教育講演「Fast」のコピー

•

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Hirohisa Shimizu

Education

62 #
#
(AM2:22)

!
SpO2:97%!
BP!149/97mmHg!
!
JCS!I51, !4mm/4mm! !
!

12 1 29

X"P, X"P order)

4~7 $
(AM4:00)

12 1 29

!
AM10:00 !
BP149/97mmHg,!HR99/min,SpO2!96%(room!air)!

12 1 29

!
AM10:00 !
BP149/97mmHg,!HR99/min,SpO2!96%(room!air)!

CT#order

12 1 29

!
AM10:00 !
BP149/97mmHg,!HR99/min,SpO2!96%(room!air)!

CT#order
PM2:30'CT '
'
call

12 1 29

!
!
32/min), !
: !
SpO2!100%(O2!3l !
BP146/102mmHg,HR110/min!
GCS:15 4mm/4mm, !
BT37.1 !

12 1 29

MAP $
$
ICU $
2ℓ,MAP'4U '
BP90/50mmHg'HR130/min'
FAST
!
!
RBC 307 Hb10.3g/dl!
MAP4 !
RBC 271 Hb!9.2g/dl

12 1 29

!(S3~4,S6~7)!
b

!
OPE !1h44min!
1950ml!

12 1 29

ICU,"22%"

," ,"61%
17%"

,(6%
,(7%(

PTD $ Priority, ,(
33%(
$
$ 26%(
,(

,(
(EMSQ)5432 28%(

12 1 29

80 DPL
high sensitivity

1997~ FAST
250ml Free Fluid
Morison

e(extended)FAST:FAST+

12 1 29

FAST
Focused Assessment with Sonography for Trauma

12 1 29

出血は腹腔内のどこに溜まるか？

胸腔

横隔膜
生理的湾曲

Ｌ３：最高点

腹腔

12 1 29

出血は腹腔内のどこに溜まるか？
脊椎

胸腔

横隔膜
生理的湾曲

腹腔内出血は　　こＬ３：最高点
の3点に溜まる

腹腔

12 1 29

出血は腹腔内のどこに溜まるか？
FASTではさ
らに・・・脊椎
・心嚢液
・大量血胸
胸腔

横隔膜
生理的湾曲

腹腔内出血は　　こＬ３：最高点
の3点に溜まる

腹腔

12 1 29

FAST
Focused Assessment with Sonography for Trauma

(1)
(2)Morison
(3) +
(4) Douglas
12 1 29

eFAST

(Sliding Lung sign ) (Sliding Lung sign−)
98.1%, 99.2%
(Acad Emerg Med 2005;12:844-9.
J Trauma 2004;57:288-95)
12 1 29

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教育講演「Fast」のコピー

1. 2012.1.28 FAST 12 1 29

2. Fa st 12 1 29

3. 12 1 29

4. 12 1 29

5. 12 1 29

6. 2 " 3 " 195 " 17 " " 12 1 29

7. 62 # # (AM2:22) ! SpO2:97%! BP!149/97mmHg! ! JCS!I51, !4mm/4mm! ! ! 12 1 29

8. X"P, X"P order) 4~7 $ (AM4:00) 12 1 29

9. ! AM10:00 ! BP149/97mmHg,!HR99/min,SpO2!96%(room!air)! 12 1 29

10. ! AM10:00 ! BP149/97mmHg,!HR99/min,SpO2!96%(room!air)! CT#order 12 1 29

11. ! AM10:00 ! BP149/97mmHg,!HR99/min,SpO2!96%(room!air)! CT#order PM2:30'CT ' ' call 12 1 29

12. ! ! 32/min), ! : ! SpO2!100%(O2!3l ! BP146/102mmHg,HR110/min! GCS:15 4mm/4mm, ! BT37.1 ! 12 1 29

13. CT 12 1 29

14. MAP $ $ ICU $ 2ℓ,MAP'4U ' BP90/50mmHg'HR130/min' FAST ! ! RBC 307 Hb10.3g/dl! MAP4 ! RBC 271 Hb!9.2g/dl 12 1 29

15. MAP $ $ ICU $ 2ℓ,MAP'4U ' BP90/50mmHg'HR130/min' FAST ! ! RBC 307 Hb10.3g/dl! MAP4 ! RBC 271 Hb!9.2g/dl 12 1 29

16. FAST 12 1 29

17. !(S3~4,S6~7)! b ! OPE !1h44min! 1950ml! 12 1 29

18. 12 1 29

19. ICU,"22%" ," ,"61% 17%" ,(6% ,(7%( PTD $ Priority, ,( 33%( $ $ 26%( ,( ,( (EMSQ)5432 28%( 12 1 29

20. 12 1 29

21. 12 1 29

22. Pit-Fall • • → CT 12 1 29

23. Pit-Fall • • → CT PTD 12 1 29

24. 12 1 29

25. 12 1 29

26. → 12 1 29

27. → → 12 1 29

28. Primary Survey 12 1 29

29. Primary Survey 12 1 29

30. Secondary Survey 12 1 29

31. Secondary Survey 12 1 29

32. Fa st 12 1 29

33. 12 1 29

34. 80 DPL high sensitivity 1997~ FAST 250ml Free Fluid Morison e(extended)FAST:FAST+ 12 1 29

35. CT 12 1 29

36. CT 12 1 29

37. FAST Focused Assessment with Sonography for Trauma 12 1 29

38. FAST Focused Assessment with Sonography for Trauma 12 1 29

39. 出血は腹腔内のどこに溜まるか？ 12 1 29

40. 出血は腹腔内のどこに溜まるか？胸腔横隔膜腹腔 12 1 29

41. 出血は腹腔内のどこに溜まるか？胸腔横隔膜生理的湾曲Ｌ３：最高点腹腔 12 1 29

42. 出血は腹腔内のどこに溜まるか？脊椎胸腔横隔膜生理的湾曲腹腔内出血は　　こＬ３：最高点の3点に溜まる腹腔 12 1 29

43. 出血は腹腔内のどこに溜まるか？ FASTではさらに・・・脊椎・心嚢液・大量血胸胸腔横隔膜生理的湾曲腹腔内出血は　　こＬ３：最高点の3点に溜まる腹腔 12 1 29

44. FAST Focused Assessment with Sonography for Trauma (1) (2)Morison (3) + (4) Douglas 12 1 29

45. FAST 12 1 29

46. 12 1 29

47. eFAST (Sliding Lung sign ) (Sliding Lung sign−) 98.1%, 99.2% (Acad Emerg Med 2005;12:844-9. J Trauma 2004;57:288-95) 12 1 29

48. FAST Focused Assessment with Sonography for Trauma 12 1 29

49. FAST 12 1 29

50. JATEC 12 1 29

51. (^_^;) 12 1 29

52. 12 1 29

53. 12 1 29

54. 12 1 29

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