
èª€å€æã§èšæ»äœéš
絶察ç¬ã£ãŠã¯ãããªãé°å²æ°ã®ã«ã³ãã¡ã¬ã³ã¹ã®æ¥ã«éã£ãŠ
åŠãªèª€å€æãã¿ã€ããã¹ããµãã ãã«æ£ãã°ããããŠããçœ ã
é ãã£ããçè·åž«ã®ç§ãžã®è©Šç·Žã®ããã«ããã®ã¯ãŒãã¯çªç¶ãã£ãŠããã
çè·åž«ã¯çœè¡£ã®å€©äœ¿ã§ã¯ãªãã
âæªæã®å€©äœ¿âã ã
ééããªãã
â絶察ã«ç¬ã£ãŠã¯ãããªãã«ã³ãã¡ã¬ã³ã¹âã®å§ãŸãå§ãŸãã
è¬åŒä»¥äžã«å³ããã€ãæ°äººã®äººæš©ãçãã«ãããã¡ãªICUã§ã®ã«ã³ãã¡ã¬ã³ã¹ãçãæãã³ãã¯
ãšã«ããååšæãæ¶ãããšã
ããã«æ€
åã«æ¬æ
ã§ãããã«ããã£ãŠãããšèšã£ãŠãéèšã§ã¯ãããŸããã
ãšã¯ãããã€ã³ã匷ããåæã®ãã€ã¡ããã¯å³é£ã§
ãã«ã³ãã¡ã¬ã³ã¹äžã®èªåã®SpO2ãåžžæèгå¯ããã
ãªã©ãšèš³ã®åãããªãããšãèšã£ãŠå·Šæäººå·®ãæã«ãã«ã¹ãªãã·ã¡ãŒã¿ãè£
çããŠãããã
å·Šé£ã®1ã€äžã®Néå
茩ã®åŸé éšã«ã¯çºèœç米颚ã®å¯çãã€ããŠãããã
ãã®æ®µéã§èŠèŠçã«èãé£ãçç¬å åã2ã€ãååšããŠããã®ã§ãã
éå§æéãŸã§ã²ããã錻ã®ä»ãæ ¹ãã°ã€ã°ã€ãšæŒããŠ
æ¹§ãäžããç¬ããæŒãæ®ºããŠããŸããã
æã¯æ¥ãã
ïŸïŸïœºïŸïœ¯ïœœïŸïœŒïœïœ±ïœ°ïœ°ïœ°ïœ°ïŒïŒïŒïŒïŒ
ã«ã³ãã¡ã¬ã³ã¹å®€ã®ãã¢ã¯ééã«äŒŽãã¯ã»ããšãµãŠã³ããæŸã€ã
ãã®ããšã倱念ããŠããç§ã¯
ãïŒïŒã
ãšåŽãåºãæªéé³ãçºããŠããŸãã
èªåã§åºããé³ã§ç¬ãããã«ãªããšããæ·åãèªåã«èª²ããšããããããããã
ãããªããšã¯ãæ§ããªãã«
çŸ
å¹ã®é§ããŸãšããåž«é·ãç»å Žã
éšå±ãç·åŒµæã§æºãããã
é
žçŽ æ¿åºŠãããã©ã€å±±é 䞊ã¿ã«èããªãã
ãã¯ãâŠç§ã¯å¿ããã®ãâŠã
ããã¯åž«é·ã®ã決ãŸãã®ç»å Žå°è©ãªã®ã§ãç¹ã«åé¡ã¯ãªããæ
£ããã
ãã€ã¡ããã(å°å£°)èŠãŠïŒã¿ãã£ãŠããã
ãã¿ããã
åŒåžãèãæ©ããªãããšãæå³ããæ¥ççšèªã
é »èãæå³ããè±èªãtachycardiaãã«ç±æ¥ããã
ããã€ã¡ããã®ãã«ã¹ãªãã·ã¡ãŒã¿è¡šç€ºã
ãSpO2ïŒ98% PRbpmïŒ132ã
ãæ£åžžå€ã
SpO2ïŒ96ã99%
PRïŒ60ã100å/å
ããããªãã§ãã¿ããéãã§ãããã
圌女ã®åž«é·æ§é »èããããããŠ
å¿
æ»ã«ç¬ããå ªããŠããç§ã®æããã€ã¡ããããã«ã¹ãªãã·ã¡ãŒã¿ã§æã¿ãŸãã
ãç§ã®ãã«ã¹ãªãã·ã¡ãŒã¿è¡šç€ºã
SpO2ïŒ93% PRbpmïŒ140
ãæ£åžžå€ã
SpO2ïŒ96ã99%
PRïŒ60ã100å/å
ãšãã§ããªãç°åžžå€ã
æ£è
ã ã£ããã¢ã©ãŒã 鳎ååŸ
ã£ãç¡ãã
ãããããŠãããæ»ãã§ããŸãã
è€æ°ã®æå³ã§æ»ãã§ããŸãã
é ã®äžã§é³Žãé¿ãã€ããžããªãŒã¢ã©ãŒã é³ã
ãããããã¯åºç« ã«éããªãã£ãã®ã§ãã
ãã®æ¥ã®è³æäœææ
åœã¯åŸé éšçºèœçç±³ã®Néå
茩ã
ãªããåž«é·ãå
¥ã£ãŠããŠããã®è³æé
åžã ã£ãçºã
äºåã«ç®ãéãããšãã§ããªãã£ãç§ã
ãããã圌ãäœãè³æã«ã¯
ã«ã³ãã¡ã¬ã³ã¹ã®å
容ãšã¯é¢ä¿ã®ãªãã®ãããªã€ã©ã¹ããã€ããŠããçº
çžåœæ
éã«ããŒãžãããããã°çæ»è¡éãŸã£ãããã
æãæã1æç®ãããããšâŠ

