï´ë), Àå¿ë¼ö(ÇѸ²ÀÇ´ë), Á¶±ÔÁ¾(ÇѸ²ÀÇ´ë), Á¶¿µ¼®(ÇѸ²ÀÇ´ë), Á¤¼ºÇÊ(¿¬
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¼ö(¼º±Õ°üÀÇ´ë), ³ë»ó±Õ(¼±¹®´ë), ¹ÚÇö°æ(°æÈñÀÇ´ë), ¿Àµ¿Áø(ÇѸ²ÀÇ´ë), ¿À¼¼ÀÏ(¼­¿ïÀÇ´ë), À§Áø(¿¬¼¼
ÀÇ´ë), Á¦»ó¸ð(Â÷ÀÇ´ë), Á¤¼ºÇÊ(¿¬¼¼ÀÇ´ë), Ȳ¼º¿À(¿øÁÖÀÇ´ë)
Á¦ 4ºÎ ¼Ò»ýÈÄ Ä¡·á: ±è¿µ¹Î(°¡Å縯ÀÇ´ë), ¹Ú±Ô³²(°¡Å縯ÀÇ´ë), ÃÖ½ÂÇÊ(°¡Å縯ÀÇ´ë), À̺´±¹(Àü³²ÀÇ
´ë), ¹Ú°æÀÏ(µ¿¾ÆÀÇ´ë), ±èÁ¤¹Î(¿¬¼¼ÀÇ´ë), ±èÁöÈÆ(°¡Å縯ÀÇ´ë), Á¤¼ºÇÊ(¿¬¼¼ÀÇ´ë), Ȳ¼º¿À(¿øÁÖÀÇ´ë)
Á¦ 5ºÎ ¼Ò¾Æ±âº»¼Ò»ý¼ú: ¾ÈÁöÀ±(ÇѸ²ÀÇ´ë), ÀÌÁö¼÷(¾ÆÁÖÀÇ´ë), ±èµµ±Õ(¼­¿ïÀÇ´ë), ±èÀ±Èñ(¿¬¼¼ÀÇ´ë),
À̺ÀÁø(¼­¿ïÀÇ´ë), Àå¿ø°æ(¼­¿ïÀÇ´ë), ±è±â¹ü(¼­¿ïÀÇ´ë), ±èÁøÅÂ(¿ï»êÀÇ´ë), ÇãÁØ(¼º±Õ°üÀÇ´ë), ¹ÚÁص¿
(¼­¿ïÀÇ´ë), Á¤¼ºÇÊ(¿¬¼¼ÀÇ´ë), Ȳ¼º¿À(¿øÁÖÀÇ´ë)
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±èÀ±Èñ(¿¬¼¼ÀÇ´ë), À̺ÀÁø(¼­¿ïÀÇ´ë), ±è±â¹ü(¼­¿ïÀÇ´ë), ±èÁøÅÂ(¿ï»êÀÇ´ë), ÇãÁØ(¼º±Õ°üÀÇ´ë), ¹ÚÁص¿
(¼­¿ïÀÇ´ë), Á¤¼ºÇÊ(¿¬¼¼ÀÇ´ë), Ȳ¼º¿À(¿øÁÖÀÇ´ë)
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Á¦ 7ºÎ ½Å»ý¾Æ¼Ò»ý¼ú: ±èÀº¼±(°­¿øÀÇ´ë), ±è¾Ö¶õ(¿ï»êÀÇ´ë), ±èÇѼ®(¼­¿ïÀÇ´ë), Á¶¼öÁø(ÀÌÈ­ÀÇ´ë), ÃÖ
¿ë¼º(°æÈñÀÇ´ë), ¹ÚÇý¿ø(°Ç±¹ÀÇ´ë), Àü¿ëÈÆ(ÀÎÇÏÀÇ´ë), ¹Ú¹®¼º(¾ÆÁÖÀÇ´ë), ÀåÀ±½Ç(¼º±Õ°üÀÇ´ë), ±è¿µÇÑ
(¿¬¼¼ÀÇ´ë), ±èµ¿¿¬(°¡Å縯´ë ¼­¿ï¼º¸ðº´¿ø), À±ÈñÁ¶(´Ü±¹ÀÇ´ë), ±è¿¬Èñ(°¡Å縯ÀÇ´ë), Á¤¼ºÇÊ(¿¬¼¼ÀÇ
´ë), Ȳ¼º¿À(¿øÁÖÀÇ´ë)
Á¦ 8ºÎ ½ÉÆó¼Ò»ý¼ú ±³À°Áöħ: ¾çÇõÁØ(°¡ÃµÀÇ´ë), ±è±â¿î(¾ÆÁÖÀÇ´ë), Á¶±ÔÁ¾(ÇѸ²ÀÇ´ë), Ź¾çÁÖ(±³Åë
´ë), Á¤¼ºÇÊ(¿¬¼¼ÀÇ´ë), Ȳ¼º¿À(¿øÁÖÀÇ´ë)
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9
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13
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17
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Æ÷ÇÔÇÑ Àü¹®¼Ò»ý¼úÀ» ½ÃÇàÇØ¾ß ÇÑ´Ù. ½ÉÁ¤Áö ȯÀÚÀÇ Àڹ߼øȯÀÌ È¸º¹µÈ ÈÄ¿¡´Â ½ÉÁ¤Áö ¿øÀÎÀ»
±³Á¤ÇÏ°í ÅëÇÕÀûÀÎ ½ÉÁ¤Áö ÈÄ Ä¡·á¸¦ ½ÃÇàÇÔÀ¸·Î½á ½ÉÁ¤Áö ȯÀÚ°¡ ½Å°æÇÐÀûÀ¸·Î ¿ÏÀüÈ÷ ȸº¹µÉ
¼ö ÀÖµµ·Ï ³ë·ÂÇØ¾ß ÇÑ´Ù. ½ÉÁ¤Áö ȯÀÚÀÇ »ýÁ¸À²À» ³ôÀ̱â À§Çؼ­´Â ÀÌ¿Í °°Àº 5°¡ÁöÀÇ ÇʼöÀûÀÎ
´Ü°èµéÀÌ »ç½½°ú °°ÀÌ ¼­·Î À¯±âÀûÀ¸·Î ¿¬°áµÇ¾î¾ß¸¸ ÇÑ´Ù(±×¸² 2-1).
±×¸² 2-1. »ýÁ¸ »ç½½. ½ÉÁ¤ÁöÀÇ ¿¹¹æ°ú Á¶±â ¹ß°ß-½Å¼ÓÇÑ ½Å°í-½Å¼ÓÇÑ ½ÉÆó¼Ò»ý¼ú-½Å¼ÓÇÑ Á¦¼¼µ¿-
È¿°úÀû Àü¹®¼Ò»ý¼ú°ú ½ÉÁ¤Áö ÈÄ Ä¡·á
1. ½ÉÁ¤ÁöÀÇ ¿¹¹æ°ú Á¶±â ¹ß°ß
18
»ýÁ¸»ç½½ÀÇ Ã¹ ¹ø° °í¸®·Î 2015³â¿¡ »õ·Ó°Ô µµÀÔÇÑ °³³äÀº ½ÉÁ¤ÁöÀÇ ¿¹¹æ°ú Á¶±â ¹ß°ßÀÌ´Ù.
½ÉÁ¤Áö°¡ ¹ß»ýµÈ ÀÌÈÄ¿¡´Â ÀûÀýÇÑ ½ÉÆó¼Ò»ý¼úÀÌ ½ÃÇàµÇ´õ¶óµµ »ýÁ¸À²ÀÌ ¸Å¿ì ³·´Ù1). ¼Ò¾Æ¿¡¼­´Â
Áúº´º¸´Ù´Â »ç°í ¶Ç´Â ¼Õ»ó¿¡ ÀÇÇÑ ½ÉÁ¤Áö ¹ß»ýÀ²ÀÌ ³ôÀ¸¹Ç·Î ½ÉÁ¤Áö¸¦ ¿¹¹æÇÒ ¼ö ÀÖ´Ù.
¼ºÀο¡¼­µµ ½ÉÀå, ³úÇ÷°ü Áúȯ¿¡ ´ëÇÑ À§ÇèÀÎÀÚ¸¦ ÁÙÀÓÀ¸·Î½á ½ÉÁ¤ÁöÀÇ ¹ß»ýÀ» ¿¹¹æÇÒ ¼ö ÀÖ´Ù.
¿ì¸®³ª¶óÀÇ ¼ºÀÎ ½ÉÁ¤Áö ȯÀÚÀÇ ³·Àº »ýÁ¸À²À» °í·ÁÇÒ ¶§ ½ÉÁ¤Áö ¹ß»ýÀ» ¿¹¹æÇÏ´Â °ÍÀº ¼Ò¾Æ
½ÉÁ¤Áö¿Í ¸¶Âù°¡Áö·Î ¸Å¿ì Áß¿äÇÏ´Ù. º´¿ø ¹Û¿¡¼­´Â ½ÉÁ¤Áö¸¦ ÀÏÀ¸Å³ ¼ö ÀÖ´Â À¯¹ß¿äÀÎ ¹×
À§Çè¿äÀÎÀ» °¨¼Ò½ÃÅ°±â À§ÇØ ³ë·ÂÇØ¾ß Çϸç, º´¿ø ¾È¿¡¼­´Â ½ÉÁ¤Áö ¹ß»ý Àü¿¡ ³ªÅ¸³ª´Â ¡ÈĵéÀ»
»¡¸® ÆľÇÇÏ°í ´ëó¸¦ ÇÒ ¼ö ÀÖ´Â ¿ø³»ÀÀ±ÞÆÀ(medical emergency team)À̳ª ¿ø³»½Å¼Ó¹ÝÀÀÆÀ(rapid
response team)ÀÇ ¿ªÇÒÀÌ ÇÊ¿äÇÏ´Ù.
