- The fatality rate of crushing accidents is 56%... Low CPR effect
- Difficult to take reasonable measures on-site due to fear -
Concerns about acute stress disorder by survivors and witnesses
- Consideration of artificial respiration training in addition to CPR
■ Broadcast: SBS Kim Tae-hyun's political show (FM 103.5 MHz 7:00 ~ 09:00)
■ Date: October 31, 2022 (Mon)
■ Host: Kim Tae-hyun, lawyer
■ Appearance: Cho Dong-chan, SBS medical reporter
▷ Kim Tae-hyun: Cho Dong-chan, SBS medical reporter.
hello.
▶ Dongchan Jo: Hello.
▷Kim Tae-hyun: The number of victims has now exceeded 150.
How should I view this medically?
▶Dongchan Jo: Yesterday was the first time I properly reported on this kind of crushing death.
▷Kim Taehyung: You must be.
Because there has never been an accident like this.
▶ Dongchan Jo: In our screen, many people really showed their consciousness and did CPR, but the death toll was too large.
So I wondered why so many victims were killed even when such young and healthy people did CPR, but the fatality rate of such a crushing accident is quite high.
So, although there are not many systematic studies on this, a recent paper shows the fatality rate at a whopping 56%.
Because it doesn't just stop the heart, this pressure presses on my heart and damages the blood vessels and airways corresponding to my upper body above.
So, it's not just a normal structure, a structure that only needs to return to the heart.
And if you go a little further, the internal organs are also ruptured.
However, when the internal organs are ruptured, it is difficult to live, no matter how good CPR and first aid treatment are.
▷Kim Tae-hyun: It's not just a matter of cardiac arrest.
▶ Dongchan Jo: And because the airways and blood vessels in the upper part are damaged, they say our golden time is 4 minutes.
no.
The golden time for CPR at the New York University lab may be less than 130 seconds.
So, 2 minutes is much longer...
▷Kim Tae-hyun: Why is that?
▶ Dongchan Cho: So, it is a more urgent situation that requires emergency measures much faster.
And since the pressure in the chest is already very high, it is difficult to resuscitate it with just CPR.
High-concentration oxygen and ventilator treatment should be administered at the same time, in fact, first.
So, I interviewed how to deal with this first aid, and how did I come to a conclusion?
It is meaningless to respond to first aid in a crushing accident.
Of course, it's not meaningless, but we should do our best anyway, but what we need to focus on is not how to deal with a crushing accident well, but rather how to avoid such an accident at all.
It's too difficult to deal with medically.
For example, we have to make sure the dam doesn't collapse, the dam doesn't collapse and the village is buried. When the dam collapses and the village is buried, how to survive there.
▷Kim Tae-hyun: Then, during the so-called golden time on site for 4 minutes.
Four minutes have passed, in fact.
Because there is no on-site access.
It may not have been easy even if you did CPR within 4 minutes, which is said to be the golden time.
▶Dongchan Jo: So, even though we calculated the fatality rate for those who did it normally within the golden hour and were transported to the hospital and received high-concentration oxygen and ventilator treatment, the fatality rate was 56%.
However, the argument of the authors of that paper is that we do not give up and do our best until the end because only 56% of the paper is available.
Before that, it seems that the fatality rate was so high that they gave up on it, medical staff from around the world.
It's about not giving up, but we didn't know that either.
I didn't know that the fatality rate for a person who had a cardiac arrest when they were crushed to death was this high.
▷Kim Tae-hyun: Still, doing CPR is more helpful than not doing it in the field, because it can increase survival in probability.
▶ Dongchan Cho: So, if you don't do CPR, there's no chance at all.
▷Kim Tae-hyun: Probability.
▶ Dongchan Jo: So, I have to.
If such an accident happens again, we have to do it, but we have to work harder to prevent such an accident from happening again.
▷Kim Tae-hyun: You must not have seen the on-site video.
Was it difficult to do CPR on time?
in your sight.
▶ Dongchan Cho: First of all, this is clearly described as a paper, in several papers.
It is difficult to make a rational decision at the site where such people are crowding and crushing accidents occur.
Because everyone is engulfed in fear.
And it's too difficult to rescue the people who are usually entangled there very reasonably and medically without harming their patients.
For example, there are many cases where people lose their lives while transporting the tangled person just to rescue them quickly.
If you forcibly tow it from the wrong posture, of course it puts a strain on your body.
So, in fact, it is described in so many cases that it is difficult for the emergency medical response team to really effectively use their medical capabilities with reasonable medical judgment.
So, let's make a reasonable medical response system in such a pressure accident and push death accident?
No, there is no such thing.
All the papers focus on disaster medical care to prevent such accidents, but if we can, let's do our best to save them.
However, the most important thing is not only CPR but also artificial respiration.
So, among those who are seriously ill right now, I think there are some people who are alive but have brain damage, if you listen to the medical staff.
At that time, in fact, the general public can only do CPR, but the rescue team arrives a little earlier, so the rescue team can perform artificial respiration anyway, so it's a bit disappointing.
