심폐소생술 교육용 페이스 쉴드의 병원성 세균 차단 효과 = Effect of a CPR Educational Face Shield on Pathogenic Bacteria Protection

다국어 초록 (Multilingual Abstract)

Cross contamination between a patient and rescuer or CPR trainees can occur when performing mouth to mouth ventilationduring cardiopulmonary resuscitation (CPR). On the other hand, there has been a lack of research on the filtrationefficacy of face shields that are designed to protect people from cross-contamination. This study aims to secure the safetyof rescuers from communicable diseases in pre-hospital emergency settings and CPR trainees by verifying the protectiveeffects of face shields. The FA shield and CM Shield were used to verify the safety. The bacteria collected from filtersused by CPR trainees were incubated. These incubated bacteria were smeared onto the new filters, and were then blownout through the filters using a Bag Valve Mask (BVM) and the pathogens at the front and the back of the filters werechecked. While the FA shield was effective in preventing the transmission of pathogens, the CM shield did not prevent thetransmission of pathogens. Therefore, some of face shields that received national certification are ineffective in preventingcross-contamination. Accordingly, it is necessary to verify the safety of other face shields used domestically.

국문 초록 (Abstract)

심폐소생술에서 인공호흡은 환자와 구조자간 또는 심폐소생술 교육생들 간의 교차 감염 가능성이 높으나, 감염방지 도구인 페이스 쉴드(face shield)의 병원성 세균 여과 성능에 대한 연구 자료는 매우 부족하다. 따라서 본 연구는 인공호흡용 페이스 쉴드의 병원성 세균 여과 성능을 비교하여 전염성 질환으로부터 심폐소생술 교육생과 병원 전 구조자의 안전을 확보하기 위해 시행되었다. 대상 쉴드는 국내 심폐소생술 교육기관에서 일반적으로 사용되고 있는 FA shield와CM shield 2종을 임의로 선정하였다. 실험방법은 실제 교육생이 입으로 불어넣은 필터에서 채취한 세균을 대상 필터에각각 도말한 후 백밸브마스크(Bag valve mask, BVM)로 환기하여 필터의 앞면과 뒷면의 세균 검출 유무를 확인하였다.
그 결과 FA Shield는 병원성 세균 여과 성능이 있는 것으로 확인되었으나, CM Shield는 병원성 세균 여과 성능이 없는 것으로 나타났다. 결론적으로 안전한 인공호흡을 위해서는 국내에서 판매되는 페이스 쉴드의 전반적 성능 평가와 페이스 쉴드의 여과 성능 기준이 제시되어야 할 것으로 판단된다.

참고문헌 (Reference)

• 1 F. Ahmad, "Transmission of Salmonella via Mouth-to-Mouth Resuscitation" 335 (335): 787-788, 1990
• 2 M. Chalumeau, "Transmission of Panton-Valentine Leukocidin-Producing Staphylococcus Aureus to a Physician during Resuscitation of a Child" 41 (41): 29-30, 2005
• 3 M. J. Mannis, "Transmission of Herpes Simplex During CPR Training" 16 (16): 64-66, 1984
• 4 Y. S. Park, "Survey on Contamination Rate of CPR Manikin and Management Plan" Chungnam National University 2015
• 5 A. A. Hendricks, "Primary Herpes Simplex Infection following Mouth-to-Mouth Resuscitation" 243 (243): 257-258, 1980
• 6 M. E. Kleinman, "Part 5: Adult Basic Life Support and Cardiopulmonary Resuscitation Quality 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care" 132 (132): S414-S435, 2015
• 7 R. A. Berg, "Part 5: Adult Basic Life Support 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care" 122 (122): S685-S705, 2010
• 8 J. Soar, "Part 12: Education, Implementation, and Teams: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations" 81 : 288-330, 2010
• 9 E. J. Lavonas, "Part 10: Special Circumstances of Resuscitation:2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care" 132 (132): S501-S518, 2015
• 10 N. Figura, "Mouth-to-Mouth Resuscitation and Helicobacter Pylori Infection" 347 (347): 1342-, 1996
• 11 E. M. Kim, "Matrix Metalloproteinase-3 is Increased and Participates in Neuronal Apoptotic Signaling Downstream of Caspase-12 during Endoplasmic Reticulum Stress" 285 (285): 16444-16452, 2010
• 12 R. S. Finkelhor, "Herpes Simplex Infection following Cardiopulmonary Resuscitation" 243 (243): 650-, 1980
• 13 Australian Resuscitation Council, "Guideline 10.3.: Cross Infection Risks and Manikin Disinfection"
• 14 G. Sezonov, "Escherichia coli Physiology in Luria-Bertani Broth" 189 (189): 8746-8749, 2007
• 15 American Heart Association, "Equipment Decontamination Guidelines for CPR Training"
• 16 김현철, "Development of Broad-range and Specific 16S rRNA PCR for Use in Routine Diagnostic Clinical Microbiology" 한국생명과학회 24 (24): 361-369, 2014
• 17 Korean Center for Disease Control and Prevention, "2015 Annual Report on the Notified HIV/AIDS in Korea"