½ÉÁ¤Áö°¡ ¹ß»ýÇßÀ» ¶§´Â ¸ñ°ÝÀÚ°¡ ½ÉÁ¤Áö¸¦ ½Å¼ÓÇÏ°Ô ÀÎÁöÇÔÀ¸·Î½á ÀÀ±ÞÀÇ·áü°è·ÎÀÇ ½Å°í
½Ã°£À» ´ÜÃà½ÃÄÑ¾ß ÇÑ´Ù. ½ÉÁ¤Áö¸¦ ¸ñ°ÝÇÒ °¡´É¼ºÀÌ ³ôÀº ÀϹÝÀÎ ¶Ç´Â ÀÇ·áÁ¦°øÀÚ¿¡°Ô ½ÉÁ¤Áö
Áõ»óÀ» ±³À°ÇÔÀ¸·Î½á ½Å¼ÓÇÏ°Ô ½ÉÁ¤Áö¸¦ ÀÎÁöÇÒ ¼ö ÀÖµµ·Ï ÇØ¾ß ÇÑ´Ù.
2. ½Å¼ÓÇÑ ½Å°í
»ýÁ¸»ç½½ÀÇ µÎ ¹ø° °í¸®´Â ½Å¼ÓÇÑ ½Å°íÀÌ´Ù. ÀÌ °úÁ¤¿¡¼­´Â ½ÉÁ¤Áö¸¦ ÀνÄÇÑ ¸ñ°ÝÀÚ°¡
ÀÀ±ÞÀÇ·áü°è¿¡ ÀüÈ­¸¦ °É¾î ½ÉÁ¤ÁöÀÇ ¹ß»ýÀ» ¾Ë¸®°í, ¿¬¶ôÀ» ¹ÞÀº ÀÀ±ÞÀÇ·áÀüÈ­»ó´ã¿øÀÌ
ȯÀڹ߻ý Áö¿ªÀ¸·Î 119±¸±Þ´ë¿øÀ» Ã⵿½ÃÅ°´Â ÀÏ·ÃÀÇ °úÁ¤ÀÌ Æ÷ÇԵȴÙ. µÎ ¹ø° °í¸®°¡ ½Å¼ÓÇÏ°Ô
¿¬°áµÇ·Á¸é ÀÀ±ÞȯÀÚ¸¦ ½Å°íÇÒ ¼ö ÀÖ´Â ½Å°íü°è°¡ °®Ãß¾îÁ®¾ß Çϸç, ÀüÈ­½Å°í¿¡ ¹ÝÀÀÇÏ¿©
±¸±Þ´ë¿øÀÌ Ã⵿ÇÒ ¼ö ÀÖ´Â ¿¬¶ôü°è°¡ ÀÖ¾î¾ß ÇÑ´Ù. ¿ì¸®³ª¶ó¿¡¼­ ½ÉÁ¤Áö ȯÀÚ¸¦ ½Å°íÇÏ´Â
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ÀÇÇÑ ½ÉÆó¼Ò»ý¼úÀÌ´Ù. ¸ñ°ÝÀÚ¿¡ ÀÇÇÑ ½ÉÆó¼Ò»ý¼úÀÌ ½ÃÇàµÈ °æ¿ì¿¡´Â ¸ñ°ÝÀÚ¿¡ ÀÇÇÑ ½ÉÆó¼Ò»ý¼úÀÌ
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4. ½Å¼ÓÇÑ Á¦¼¼µ¿
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ÀÇ·áÀåºñÀ̹ǷΠÀϹÝÀεµ ÀÏÁ¤ ¼öÁØÀÇ ±³À°À» ½ÃÇà ¹ÞÀº µÚ¿¡ ¾ÈÀüÇÏ°Ô »ç¿ëÇÒ ¼ö ÀÖ´Ù.
5. È¿°úÀû Àü¹®¼Ò»ý¼ú°ú ½ÉÁ¤Áö ÈÄ Ä¡·á
Á¦¼¼µ¿ óġ¿¡ ¹ÝÀÀÇÏÁö ¾Ê´Â ½ÉÁ¤Áö ȯÀÚÀÇ Àڹ߼øȯÀ» ȸº¹½ÃÅ°·Á¸é ¾à¹°Åõ¿©·Î È®º¸,
Ç÷°ü¼öÃàÁ¦ ¶Ç´Â Ç׺ÎÁ¤¸ÆÁ¦ µîÀÇ ¾à¹° Åõ¿©, Àü¹®±âµµÀ¯Áö¼ú µîÀÇ Àü¹®¼Ò»ý¼úÀ» ½ÃÇàÇØ¾ß ÇÑ´Ù.
È¿°úÀûÀÎ Àü¹®¼Ò»ý¼úÀº ½ÉÁ¤Áö ȯÀÚÀÇ »ýÁ¸À²À» Áõ°¡½Ãų °ÍÀ¸·Î ¿¹ÃøµÇ¾úÁö¸¸ ÇöÀå¿¡¼­ÀÇ
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Àü¹®¼Ò»ý¼úÀº ȯÀÚÀÇ »ýÁ¸¿¡ Áß¿äÇÏ´Ù.
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ÀϹÝÀûÀÎ ÁßȯÀÚ Ä¡·á¿Í ´õºÒ¾î ¸ñǥü¿ÂÄ¡·á, ±Þ¼º½É±Ù°æ»ö¿¡ ´ëÇÑ °ü»óµ¿¸ÆÁßÀç¼ú, °æ·Ã¹ßÀÛÀÇ
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µÎµå¸®¸é¼­ ¡°±¦ÂúÀ¸¼¼¿ä?¡±¶ó°í ¼Ò¸®Ãļ­ ¹ÝÀÀÀ» È®ÀÎÇÑ´Ù. ÀǽÄÀÌ ÀÖ´Ù¸é ±× »ç¶÷Àº ´ë´äÀ»
Çϰųª ¿òÁ÷À̰ųª ½ÅÀ½ ¼Ò¸®¸¦ ³¾ °ÍÀÌ´Ù. ¾²·¯Á® ÀÖ´Â »ç¶÷ÀÇ ¸Ó¸®³ª ¸ñÀÇ ¿Ü»óÀÌ ÀǽɵǸé
ºÒÇÊ¿äÇÑ ¿òÁ÷ÀÓÀ» ÃÖ¼ÒÈ­ÇÏ¿© ¼Õ»óÀÌ ¾ÇÈ­µÇÁö ¾Êµµ·Ï ÇÑ´Ù.
2. ÀÀ±ÞÀÇ·áü°è ½Å°í
¹ÝÀÀÀÌ ¾øÀ¸¸é¼­, È£ÈíÀÌ ¾ø°Å³ª ºñÁ¤»óÀûÀΠȣÈí(½ÉÁ¤Áö È£Èí)À» ÇÏ´Â »ç¶÷À» ¹ß°ßÇß´Ù¸é,
¾²·¯Áø »ç¶÷ÀÌ ½ÉÁ¤Áö »óŶó°í ÆÇ´ÜÇÏ°í Áï½Ã 119¿¡ ½Å°íÇÑ´Ù. ½ÉÁ¤Áö ȯÀÚ¸¦ ¸ñ°ÝÇÑ °æ¿ì¿¡´Â
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ÁÖº¯¿¡ Å« ¼Ò¸®·Î ±¸Á¶¸¦ ¿äûÇÏ¿© ´Ù¸¥ »ç¶÷¿¡°Ô 119¿¡ ½Å°íÇϵµ·Ï ÇÏ´Â µîÀÇ µµ¿òÀ» ¹ÞÀ» ¼ö
ÀÖµµ·Ï ÇÑ´Ù. ÇÏÁö¸¸ ÁÖº¯¿¡ ¾Æ¹«µµ ¾ø´Â °æ¿ì¿¡´Â Á÷Á¢ 119¿¡ ½Å°íÇÑ´Ù.
ÀϹÝÀÎÀº È£Èí »óŸ¦ Á¤È®È÷ Æò°¡Çϱ⠾î·Æ´Ù. ÀϹÝÀÎÀÇ °æ¿ì ÀÀ±ÞÀÇ·áÀüÈ­»ó´ã¿øÀÇ µµ¿òÀ»
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gasping)ÀÎÁö ÇÔ²² È®ÀÎÇÑ´Ù8-10). µû¶ó¼­ ÀÀ±ÞÀÇ·áÀüÈ­»ó´ã¿øÀº ½ÉÁ¤Áö°¡ ÀǽɵǴ »óȲÀ» ½Å°íÇÏ´Â
¸ñ°ÝÀÚ¿¡°Ô ÀûÀýÇÑ Áú¹®À» ÇÏ¿© ¹ÝÀÀÀÇ ¿©ºÎ¿Í ºñÁ¤»óÀûÀΠȣÈí(½ÉÁ¤Áö È£Èí: gasping) »óŸ¦
ÆľÇÇÒ ¼ö ÀÖ¾î¾ß ÇÑ´Ù. ½ÉÁ¤Áö°¡ ÀǽɵǴ °æ¿ì¿¡´Â ¸ñ°ÝÀÚ°¡ Áï½Ã ½ÉÆó¼Ò»ý¼úÀ» ÇÒ ¼ö ÀÖµµ·Ï
µµ¿ÍÁÖ¾î¾ß ÇÑ´Ù. ÀÀ±ÞÀÇ·áÀüÈ­»ó´ã¿øÀº ½ÉÁ¤Áö ȯÀÚ¿¡¼­ ¹ß»ýÇÏ´Â ºñÁ¤»ó È£ÈíÀ» È®½ÇÈ÷
ÆľÇÇÏ°í ÀÖ¾î¾ß Çϸç, ¸ñ°ÝÀÚ¿¡°Ô ½Ç°¨ ÀÖ°Ô ¼³¸íÇÒ ¼ö ÀÖ¾î¾ß ÇÑ´Ù8-10).