2021.1.30å ¬é
æ¯ã®è©±ã§ããªãã§ããªãã®ã«ããã
A4ã®çŽã«ç®äžæ¯ã®æ¯ã®å€©äœ¿ã
å 倩䜿ãªãã¬âæ¯å€©äœ¿âã
ãã€ããªãã°ãã£ãšäžå€®ãããã®ããŒãžã®
æåãšæåã®éãããã«å¿ã°ããŠããã®ã«
ãã®æ¥ã«éã£ãŠè¡šçŽã®çŽåŸã
ãã©ããªããã®
åºæŒåå¹ã§èšãã°ãµã䞻人å
¬ããžã·ã§ã³ã«ã¶ã£èŸŒãã§ãããµããããã
ãããâ絶察ã«ç¬ã£ãŠã¯ãããªãã«ã³ãã¡ã¬ã³ã¹âã§ããªãã§ããªããã°ããããããªã¯å€§å¥œãã§ãã
ã§ãããã誰ããªããšèšãããš
â絶察ã«ç¬ã£ãŠã¯ãããªãã«ã³ãã¡ã¬ã³ã¹âãªã®ã§ãã
ç¬ãããã®ãªãå«ç«ã«ãã¶ãããæªæ¥ãåŸ
ã£ãŠããŸããããã
åž«é·ã¯ãšãããš
ãããå®å
šã«ã¹ã«ãŒã
衚æ
ã¯ãŸãã«å·ãåã£ãéã
å
šãåããªãã
ããªããäžåæçããæ
æ²ãå
šãŠæãåã£ããšãã£ã圢çžã
ã¹ã«ãŒãã€ã€ã確å®ã«æãã®ãã«ããŒãžãäžãã£ãŠããããšã ãã¯ããããŸãã
ãããéæ«ã§ãããã®ããã«Néå
茩ã¯èšèãæŸã¡ãŸãã
Néå
茩ã2ããŒãžç®ã¯åããçãããžã®å¿ã°ããã®ãã¬ãŒã³ãã§ããããã§ã¯ä»ããã«ã³ãã¡ã¬ã³ã¹ãå§ããããšâæããŸãâãã
åž«é·ãâæããªããŠããâããå§ããŠãç§ã¯å¿ãããã ãããã
ã²ãšããèŠããããã§èŠãã¬æµãšæŠãç§ãããã«ã«ã³ãã¡ã¬ã³ã¹ã¯é²ãã§ãããŸãã
ç§éã¯ãµã€ãã¹ãªãºã ãå»ãã®ã«ã
ç§ã®å¿èã¯VFãåŠãã
å°ããªé»ãæåãçããçé¢ç®ã«æŽåããŠãã5ããŒãžç®ã
ãããé²è¡ããæªãããªãååããå°ãäžã
èµ€æåã®èæ¯ã¯èå
ã€ãšããŒããããŠå€ªåãããã«è¥å¹²åã倧ãããªã£ãŠããã

äœãã©ã倿ããã°ãããªããã§ããã
ãããšã§ããã
èš between æ» and æ»
ãã¯ãç§ãâèšâãšããæåã«ãªã£ãæ°åã§ãã


ICUã«ã¯æ»èšæ»ã·ãªã³ãžãã³ãã¿ã¯ãŒãåœããåã®ããã«ååšããŠããã®ã§
ä»åŸæ¥åäžâæ»èšæ»âãåºãŠããããã®ãªãåžžæèšæ»äœéšã ãšæãã€ã€ã
âæ»èšæ»âãç»å Žããªãæ¥ãªã©ãšãããã®ã¯ååšããªãã®ã§
ãã®ä»äºãããŠããéãæ°žé ã«âæ»èšæ»âã«åœãçãããªããã°ãªããªããšæ°ã¥ããŠããŸããŸããã
ç
é¢äžã®æ»èšæ»ã亡ãè
ã«ããŠããããšæ±ºæããçµæã
èªåã亡ãè
ã«ãããŸããã
ããçš®ãâ瀟äŒçèšæ»äœéšâã§ãã
éè·ããŠããNéå
èŒ©ã«æ»èšæ»ã®ççžã«ã€ããŠè©°ããã
ãèª€å€æã«ã¯æ°ä»ããŠãããã©ãé¢çœããããã®ãŸãŸã«ããŠããããã
ãšèªçœããŸããã
鮿ã§ãã