Perhaps it was to save even one more life, which is a bit disappointing.
▷Kim Tae-hyun: There were people who were lightly injured or those who were sitting there after taking first aid next to the video.
They must have been given first aid and went home, but they suffered a crushing accident in their own way.
What symptoms do you complain about the most?
▶Dongchan Jo: These people have chest pain because they are pressed, and then there may be a feeling of swelling of the pressed parts of the face, difficulty breathing, and headaches.
You can think of it that way.
If the pain is better than yesterday, that's fine.
But whether the pain is chest pain, headache, or facial pain, it doesn't get better than yesterday, it's very uncomfortable and it gets worse than yesterday, then you need to go to the hospital right away.
Another thing to worry about is that this may be a trauma to the public, but it is a huge trauma for the bereaved family and those who were at the scene.
▷ Taehyun Kim: Are you talking about post-traumatic stress disorder?
▶ Dongchan Cho: It is not yet the time to discuss post-traumatic stress disorder.
That's over a month away.
It's acute stress syndrome.
You have a problem right now.
And if this is a long time, it will last more than 10 years.
There are people who have suffered for over 10 years during our Sealand disaster.
So, I have to do these parts too, but anyway, there are people who have suffered from traumatic syndrome and there are people who have suffered for more than 10 years.
So, you have to do these parts too, but anyway, I think it would be better for those who were there to ask for all the help they can get from those around them as much as possible.
▷Kim Tae-hyun: Those who were at the scene.
▶ Dongchan Jo: So, whether it be physically or mentally, I think it would be better to ask for everything that I can do, and for the family and acquaintances of those who were in the field to do everything we can from now on.
▷Kim Tae-hyun: The government said that it would provide psychological treatment for the victims' families, but what specific measures are there?
▶ Dongchan Cho: The response team was equipped with this kind of thing during the Sewol ferry disaster.
So now, the teachers in the Department of Mental Health have a team, and there are counselors there.
You can get help in that way.
▷Kim Tae-hyun: Those who went there and were there.
▶Dongchan Jo: Those who were at the scene and any people who are having a hard time related to this case.
▷Kim Tae-hyun: In fact, we saw it on video earlier, but not only the first responders but also the citizens at the scene did a lot of CPR.
As I said before, there are places where schools and workplaces teach this basically, so in order to be helpful in an emergency.
I got a message like that before.
I don't know how to do this, because I didn't learn it at school and I didn't learn it at work.
If something like this happens, I have to help the person next to me, so I got a text message asking me to tell you how to do CPR.
▶Dongchan Jo: Really, we are planning this separately, but to put it simply, most people usually have the heart on the left chest, but it doesn't press the heart itself.
The heart is the cage of the chest.
It's because you squeeze the closed space, the heart's space, and squeeze the heart with the pressure of that space.
▷Kim Tae-hyun: It's not about pressing the heart itself.
▶Dongchan Jo: Since we have ribs, no matter how much we want to press on our heart, no matter how hard we try, it will not be pressed.
So you have a reputation.
It can be confusing depending on the situation, i.e. which side it is on, but don't do it.
You have to put the base of your thumb on the side of your stomach and extend your arm so that the power is transmitted as it is.
However, it should be a little bit stronger.
You have to be really strong.
Actually, in such a situation, you have to do it really hard enough to make a crackling sound, and it's 100-120 reps, which is very difficult.
However, you have to think about it 100 times and do it.
However, when it comes to CPR, it is so difficult that even doctors will vomit.
So, in fact, it is very difficult to do it alone, but if we have to do it, we have to be strong and do it as fast as 100 reps.
Then, artificial respiration was more important in this situation, but breathing is a little difficult.
Because I have to make sure that the exhaled breath I enter goes completely into the patient, and for that, the airway must be maintained well.
So, to put it simply, the principle is to put the center of the body in the middle, cover the nose so that the wind does not leak to the other side, and then let it go in completely.
Of course, the tongue and other things can block it, so you have to organize those things well. So, in fact, artificial respiration is difficult for ordinary people to do, so we simplified this part to chest compression CPR, but in a situation like yesterday, artificial respiration is quite It is an important part, but because of that part, the school seems to be a little worried.
▷Kim Taehyun: Anyway, from what I heard, it's not a heart massage, it's saying that you need to use the palm of your right hand to break the ribs at the tip of the mediterranean region.
▶ Dongchan Cho: It shouldn't be broken, but it's strong, much stronger than we thought.
▷Kim Tae-hyun: With artificial respiration, the person who is being resuscitated covers the nose because the breath I breathe cannot escape.
▶Dongchan Jo: The basic principle is that the breath I breathe goes completely into the patient's airway.
▷Kim Tae-hyun: I see.
Today, with SBS medical reporter Cho Dong-chan, we listened to stories from yesterday's Itaewon disaster to how to do CPR or artificial respiration.
Reporter Dongchan Cho, thank you for coming out today.
▶ Dongchan Jo: Thank you.
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