1) ³ªÀÌ¿¡ °ü°è¾øÀÌ ÀüÈ­¿ì¼±(call first)
¼ºÀο¡¼­ ¹ß»ýÇÏ´Â ºñ¿Ü»ó¼º ½ÉÁ¤ÁöÀÇ ÁÖ¿ä¿øÀÎÀº ½É½Ç¼¼µ¿À̸ç, ½É½Ç¼¼µ¿ÀÇ °¡Àå È¿°úÀûÀÎ
Ä¡·á´Â Á¦¼¼µ¿ÀÌ´Ù. ¹Ý¸é, ¿µ¾Æ¿Í ¼Ò¾Æ¿¡¼­´Â ±âµµ³ª ȯ±âÀÇ ¹®Á¦·Î ÀÎÇÑ ÀÏÂ÷¼º È£ÈíÁ¤Áö°¡
½ÉÁ¤ÁöÀÇ °¡Àå ÈçÇÑ ¿øÀÎÀÌ´Ù. µû¶ó¼­ ½ÉÁ¤Áö°¡ ÀǽɵǴ ¼ºÀÎÀ» ¹ß°ßÇÑ ¸ñ°ÝÀÚ´Â 119¿¡ ÀüÈ­
¿¬¶ôÀ» ¸ÕÀú ÇÏ¿© ÀÚµ¿Á¦¼¼µ¿±â°¡ ÇöÀå¿¡ »¡¸® µµÂøÇÒ ¼ö ÀÖµµ·Ï (ÀüÈ­¿ì¼±) ÇÑ´Ù. ±×·¯³ª ¼Ò¾Æ
½ÉÁ¤ÁöÀÇ ¸ñ°ÝÀÚ´Â 2ºÐ°£ ½ÉÆó¼Ò»ý¼úÀ» ¸ÕÀú ÇÑ ´ÙÀ½ ÀÀ±ÞÀÇ·áü°è¿¡ ½Å°íÇϵµ·Ï
±ÇÀå(½ÉÆó¼Ò»ý¼ú ¿ì¼±)ÇÏ´Â ±¹°¡°¡ ¸¹´Ù.
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½ÉÁ¤Áö°¡ ¹ß»ýÇÑ ÇöÀå¿¡¼­´Â ½ÉÁ¤ÁöÀÇ ¿øÀÎÀÌ ½ÉÀ强ÀÎÁö È£Èí¼ºÀÎÁö¸¦ ¾Ë±â ¾î·Æ´Ù. ±×»Ó¸¸
¾Æ´Ï¶ó 2ºÐ°£ ½ÉÆó¼Ò»ý¼úÀ» ½ÃÇàÇÑ ÈÄ ½Å°íÇÑ´Ù¸é º´¿øµµÂø±îÁöÀÇ ½Ã°£ÀÌ Áö¿¬µÉ ¼ö ÀÖ´Ù.
´õ±¸³ª, ¿ì¸®³ª¶ó´Â ÈÞ´ëÆù º¸±Þ·üÀÌ ³ô±â ¶§¹®¿¡ ÇöÀå¿¡¼­ Áï½Ã ½Å°í°¡ °¡´ÉÇÏ´Ù. µû¶ó¼­ ½ÉÁ¤Áö
ȯÀÚÀÇ ¿¬·É¿¡ °ü°è¾øÀÌ ¸ñ°ÝÀÚ´Â 119¿¡ ÀüÈ­½Å°í¸¦ ¸ÕÀú ÇÑ ÈÄ¿¡ ½ÉÆó¼Ò»ý¼úÀ» ½ÃÀÛÇÏ´Â
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2) 119 ½Å°í
119¿¡ ½Å°íÇÒ ¶§¿¡´Â ȯÀÚ ¹ß»ý Àå¼Ò, ¹ß»ý »óȲ, ¹ß»ýÇÑ È¯ÀÚ ¼ö¿Í ȯÀÚÀÇ »óÅ ±×¸®°í ÇÏ°í
ÀÖ´ø ÀÀ±Þóġ¿¡ ´ëÇÏ¿© ¼³¸íÇØ¾ß ÇÑ´Ù11). ¸¸¾à¿¡ ½Å°íÀÚ°¡ ½ÉÆó¼Ò»ý¼úÀ» ÀüÇô ¹è¿ìÁö ¾Ê¾Ò°Å³ª
ÇÏ´Â ¹æ¹ýÀ» ÀØÀº °æ¿ì¶ó¸é ÀÀ±ÞÀÇ·áÀüÈ­»ó´ã¿øÀÇ Áö½Ã¿¡ µû¶ó¾ß ÇÑ´Ù. ÀÀ±ÞÀÇ·áÀüÈ­»ó´ã¿øÀÌ
ÀüÈ­·Î ¾Ë·ÁÁÖ´Â »çÇ×À» È¿À²ÀûÀ¸·Î ½ÃÇàÇϱâ À§Çؼ­´Â ½ºÇÇÄ¿ ÅëÈ­¸¦ ½ÃÇàÇÏ´Â °ÍÀÌ ¹Ù¶÷Á÷ÇÏ´Ù.
ÀÀ±ÞÀÇ·áÀüÈ­»ó´ã¿øÀÌ ´õ ÀÌ»ó Áö½Ã»çÇ×ÀÌ ¾ø¾î¼­ ²÷À¸¶ó°í ÇÒ ¶§±îÁö ÅëÈ­»óŸ¦ À¯ÁöÇÑ´Ù.
ÀÀ±ÞÀÇ·áÀüÈ­»ó´ã¿ø¿¡°Ô ¾Ë·ÁÁÖ¾î¾ß ÇÒ ³»¿ëÀº ´ÙÀ½°ú °°´Ù3).
¨ç ÀÀ±Þ »óȲÀÌ ¹ß»ýÇÑ À§Ä¡ (°¡´ÉÇÏ¸é »ç¹«½Ç À̸§, ¹æÀÇ È£¼ö, µµ·Î³ª °Å¸®À̸§)
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¨ì ´Ù¸¥ Áú¹®ÀÌ ¾ø´ÂÁö È®ÀÎÇÑ´Ù.
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ÀÀ±ÞÀÇ·áÀüÈ­»ó´ã¿øÀº ½ÉÁ¤Áö ȯÀÚÀÇ Ãʱâ ÀÀ±Þóġ¿¡ Àý´ëÀûÀ¸·Î ÇÊ¿äÇÑ ±¸¼º¿øÀ¸·Î¼­,
ȯÀÚ¿Í ½Å°íÀÚ »çÀ̸¦ ¿¬°áÇÏ´Â ¿ªÇÒÀ» ÇÑ´Ù. ÀÀ±ÞÀÇ·áÀüÈ­»ó´ã¿øÀÌ ½Å°íÀÚ¿¡°Ô È®ÀÎÇØ¾ß ÇÒ
»çÇ×Àº ¹ÝÀÀÀÌ ÀÖ´ÂÁö, È£ÈíÀÌ Á¤»óÀÎÁö ºñÁ¤»óÀÎÁöÀÌ´Ù12). ÀÀ±ÞÀÇ·áÀüÈ­»ó´ã¿ø¿¡°Ô´Â ȯÀÚ°¡
ÀǽÄÀÌ ¾øÀ¸¸é¼­ È£ÈíÀÌ ¾ø°Å³ª ºñÁ¤»ó È£ÈíÀÎ °æ¿ì¿¡´Â ½ÉÁ¤Áö »óŶó°í ÆÇ´ÜÇÏ´Â °ÍÀ»
±Ç°íÇÑ´Ù. ÀÀ±ÞÀÇ·áÀüÈ­»ó´ã¿øÀº ½ÉÁ¤Áö »óŶó°í ÆǴܵǸé Ç¥ÁØÈ­µÇ°í ÀÇÇÐÀûÀ¸·Î ½ÂÀεÈ
25
¡®ÀüÈ­µµ¿ò ½ÉÆó¼Ò»ý¼ú¡¯ÀÇ ½ÃÇàÀ» ÁöµµÇÒ °ÍÀ» ±Ç°íÇÏ¸ç ±×·³À¸·Î½á ÇöÀåÀÇ ÀϹÝÀÎÀÌ
ÀÀ±ÞÀÇ·áÁ¾»çÀÚ°¡ µµÂøÇϱâ Àü±îÁö ½ÉÆó¼Ò»ý¼úÀ» ½ÃÇàÇÒ ¼ö ÀÖµµ·Ï µµ¿ÍÁÖ¾î¾ß ÇÑ´Ù. ¡®ÀüÈ­µµ¿ò
½ÉÆó¼Ò»ý¼ú¡¯Àº ÀϹÝÀÎ ¸ñ°ÝÀÚÀÇ ½ÉÆó¼Ò»ý¼ú ½ÃÇàÀ²À» ³ôÀÌ°í °á°úÀûÀ¸·Î ½ÉÁ¤Áö ȯÀÚÀÇ »ýÁ¸À²À»
Áõ°¡½ÃŲ´Ù13-14). µû¶ó¼­ ÀÀ±ÞÀÇ·áÀüÈ­»ó´ã¿øÀº ¡®ÀüÈ­µµ¿ò ½ÉÆó¼Ò»ý¼ú¡¯ÀÇ Á߿伺À» ÀÌÇØÇÏ°í,
ÁöµµÇÏ´Â ¹æ¹ý¿¡ ´ëÇØ ±³À°À» ¹Þ¾Æ¾ß ÇÑ´Ù. ±³À° ³»¿ë¿¡´Â ºñÁ¤»ó È£ÈíÀ» ¾Ë¾Æ³»´Â ¹æ¹ý, ½ÉÁ¤Áö
È£ÈíÀÌ ½ÉÁ¤Áö¸¦ ÀǹÌÇÑ´Ù´Â °Í, °æ·Ã¹ßÀÛÀÌ ½ÉÁ¤ÁöÀÇ Ã¹ Áõ»óÀÏ ¼ö ÀÖ´Ù´Â °Í, ±×¸®°í °¡½¿¾Ð¹Ú
¼Ò»ý¼úÀ» ÁöµµÇÏ´Â ¹æ¹ý µîÀÌ Æ÷ÇԵDZ⸦ ±Ç°íÇÑ´Ù8-10).
ÀÀ±ÞÀÇ·áÀüÈ­»ó´ã¿øÀÌ ½ÉÁ¤ÁöÀÓÀ» ÆÇ´ÜÇϸé ÀϹÝÀÎ ½Å°íÀÚ¿¡°Ô´Â °¡½¿¾Ð¹Ú¸¸ ÇÏ´Â °¡½¿¾Ð¹Ú
¼Ò»ý¼úÀ» ½ÃÇàÇϵµ·Ï ÁöµµÇÒ °ÍÀ» Á¦¾ÈÇÑ´Ù15-17). ±×·¯³ª ½ÉÁ¤Áö ȯÀÚ°¡ Àͼö, Àú»ê¼Ò¼º ¿øÀÎ µîÀÇ
Ư¼öÇÑ »óȲ¿¡ ÇØ´çµÇ°í, ½Å°íÀÚ°¡ ÀΰøÈ£ÈíÀ» ½ÃÇàÇÒ ´É·ÂÀ» °®Ãß¾ú´Ù°í ÆÇ´ÜµÇ¸é °¡½¿¾Ð¹Ú°ú
ÀΰøÈ£ÈíÀ» ÇÔ²² ½ÃÇàÇϵµ·Ï ÁöµµÇÑ´Ù. ƯÈ÷ ÀÀ±ÞÀÇ·áÀüÈ­»ó´ã¿øÀº ½Å°íÀÚ°¡ ½º½º·Î ÀüÈ­¸¦ ²÷Áö
¾Êµµ·Ï Çؾ߸¸ ÀÀ±Þ»óȲ¿¡ ´ëÇØ ´õ ¸¹Àº Á¤º¸¸¦ ¾ò¾î³¾ ¼ö ÀÖÀ¸¸ç, ÀûÀýÇÑ ÀÀ±Þóġ¸¦ Á¶¾ðÇÒ ¼ö
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2. ÀÀ±ÞÀÇ·áÀüÈ­»ó´ã¿ø ¼Ò¼Ó ±â°ü¿¡ ´ëÇÑ ±Ç°í »çÇ×
±â°üÀÇ Ã¥ÀÓÀÚ´Â ½Å°í½Ã°£ºÎÅÍ ½Å°íÀÚ¿¡ ÀÇÇÑ ½ÉÆó¼Ò»ý¼ú ½ÃÀÛ±îÁöÀÇ ½Ã°£À» ´ÜÃà½ÃÄÑ¾ß Çϸç,
¡®ÀüÈ­Áöµµ ½ÉÆó¼Ò»ý¼ú¡¯ÀÇ Áöµµ °á°ú¿¡ ´ëÇÑ ÀûÀý¼º°ú ½ÉÁ¤Áö ȯÀÚÀÇ »ýÁ¸ Åð¿øÀ²À» Æò°¡ÇÏ¿©
¹Ý¿µÇÔÀ¸·Î½á º´¿ø ¹Û ½ÉÁ¤Áö ȯÀÚÀÇ »ýÁ¸À²À» Çâ»ó½Ãų ¼ö ÀÖµµ·Ï ³ë·ÂÇÏ¿©¾ß ÇÑ´Ù10,13,14).
2015³â Çѱ¹ ±âº»¼Ò»ý¼ú °¡À̵å¶óÀο¡¼­ÀÇ ÁÖ¿ä º¯°æ »çÇ×
2015³â Çѱ¹ ±âº»¼Ò»ý¼ú °¡À̵å¶óÀο¡ »õ·Ó°Ô Ãß°¡ ȤÀº ¼öÁ¤µÇ¾î º¯°æµÈ ÁÖ¿ä ³»¿ëÀº ´ÙÀ½°ú
°°´Ù(Ç¥ 2-1).
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Ç¥ 2-1. ±âº»¼Ò»ý¼úÀÇ ÁÖ¿ä ³»¿ë
¨ç ½ÉÆó¼Ò»ý¼úÀÇ ¼ø¼­¿¡¼­ ÀΰøÈ£Èí ÀÌÀü¿¡ °¡½¿¾Ð¹ÚÀ» ¸ÕÀú ½ÃÇàÇϵµ·Ï Á¦¾ÈÇÑ´Ù. 2011³â
°¡À̵å¶óÀΰú ¸¶Âù°¡Áö·Î ½ÉÆó¼Ò»ý¼ú ¼ø¼­´Â °¡½¿¾Ð¹Ú(compression)-±âµµÀ¯Áö(airway)-
ÀΰøÈ£Èí(breathing)ÀÇ ¼ø¼­(C-A-B)¸¦ À¯ÁöÇÑ´Ù18,19).
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ÀΰøÈ£ÈíÀ» ÇÒ ¼ö ÀÖ´Â ±¸Á¶ÀÚ´Â ÀΰøÈ£ÈíÀÌ Æ÷ÇÔµÈ ½ÉÆó¼Ò»ý¼úÀ» ½ÃÇà ÇÒ ¼ö ÀÖ´Ù. ±×·¯³ª
119±¸±Þ´ë¿øÀ» Æ÷ÇÔÇÑ ÀÀ±ÞÀÇ·áÁ¾»çÀÚ´Â ¹Ýµå½Ã °¡½¿¾Ð¹Ú°ú ÀΰøÈ£ÈíÀ» ÇÔ²² ÇÏ´Â ½ÉÆó¼Ò»ý¼úÀ»
½ÃÇàÇÒ °ÍÀ» Á¦¾ÈÇÑ´Ù18, 20-25).
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Á¦¾ÈÇϸç, ÀΰøÈ£ÈíÀ» °úµµÇÏ°Ô ½ÃÇàÇÏÁö ¾Ê¾Æ¾ß ÇÑ´Ù18, 26-32).
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¸»ÇÑ´Ù18).
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1. ¹ÝÀÀÀÇ È®ÀÎ
ȯÀÚ¿¡°Ô Á¢±ÙÇϱâ Àü¿¡ ±¸Á¶ÀÚ´Â ÇöÀå »óȲÀÌ ¾ÈÀüÇÑÁö¸¦ ¿ì¼± È®ÀÎÇÑ´Ù. ¾ÈÀüÇÏ´Ù°í
ÆǴܵǸé ȯÀÚ¿¡°Ô ´Ù°¡°¡ ¾î±ú¸¦ °¡º±°Ô µÎµå¸®¸ç ¡°±¦ÂúÀ¸¼¼¿ä?¡±¶ó°í ¹°¾îº»´Ù(±×¸² 2-4). ÀǽÄÀÌ
ÀÖ´Ù¸é ȯÀÚ´Â ´ë´äÀ» Çϰųª ¿òÁ÷À̰ųª ¶Ç´Â ½ÅÀ½ ¼Ò¸®¸¦ ³»´Â °Í°ú °°Àº ¹ÝÀÀÀ» ³ªÅ¸³½´Ù.
È®ÀÎÇÏ´Â µ¿¾È¿¡ ¾²·¯Á® Àִ ȯÀÚÀÇ ¸Ó¸®³ª ¸ñÀÇ ¿Ü»óÀÌ ÀÇ½ÉµÇ¸é ¼Õ»óÀÌ ´õ ¾ÇÈ­µÇÁö ¾Êµµ·Ï
ºÒÇÊ¿äÇÑ ¿òÁ÷ÀÓÀ» ÃÖ¼ÒÈ­ÇÑ´Ù. À̶§ ȯÀÚÀÇ ¹ÝÀÀÀÌ ¾øÀ¸¸é ÀÀ±ÞÀÇ·áü°è¿¡ ¿¬¶ôÇϸç,
¿ì¸®³ª¶ó¿¡¼­´Â 119¿¡ ½Å°íÇÑ´Ù. ±×·¯³ª ¹ÝÀÀÀÌ ÀÖ°í Áø·á°¡ ÇÊ¿äÇÑ »óÅÂÀ̸é 119¿¡ ¿¬¶ôÀ» ÇÑ
´ÙÀ½ ȯÀÚÀÇ »óŸ¦ ÀÚÁÖ È®ÀÎÇϸ鼭 ÀÀ±ÞÀÇ·áÀüÈ­»ó´ã¿øÀÇ Áö½Ã¸¦ µû¸¥´Ù33-35).
32
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2. 119 ½Å°í
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ÀÚµ¿Á¦¼¼µ¿±â¸¦ ¿äûÇÑ´Ù(±×¸² 2-5). ȯÀÚ°¡ ¹ÝÀÀÀÌ ¾ø°í, È£ÈíÀÌ ¾ø°Å³ª ½ÉÁ¤Áö È£Èíó·³
ºñÁ¤»óÀûÀΠȣÈíÀ» º¸ÀÎ´Ù¸é ½ÉÁ¤Áö »óÅ·ΠÆÇ´ÜÇÑ´Ù. ƯÈ÷, ½ÉÁ¤Áö È£ÈíÀº ½ÉÁ¤Áö ȯÀÚ¿¡°Ô¼­ ù
¼ö ºÐ°£ ÈçÇÏ°Ô ³ªÅ¸³ª¸ç, ÀÌ·¯ÇÑ Â¡Èĸ¦ ³õÄ¡¸é, ½ÉÁ¤Áö ȯÀÚÀÇ »ýÁ¸ °¡´É¼ºÀº ³·¾ÆÁø´Ù.
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»ç¿ëÇÑ´Ù. µÎ ¸í ÀÌ»óÀÇ ±¸Á¶ÀÚ°¡ ÇöÀå¿¡ ÀÖ´Ù¸é ÇÑ ¸íÀº ½ÉÆó¼Ò»ý¼úÀ» ½ÃÀÛÇÏ°í, ´Ù¸¥ ÇÑ ¸íÀº
½Å°í¿Í ÀÚµ¿Á¦¼¼µ¿±â¸¦ °¡Á®¿Àµµ·Ï ÇÑ´Ù18).
119¿¡ ½Å°íÇÒ ¶§ ±¸Á¶ÀÚ´Â ÀÀ±ÞÀÇ·áÀüÈ­»ó´ã¿ø¿¡°Ô ¹ß»ý Àå¼Ò¿Í »óȲ, ȯÀÚÀÇ ¼ýÀÚ¿Í »óÅÂ,
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34
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¾øÀ¸¸é 119¿¡ ½Å°íÇÏ°í ÀÚµ¿Á¦¼¼µ¿±â¸¦ ¿äûÇÑ ÈÄ ¸Æ¹Ú°ú È£ÈíÀÇ À¯¹« ¹× ºñÁ¤»ó ¿©ºÎ¸¦ µ¿½Ã¿¡
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5. ÀÀ±ÞÀÇ·áÀüÈ­»ó´ã¿ø Áö½Ã¿¡ ÀÇÇÑ ½ÉÆó¼Ò»ý¼ú
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°¡»óÀÇ ¼±À» ÀÌ¿ëÇÒ ¼ö ÀÖÀ¸³ª ȯÀÚÀÇ Æ¯¼º¿¡ µû¶ó Á¤È®ÇÑ ¾Ð¹Ú À§Ä¡ ¼±Á¤¿¡ µµ¿òÀÌ µÇÁö ¾ÊÀ»
¼öµµ ÀÖ´Ù. º¹°­ ³» Àå±âÀÇ ¼Õ»óÀ» ¹æÁöÇϱâ À§ÇØ °¡½¿»ÀÀÇ °¡Àå ÇÏ´Ü¿¡ À§Ä¡ÇÑ Ä®µ¹±â¸¦
¾Ð¹ÚÇÏÁö ¾Êµµ·Ï ÁÖÀÇÇÑ´Ù36,37).
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ÆòÆòÇÏ°í ´Ü´ÜÇÑ °÷¿¡ µîÀ» ´ë°í ´¯È÷°Å³ª ȯÀÚÀÇ µî¿¡ ´Ü´ÜÇÑ ÆÇÀ» ±ò¾ÆÁØ´Ù. ±¸Á¶Àڴ ȯÀÚÀÇ
°¡½¿ ¿·¿¡ ¹«¸­À» ²ÝÀº ÀÚ¼¼¸¦ ÃëÇÑ´Ù. Á¦ÇÑµÈ °ø°£¿¡¼­´Â ȯÀÚÀÇ ¸Ó¸®¸Ã¿¡¼­ °¡½¿¾Ð¹ÚÀ» ÇÒ
¼öµµ ÀÖ´Ù. ±¸Á¶ÀÚ´Â ÇÑ ÂÊ ¼Õ¹Ù´ÚÀ» ¾Ð¹Ú À§Ä¡¿¡ ´ë°í ±× À§¿¡ ´Ù¸¥ ¼Õ¹Ù´ÚÀ» ÆòÇàÇÏ°Ô °ãÃÄ µÎ
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Æì¼­ ÆÈÀÌ ¹Ù´Ú¿¡ ´ëÇØ ¼öÁ÷À» ÀÌ·é »óÅ¿¡¼­ üÁßÀ» ÀÌ¿ëÇÏ¿© ¾Ð¹ÚÇÑ´Ù(±×¸² 2-10)49,50).
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±×¸² 2-10. °¡½¿¾Ð¹Ú ¹æ¹ý
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2. °¡½¿¾Ð¹Ú ±íÀÌ
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°ÍÀ¸·Î ¾Ë·ÁÁ³´Ù27,28,51,52). ƯÈ÷ 9,136¸íÀÇ º´¿ø ¹Û ¼ºÀÎ ½ÉÁ¤Áö ȯÀÚµéÀ» ºÐ¼®ÇÑ ¿¬±¸´Â
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»ýÁ¸ Åð¿øÀ²À» º¸¿´´Ù°í ÇÏ¿´´Ù28,52). ¶ÇÇÑ °¡½¿¾Ð¹ÚÀÇ ±íÀÌ°¡ 6cm ÀÌ»óÀ¸·Î ½ÃÇàµÈ °æ¿ì¿¡´Â 6cm
¹Ì¸¸À¸·Î ½ÃÇàµÈ °æ¿ì¿¡ ºñÇØ °¡½¿»À °ñÀý, ´Á°ñ°ñÀý µîÀÇ ¼Õ»óÀÌ À¯ÀÇÇÏ°Ô Áõ°¡µÇ´Â °ÍÀ¸·Î
¾Ë·ÁÁ³´Ù53). µû¶ó¼­ º¸Åë ü°ÝÀÇ ¼ºÀÎ ½ÉÁ¤Áö ȯÀÚ¿¡°Ô °¡½¿¾Ð¹ÚÀÇ ±íÀÌ´Â ¾à 5cm·Î ½ÃÇàÇÒ °ÍÀ»
±Ç°íÇÑ´Ù. ¾Ð¹Ú ±íÀÌ°¡ 6cm¸¦ ³Ñ´Â °æ¿ì¿¡´Â ÇÕº´ÁõÀÇ ¹ß»ýÀÌ Áõ°¡µÉ °¡´É¼ºÀÌ ³ô´Ù. ±×·¯³ª,
½ÇÁ¦ ½ÉÁ¤Áö ÇöÀå¿¡¼­ ÀϹÝÀÎ ¶Ç´Â ÀÇ·áÁ¦°øÀÚ°¡ ½ÃÇàÇÑ ½ÉÆó¼Ò»ý¼úÀÇ 40% Á¤µµ¿¡¼­´Â °¡½¿¾Ð¹Ú
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Ç÷¿ªÇÐÀû È¿°ú¸¦ ³ªÅ¸³¾ ¼ö ¾ø±â ¶§¹®¿¡ ¸ðµç ±¸Á¶ÀÚ´Â È¿°úÀûÀÎ °¡½¿¾Ð¹ÚÀ» ½ÃÇàÇÒ ¼ö ÀÖµµ·Ï
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¾ø´Ù49,50).
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ÇÑ´Ù. °ü»óµ¿¸Æ ¹× ³ú °ü·ù´Â °¡½¿¾Ð¹ÚÀÇ ¼Óµµ°¡ ºÐ´ç 130~150ȸ·Î »¡¶óÁú ¶§±îÁö »ó½ÂµÇ´Â
°ÍÀ¸·Î ¾Ë·ÁÁ® ÀÖÀ¸³ª, ¼Óµµ°¡ »¡¶óÁü¿¡ µû¶ó ½ÃÇàµÇ´Â °¡½¿¾Ð¹ÚÀÇ ±íÀÌ°¡ ¾è¾ÆÁö¸é¼­ ÀüüÀûÀÎ
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°¡½¿¾Ð¹ÚÀÇ ÁúÀÌ ³·¾ÆÁö´Â °ÍÀ¸·Î º¸°íµÇ°í ÀÖ´Ù54-56). µû¶ó¼­ °¡½¿¾Ð¹Ú ¼Óµµ´Â ºÐ´ç
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À̿ϽÃÅ°Áö ¾Ê´Â °æ¿ì°¡ ÀÚÁÖ ¹ß»ýµÇ°í ÀÖÀ¸¸ç, ÀÌ·¯ÇÑ »óȲÀº ±¸Á¶ÀÚ°¡ ÁöÃÆÀ» ¶§ ¸¹ÀÌ
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°ü»óµ¿¸Æ°ú ³úµ¿¸ÆÀ¸·Î °¡´Â Ç÷·ù¸¦ °¨¼Ò½ÃŲ´Ù38,57). ¿ÏÀüÇÑ °¡½¿ ÀÌ¿ÏÀº È¿°úÀûÀÎ
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5. °¡½¿¾Ð¹Ú Áß´ÜÀÇ ÃÖ¼ÒÈ­
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Á¤µµ°¡ Áö³ª¸é ¾Ð¹Ú ±íÀÌ°¡ ÁÙ¾îµç´Ù58,59). µÎ ¸í ÀÌ»óÀÇ ±¸Á¶ÀÚ°¡ ½ÉÆó¼Ò»ý¼úÀ» ÇÒ ¶§¿¡´Â
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Ç÷Èä, ÆóÁ»ó, °£ ¿­»ó, Áö¹æ»öÀüÁõ, Ç÷½É³¶¿°, ´ëµ¿¸Æ¿­»ó, ºñÀå ¼Õ»ó µîÀÌ ¹ß»ýÇÑ´Ù°í ¾Ë·ÁÁ³´Ù53).
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1) ÀϹÝÀÎ ±¸Á¶ÀÚ¿¡ ÀÇÇÑ ±âµµÀ¯Áö
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1) ÀÔ-ÀÔ ÀΰøÈ£Èí
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¶§ ȯÀÚÀÇ °¡½¿ÀÌ »ó½ÂµÇÁö ¾Ê´Â´Ù¸é ¸Ó¸®±â¿ïÀÓ-Åεé¾î¿Ã¸®±â¸¦ ´Ù½Ã Á¤È®ÇÏ°Ô ½ÃÇàÇÑ ´ÙÀ½¿¡
µÎ ¹ø° ÀΰøÈ£ÈíÀ» ½ÃÇàÇÑ´Ù.
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±×¸² 2-12. ÀÔ-ÀÔ ÀΰøÈ£Èí ¹æ¹ý
2) ÀÔ-º¸È£±â±¸(barrier device) ÀΰøÈ£Èí
±¸Á¶ÀÚ´Â ÀÔ-ÀÔ ÀΰøÈ£ÈíÀ» Á÷Á¢ ½ÃÇàÇϱ⠺¸´Ù´Â º¸È£±â±¸ »ç¿ëÀ» ¼±È£ÇÑ´Ù. ±×·¯³ª ÀÔ-ÀÔ
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3) ÀÔ-ÄÚ, ÀÔ-â(stoma, ½ºÅ丶) ÀΰøÈ£Èí
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ÇÑ´Ù79).
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ÀϹÝÀÎ Á¦¼¼µ¿ ÇÁ·Î±×·¥¿¡ ÀÇÇÏ¿© ¼³Ä¡µÈ ÀÚµ¿Á¦¼¼µ¿±â°¡ ½ÇÁ¦ ½ÉÁ¤Áö »óȲ¿¡¼­ ¸ðµÎ ÀÌ¿ëµÇ´Â
°ÍÀº ¾Æ´Ï´Ù. ½ÇÁ¦·Î ÇÑ ¿¬±¸°á°ú¿¡ ÀÇÇÏ¸é º´¿ø ¹Û ½ÉÁ¤Áö ¸ñ°ÝÀÚÀÇ 50% Á¤µµ¸¸ÀÌ ¸ñ°ÝÀÚ
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ÀÚµ¿Á¦¼¼µ¿±â´Â ±¸Á¶ÀÚ¿¡°Ô Á¦¼¼µ¿À» À¯µµÇÏ´Â ¹æ¹ý¿¡ µû¶ó ´ÙÀ½ÀÇ µÎ °¡Áö ÇüÅ·Π±¸ºÐµÈ´Ù.
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½º½º·Î ȯÀÚÀÇ ½ÉÀüµµ¸¦ ºÐ¼®ÇÏ°í, ¿¡³ÊÁö¸¦ ÃæÀüÇÏ¿© ±¸Á¶ÀÚ¿¡°Ô ¾Ë¸° µÚ¿¡ Á¦¼¼µ¿À»
ÀÚµ¿ÀûÀ¸·Î ½ÃÇàÇÑ´Ù. ¹Ý¸é¿¡ ¹ÝÀÚµ¿ Á¦¼¼µ¿±â(semi-automated)´Â ½ÉÀüµµ¸¦ ºÐ¼®ÇÏ¿© Á¦¼¼µ¿ÀÌ
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ÀϹÝÀÎÀ» ´ë»óÀ¸·Î ÇÑ ÀÚµ¿Á¦¼¼µ¿±â ±³À° ¹× È«º¸°¡ ºÎÁ·ÇÑ ¿ì¸®³ª¶ó¿¡¼­´Â ÇöÀç ¹ÝÀÚµ¿
Á¦¼¼µ¿±â°¡ ÁÖ·Î º¸±ÞµÇ°í ÀÖ´Ù.
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º»Ã¼¿¡ ÀÌ¹Ì ¿¬°áµÈ ÇüÅÂ(pre-connected)ÀÇ ÀÚµ¿Á¦¼¼µ¿±â°¡ ÁÖ·Î º¸±ÞµÇ¾î ¼³Ä¡µÇ°í ÀÖ´Ù. ÀÌ·±
ÇüÅÂÀÇ ÀÚµ¿Á¦¼¼µ¿±â´Â Àü¿øÀ» ÄÒ µÚ¿¡ ȯÀÚÀÇ °¡½¿¿¡ µÎ °³ÀÇ Æе带 ºÎÂøÇϱ⸸ ÇÏ¸é µÇ¹Ç·Î
ÀϹÝÀεµ ½±°Ô »ç¿ëÇÒ ¼ö ÀÖ´Ù. ÃÖ±Ù¿¡´Â ¸ñ°ÝÀÚ¿¡ ÀÇÇØ ½ÃÇàµÇ´Â °¡½¿¾Ð¹ÚÀÇ ¼Óµµ¿Í ÀΰøÈ£ÈíÀÇ
Áֱ⸦ À½¼ºÀ¸·Î ¾È³»ÇØ ÁÖ´Â ±â´ÉÀ» °®Ãá ÀÚµ¿Á¦¼¼µ¿±âµµ ¼³Ä¡µÇ°í ÀÖ´Ù.
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¿øÄ¢Àº °°´Ù. ½ÉÆó¼Ò»ý¼úÀ» ½ÃÇàÇÏ°í ÀÖ´Â µµÁß¿¡ ÀÚµ¿Á¦¼¼µ¿±â°¡ µµÂøÇϸé, ¸ÕÀú ÀÚµ¿Á¦¼¼µ¿±â¸¦
½ÉÆó¼Ò»ý¼ú¿¡ ¹æÇØ°¡ µÇÁö ¾Ê´Â À§Ä¡¿¡ ³õÀº ÈÄ¿¡ Àü¿ø¹öÆ°À» ´©¸¥´Ù. ȯÀÚÀÇ »óÀǸ¦ ¹þ±ä ÈÄ¿¡,
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¾Êµµ·Ï ÇÑ´Ù. Á¦¼¼µ¿ÀÌ ÇÊ¿äÇÑ °æ¿ì¶ó¸é ¡®Á¦¼¼µ¿ÀÌ ÇÊ¿äÇÕ´Ï´Ù¡¯¶ó´Â À½¼º ¶Ç´Â È­¸é ¸Þ½ÃÁö¿Í
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Á¦¼¼µ¿ ¹öÆ°À» ´©¸¥´Ù. Á¦¼¼µ¿À» ½ÃÇàÇÑ µÚ¿¡´Â Áöü ¾øÀÌ ½ÉÆó¼Ò»ý¼úÀ» ´Ù½Ã ½ÃÀÛÇØ¾ß ÇϹǷÎ,
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8¼¼ ¹Ì¸¸ÀÇ ¼Ò¾Æ¿¡¼­´Â ¼ºÀο¡ ºñÇØ ½ÉÁ¤ÁöÀÇ ¹ß»ýºóµµ°¡ ÀûÀ¸¸ç, ´Ù¾çÇÑ ¿øÀο¡ ÀÇÇØ
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ÇÊ¿äÇÏ´Ù109,110).
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µ¿ÀǸ¦ ¾òÀ» ¼ö ¾ø´Ù116,117). µû¶ó¼­ ½ÉÁ¤Áö ¶Ç´Â ½ÉÆó¼Ò»ý¼úÀ» ¿¬±¸ÇÒ ¶§¿¡ ´ë»óÀÚÀÇ µ¿ÀǸ¦ ¾òÁö
¾Ê¾Æµµ µÇ´Â ¿¹¿ÜÀÇ °æ¿ì¸¦ Çã¿ëÇϱ⵵ ÇÑ´Ù118). ´ë»óÀÚÀÇ µ¿ÀǸ¦ ¾òÁö ¾Ê´Â ½ÇÇè ÇÁ·ÎÅäÄÝÀº
¹Ýµå½Ã ¿¬±¸À±¸®½ÉÀÇÀ§¿øȸÀÇ ½ÂÀÎÀ» ¹Þ¾Æ¾ß ÇÑ´Ù. ´ë»óÀÚÀÇ µ¿ÀǸ¦ ¾òÁö ¾Ê¾Æµµ µÇ´Â ¿¹¿ÜÀÇ
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»ý¸íÀ» À§ÇùÇÏ´Â »óȲÀÌÁö¸¸ ¾Ë·ÁÁø Ä¡·á¹ýÀÌ ¾ÆÁ÷ ¿¬±¸ ÁßÀ̰ųª È¿°ú°¡ Áõ¸íµÇÁö ¾Ê¾Ò°Å³ª
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ÀÌ¿Ü¿¡ °ËÁõµÈ ´õ ÁÁÀº ¹æ¹ýÀÌ ¾ø´Â °æ¿ì
4. º´¿ø ¹Û ½ÉÁ¤Áö ȯÀÚ¿¡°Ô ½ÉÆó¼Ò»ý¼úÀ» ½ÃÀÛÇÏÁö ¾Ê°Å³ª Áß´ÜÇÏ´Â »óȲ
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ÇÏ´Â ´ÙÀ½ÀÇ ¸î °¡Áö ¿¹¿Ü»çÇ×ÀÌ ÀÖ´Ù119).
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º´¿ø ¹Û ½ÉÁ¤ÁöÀÇ ½ÉÆó¼Ò»ý¼ú ½Ãµµ±ÝÁö´Â ȯÀÚ³ª °¡Á· ¹× °ü·ÃµÈ ÀÇ·áÀεéÀÌ ¸íÈ®ÇÏ°Ô ¾Ë ¼ö
ÀÖµµ·Ï ±â¼úµÇ¾î¾ß Çϸç, ÇØ´ç Ç¥½ÄÀ» ÈÞ´ëÇÒ ¼ö ÀÖ¾î¾ß ÇÑ´Ù120). °¡¸Á ¾ø´Â ȯÀÚ¿¡ ´ëÇÑ
Çü½ÄÀûÀÎ ½ÉÆó¼Ò»ý¼úÀ̳ª Áö¿¬µÈ ½ÉÆó¼Ò»ý¼úÀ» ½ÃÇàÇÏ´Â °ÍÀº ºÎÀûÀýÇÏ´Ù. ÀÌ·± ÇàÀ§´Â ÀÇ·áÀÎÀÇ
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ÀÌ·ç¾îÁö°í ÀÖ´Ù°í º¸°íµÇ¾ú´Ù121,122).
2) º´¿ø ¹Û ½ÉÁ¤ÁöÀÇ »çÀüÀÇ»ç°áÁ¤
119°¡ Ã⵿ÇÑ º´¿ø ¹Û ½ÉÁ¤Áö ȯÀÚÀÇ »ó´ç¼ö´Â ¸»±âÁúȯÀ» °¡Áö°í ÀÖÀ¸¸ç, ÀϺδÂ
»çÀüÀÇ»ç°áÁ¤¼­¸¦ °¡Áö°í ÀÖ´Ù. »çÀüÀÇ»ç°áÁ¤¼­´Â 119°¡ ÇöÀå¿¡ µµÂøÇÏÀÚ¸¶ÀÚ º¸¿©ÁÖ¾î¾ß ÇÑ´Ù.
ÀϹÝÀûÀ¸·Î ½ÉÆó¼Ò»ý¼ú Æ÷±âÀÇ Å¸´ç¼ºÀÌ Àǽɵǰųª, ȯÀÚÀÇ ½ÉÀû º¯È­°¡ ÀÖÀ» °¡´É¼ºÀÌ ÀÖ´Â
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3) º´¿ø ¹Û ½ÉÁ¤ÁöÀÇ ½ÉÆó¼Ò»ý¼ú Áß´Ü
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°è¼ÓÇØ¾ß ÇÑ´Ù113).
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5. º´¿ø ³»¿¡¼­ ½ÉÆó¼Ò»ý¼úÀ» ½ÃÀÛÇÏÁö ¾Ê°Å³ª Áß´ÜÇÏ´Â »óȲ
1) º´¿ø ³» ½ÉÁ¤ÁöÀÇ ½ÉÆó¼Ò»ý¼ú ½Ãµµ ±ÝÁö
º´¿ø¿¡¼­ ½ÉÁ¤Áö°¡ ¹ß»ýÇߴµ¥, ½ÉÆó¼Ò»ý¼ú Æ÷±â¿¡ ´ëÇÑ »çÀü °áÁ¤ÀÌ ¾ø´Ù¸é ½ÉÆó¼Ò»ý¼úÀ»
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Áß´ÜÀÌ °¢±â ´Ù¸¥ Àã´ë·Î °áÁ¤µÇÁö ¾Êµµ·Ï ÇÏ´Â µ¥ µµ¿òÀÌ µÉ °ÍÀÌ´Ù 128).
68
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ÀÔÀεΠ±âµµ±â´Â ¹«ÀÇ½Ä »óųª ¹«¹ÝÀÀÀΠȯÀÚ¿¡°Ô ±ÇÀåµÈ´Ù. ÀÔÀεΠ±âµµ±â¸¦ »ðÀÔÇÒ ¶§ Çô°¡
ÇÏÀεηΠ¹Ð·Áµé¾î°¡ ±âµµÆó¼â¸¦ ÀÏÀ¸Å³ ¼ö ÀÖÀ¸¹Ç·Î ÁÖÀÇÇØ¾ß ÇÑ´Ù. ÀǽÄÀÌ Àִ ȯÀÚ¿¡¼­´Â ±¸
¿ªÁú¹Ý»ç¸¦ ÀÏÀ¸ÄÑ ±¸¿ªÁú, ±¸Åä ¶Ç´Â ¼º¹® ¿¬ÃàÀ» À¯¹ßÇÒ ¼ö ÀÖ´Ù. ÀÔÀεΠ±âµµ±â´Â ¿µ¾Æ¿ë, ¼Ò
¾Æ¿ë ±×¸®°í ¼ºÀοëÀÇ ´Ù¾çÇÑ Å©±â·Î ÁغñÇØ¾ß Çϸç, ÃæºÐÈ÷ ±³À°À» ¹ÞÀº »ç¶÷¸¸ÀÌ »ðÀÔÇØ¾ß ÇÑ
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3. ÄÚÀεΠ±âµµ±â
ÄÚÀεΠ±âµµ±â´Â ÀÔ ¹ú¸² Àå¾Ö, ¹°±â, ²Ë ´Ù¹® ÅÎ ¶Ç´Â ÅÎ-¾ó±¼ ¼Õ»ó ¶§¹®¿¡ ÀÔÀεΠ±âµµ±â »ð
ÀÔÀÌ ºÒ°¡´ÉÇÑ È¯ÀÚ¿¡°Ô »ç¿ëÇÒ ¼ö ÀÖ´Ù. µÎ°³°ñ ±âÀúºÎ °ñÀý µî ½ÉÇÑ µÎ°³ ¾È¸éºÎ ¼Õ»óÀÌ ÀǽÉ
µÇ´Â ȯÀÚ¿¡°Ô´Â Á¶½É½º·´°Ô »ç¿ëÇØ¾ß ÇÑ´Ù. ±íÀº ¹«ÀÇ½Ä »óÅ¿¡ ºüÁöÁö ¾ÊÀº ȯÀÚ´Â ÀÔÀεΠ±â
µµ±âº¸´Ù ÄÚÀεΠ±âµµ±â¸¦ Àß °ßµò´Ù. »ðÀÔÇÒ ¶§ ÄÚ Á¡¸·ÀÌ ¼Õ»óµÇ¾î ÃâÇ÷ÀÌ ÀϾ ¼ö ÀÖÀ¸¹Ç·Î
À±È°Á¦¸¦ ÃæºÐÈ÷ ¹Ù¸¥ ÈÄ »ðÀÔÇÑ´Ù.
4. ÈíÀԱⱸ
»ó±âµµ¿¡¼­ ¾×ü(ÇÇ, ħ, À§ ³»¿ë¹°)¸¦ Á¦°ÅÇÒ ¶§ ³»°æÀÌ Å©°í ´Ü´ÜÇÑ ÈíÀÔ±â(¾çÄ«¿ì¾î ÈíÀÔ±â
(Yankauer suction))¸¦ »ç¿ëÇÑ´Ù. ȯÀÚ°¡ ±¸¿ª¹Ý»ç°¡ ÀÖÀ¸¸é Àεθ¦ ÀÚ±ØÇÏ¿© ±¸Å並 À¯¹ß ÇÒ ¼ö ÀÖ
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À¸¹Ç·Î, ÈíÀԱ⠻ç¿ë¿¡ ÁÖÀÇÇØ¾ß ÇÑ´Ù.
5. Èĵ趽ºÅ© ±âµµ±â(laryngeal mask airway: LMA)
±× µ¿¾È Ŭ·¡½Ä Èĵ趽ºÅ© ±âµµ±â(classic LMA)°¡ ¸¹ÀÌ »ç¿ëµÇ¾úÁö¸¸, ¾î´À ¿¬±¸¿¡¼­µµ Èĵθ¶
½ºÅ© ±âµµ±â¿Í ±â°ü³»»ð°üÀÇ È¿À²¼ºÀ» Á÷Á¢ ºñ±³ÇÑ ¿¬±¸´Â ¾ø´Ù. 2¼¼´ë Èĵ趽ºÅ©´Â Ŭ·¡½Ä ÈĵÎ
¸¶½ºÅ© ±âµµ±âº¸´Ù ´õ ¼¾ ¹ÐÂø¾Ð·ÂÀ̳ª À§¾× ¹è¾× µîÀÇ ´õ ÁÁÀº ±â´ÉÀ» °¡Áö°í ÀÖÀ¸¹Ç·Î ÃÖ±Ùµé
¾î ÀÀ±Þ±âµµ °ü¸®¿¡ ¸¹ÀÌ »ç¿ëÇÏ°Ô µÇ¾ú´Ù65).
Èĵ趽ºÅ© ±âµµ±â¸¸À¸·Î´Â 100%ÀÇ »ðÀÔ°ú ȯ±â¸¦ º¸ÀåÇÒ ¼ö ¾ø±â ¶§¹®¿¡ ÀÀ±Þ±âµµÀ¯Áö¸¦ ÇÒ
¶§¿¡´Â ±âµµ °ü¸®¿¡ ´ëÇÑ ´ëü Àü·«À» ¼¼¿öµÎ´Â °ÍÀÌ Áß¿äÇÏ´Ù. ½ÃÇàÀÚµéÀº Èĵ趽ºÅ© ±âµµ±âÀÇ
»ç¿ë¿¡ ´ëÇÑ ÃæºÐÇÑ ÃʱⱳÀ°À» ¹Þ¾Æ¾ß ÇÏ°í, »ðÀÔ ¼º°ø·üÀ» ±Ø´ëÈ­ÇÏ°í ÇÕº´Áõ ¹ß»ýÀ» ÃÖ¼ÒÈ­ÇÏ
±â À§ÇØ Á¤±âÀûÀ¸·Î ½Ç½ÀÇØ¾ß ÇÑ´Ù.
6. i-gel
i-gel Ä¿ÇÁ´Â ¿­°¡¼Ò¼º ź¼ºÃ¼ Á©(thermoplastic elastomer gel)·Î ÀÌ·ç¾îÁ® À־ Ä¿ÇÁ¸¦ ºÎÇ®ÀÏ ÇÊ
¿ä°¡ ¾ø´Ù. i-gel Àº »ðÀÔÇϱⰡ ¸Å¿ì ½±°í »ðÀÔ¹æ¹ýÀ» ¹è¿ì±â ½±´Ù. ÈĵΠ¹ÐÂø¾Ð·ÂÀº 20-24cmH2O
Á¤µµ ÀÌ´Ù. ½¬¿î »ð°ü°ú »ó´çÇÑ ¹ÐÂø·ÂÀ¸·Î ±âµµ»ð°ü¿¡ °æÇèÀÌ ÀûÀº ±¸Á¶ÀÚ¿¡°Ô ¼±È£µÇ´Â Àåºñ°¡
µÉ ¼ö ÀÖ´Ù. °üÂû ¿¬±¸¿¡¼­ i-gelÀÇ »ð°ü ¼º°ø·üÀÌ º´¿ø ¹Û ½ÉÁ¤Áö¿¡¼­ ÀÀ±Þ±¸Á¶»ç°¡ »ç¿ëÇÑ °æ¿ì
93%(n=98), º´¿ø³» ½ÉÁ¤Áö¿¡¼­ ÀÇ»ç¿Í °£È£»ç°¡ »ç¿ëÇÑ °æ¿ì 99%(n=100)·Î º¸°í ÇÏ¿´´Ù66, 67).
7. ÈĵÎÆ©ºê(Laryngeal Tube)
ÈĵÎÆ©ºê´Â ½Äµµ-±â°ü ÄÞºñÆ©ºê¿Í À¯»çÇÏ°Ô »ý°åÁö¸¸ Á» ´õ ÀÛ°í °£´ÜÇÏ´Ù. ½Äµµ-±â°ü ÄÞºñÆ©ºê
¿Í´Â ´Þ¸® ÈĵÎÆ©ºê´Â ½Äµµ·Î¸¸ µé¾î°£´Ù. ÈĵÎÆ©ºê »ð°ü¹ýÀ» 2½Ã°£ ±³À°¹ÞÀº °£È£»ç°¡ º´¿ø ¹Û
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½ÉÁ¤Áö¿¡°Ô ½ÃÇàÇÑ ÈĵÎÆ©ºê »ð°ü ¹× ȯ±â¼º°øÀ²Àº 80%(n=30)¿´´Ù68). 5°³ÀÇ °üÂû ¿¬±¸¿¡¼­ º´¿ø
¹Û ½ÉÁ¤Áö¿¡¼­ ÀÏȸ¿ë ÈĵÎÆ©ºêÀÇ »ð°ü ¼º°øÀ²Àº 85-100%(n=92-347)·Î º¸°íµÇ¾ú´Ù69). ÀϺΠ¿¬±¸¿¡
¼­´Â ÈĵÎÆ©ºêÀÇ À§Ä¡ ¿À·ù¿Í °ø±â°¡ »õ´Â ¹®Á¦Á¡ÀÌ º¸°íµÇ¾ú´Ù70).
8. ±â°ü³»»ð°ü
±â°üÆ©ºê´Â ±âµµ¸¦ À¯ÁöÇÏ°í, ±âµµ ³» ºÐºñ¹°À» ÈíÀÔÇϸç, °í³óµµÀÇ »ê¼Ò°ø±ÞÀÌ °¡´ÉÇÏ°í, ÀϺÎ
¾à¹°ÀÇ Åõ¿© Åë·Î·Î »ç¿ëµÈ´Ù. ¶ÇÇÑ Æóȯ±â¸¦ À¯ÁöÇÏ°í, À§ ³»¿ë¹°À̳ª ÀÔ, ÀεÎÀÇ Ç÷¾×°ú Á¡¾×
ÈíÀÎÀ¸·ÎºÎÅÍ ±âµµ¸¦ º¸È£ÇÏ´Â ¿ªÇÒÀ» ÇÑ´Ù71). ¼Ò»ý¼ú Áß ¸¶ÁÖÄ¡´Â ´Ù¾çÇÑ È¯ÀÚµé°ú ȯ°æÁ¶°Ç¿¡µµ
ºÒ±¸ÇÏ°í ¹Ýº¹ÀûÀ¸·Î ¾ÈÀüÇÏ°í È¿°úÀûÀ¸·Î ±â°ü³»»ð°üÀ» ÇÏ·Á¸é »ó´çÇÑ ±â¼ú°ú °æÇèÀÌ ÇÊ¿äÇÏ´Ù.
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°¡´É¼º, ³ôÀº »ð°ü½ÇÆÐÀ², ¼÷·Ãµµ À¯ÁöÀÇ ¾î·Á¿òÀÌ ÀÖ´Ù18, 73-76). º´¿ø Àü ´Ü°è¿¡¼­ ±â°ü³»»ð°üÀ» ÇÏ
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°¡½¿¾Ð¹ÚÀ» ¸ØÃßÁö ¾ÊÀ¸·Á¸é Àڹ߼øȯ ȸº¹ ÀÌÈÄ·Î »ð°üÀ» ¹Ì·ê ¼ö ÀÖ´Ù. ±âµµ»ð°ü ½Ã °¡½¿¾Ð¹Ú
Áß´ÜÀº 5ÃÊ À̳»·Î ÇØ¾ß ÇÑ´Ù. »ð°üÀÌ ½ÇÆÐÇÏ¸é ¹é¹ëºê¸¶½ºÅ© ȯ±â¸¦ ±ÇÀåÇÑ´Ù9). ½Äµµ »ð°üÀ» È®
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ÀÇ º¯È­°¡ ¾ø´Ù. ¸ðºñÃ÷ 2Çü 2µµ ¹æ½ÇÂ÷´ÜÀº ¹æ½ÇÂ÷´Ü ºÎÀ§°¡ ¹æ½Ç°áÀý ¾Æ·¡ ºÎÀ§ÀÎ È÷½º-Ǫ¸£Å°
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Àº ¹æ½Ç°áÀý, È÷½º´Ù¹ß, ´Ù¹ß°¥·¡ ºÎÀ§¿¡¼­ ¹ß»ýÇÒ ¼ö ÀÖ´Ù84,85,89).
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ÀÖ¾î¾ß ÇÑ´Ù. ½É½Ç»ó¼º°ú ½É½Ç¼º ºó¸ÆÀÌ °¨º°ÀÌ µÇÁö ¾ÊÀ¸¸é ³ÐÀº QRSÆÄ ºó¸ÆÀº ½É½Ç¼º ºó¸ÆÀ¸
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1) Á¼Àº QRS ÆÄ ºó¸Æ
½É½Ç»ó¼º ºó¸ÆÀ¸·Î ³ªÅ¸³ª¸ç, QRS ÆÄ°¡ 0.12 ÃÊ À̳»ÀÌ´Ù. ºóµµ¼ø¿¡ µû¸¥ Á¼Àº QRSÆÄ ºó¸ÆÀÇ ¿ø
ÀÎÀº µ¿¼ººó¸Æ, ½É¹æ¼¼µ¿, ½É¹æÁ¶µ¿, ¹æ½Ç°áÀý ȸ±Í¼º(AV nodal reentry) ºó¸Æ, ºÎÀüµµ·Î Áß°³ ºó¸Æ
(accessory pathway mediated tachycardia), ½É¹æºó¸Æ(ÀÚµ¿¼º°ú ȸ±Í¼º Æ÷ÇÔ), ´Ù¼Ò¼º ½É¹æºó¸Æ, Á¢ÇÕºÎ
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2) ³ÐÀº QRS ÆÄ ºó¸Æ
QRS ÆÄ°¡ 0.12 ÃÊ ÀÌ»óÀÎ ºó¸ÆÀ» ¸»Çϸç, ºóµµ¼ø¿¡ µû¸¥ ³ÐÀº QRSÆÄ ºó¸ÆÀÇ ¿øÀÎÀº ½É½Çºó¸Æ°ú
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2. ºó¸ÆÀÇ Ãʱâ Æò°¡¿Í Ä¡·á
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¿ì Ç÷¿ªÇÐÀû ºÒ¾ÈÁ¤¼ºÀÇ Á¤µµ¸¦ Æò°¡ÇÏ°í, Ç÷¿ªÇÐÀû ºÒ¾ÈÁ¤¼ºÀÌ ºó¸Æ°ú °ü·ÃµÈ °ÍÀÎÁö È®ÀÎÇÑ´Ù.
¸¸¾à ȯÀÚ°¡ ½É¹Úµ¿¼ö¿Í ¿¬°üµÈ ½ÉÇ÷°ü°è ¼Õ»óÀÇ Â¡ÈÄ¿Í Áõ»ó(±Þ¼º ÀǽĻóÅ º¯È­, ÇãÇ÷¼º ÈäºÎ
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5. ³ÐÀº QRS ºó¸Æ
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126
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2) ±ÔÄ¢ÀûÀÎ ³ÐÀº QRS ºó¸ÆÀÇ Ä¡·á
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QRS ºó¸ÆÀÌ ½É½Ç»ó¼ººó¸ÆÀÇ º¯ÇüÀüµµ¿¡ ÀÇÇÑ °ÍÀ̶ó¸é ÀϽÃÀûÀ¸·Î ´À·ÁÁö°Å³ª µ¿¼º¸ÆÀ¸·Î Àüȯ
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12 mg, 12 mgÀ¸·Î 3ȸ »ç¿ëÇÒ ¼ö ÀÖ´Ù. ¸¶Âù°¡Áö·Î ºÐ·ù ¾È µÈ ³ÐÀº QRS ºó¸Æ¿¡¼­ ¾Æµ¥³ë½ÅÀÌ »ç
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127
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hydroxocobalaminÅõ¿©, sodium thiosulfate Åõ¿©°¡ ÃßõµÈ´Ù.
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½É±Ù¿¡µµ °­ÇÑ µ¶¼ºÀ» ³ªÅ¸³½´Ù. ÁßÃ߽Űæ°è Áõ»óÀ¸·Î ºÒ¾È, ÁøÀü, ÇöÈÆ, µÎÅë, ¼¶¸Á, °æ·Ã, È¥¼ö
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150
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À» Çâ»ó½ÃŲ´Ù.
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0.1mL/kg)ÀÌ´Ù. ¿¡Çdz×ÇÁ¸°ÀÇ Ãʱâ Åõ¿© ¿ë·®À¸·Î È¿°ú°¡ ¾øÀ¸¸é 3ºÐ¿¡¼­ 5ºÐ ³»¿¡ Ãß°¡·Î Åõ¿©ÇÏ
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¸¥ Ä«Å×Äݾƹΰú °°ÀÌ ¿¡Çdz×ÇÁ¸°Àº ¿°±â¼º ¿ë¾×¿¡¼­´Â ºÒÈ°¼ºÈ­ µÇ¹Ç·Î Áßź»ê³ªÆ®·ý°ú Àý´ë ¼¯
ÀÌ¸é ¾È µÈ´Ù. ¼øȯÀ» À¯ÁöÇÏ´Â ¸®µëÀ» °¡Áø ȯÀڵ鿡¼­´Â ¿¡Çdz×ÇÁ¸°ÀÌ ºó¸Æ°ú ³ÐÀº ¸Æ¾ÐÀÇ ¿ø
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¿µ¾ÆµéÀº Æ÷µµ´ç ¿ä±¸µµ°¡ ³ô°í ÃàÀûµÈ ´ç¿øÀÌ Àû´Ù. °á°úÀûÀ¸·Î ¼îÅ© »óÅÂ¿Í °°ÀÌ ¿¡³ÊÁö ¿ä
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