教育講演「Fast」 のコピー
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教育講演「Fast」 のコピー

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教育講演「Fast」 のコピー 教育講演「Fast」 のコピー Presentation Transcript

  • 2012.1.28 FAST12 1 29
  • Fa st12 1 29
  • 12 1 29
  • 12 1 29
  • 12 1 29
  • 2 " 3 " 195 " 17 " "12 1 29
  • 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#order12 1 29
  • ! AM10:00 ! BP149/97mmHg,!HR99/min,SpO2!96%(room!air)! CT#order PM2:30CT call12 1 29
  • ! ! 32/min), ! : ! SpO2!100%(O2!3l ! BP146/102mmHg,HR110/min! GCS:15 4mm/4mm, ! BT37.1 !12 1 29
  • CT12 1 29
  • MAP $ $ ICU $ 2ℓ,MAP4U BP90/50mmHgHR130/min FAST ! ! RBC 307 Hb10.3g/dl! MAP4 ! RBC 271 Hb!9.2g/dl12 1 29
  • MAP $ $ ICU $ 2ℓ,MAP4U BP90/50mmHgHR130/min FAST ! ! RBC 307 Hb10.3g/dl! MAP4 ! RBC 271 Hb!9.2g/dl12 1 29
  • FAST12 1 29
  • !(S3~4,S6~7)! b ! OPE !1h44min! 1950ml!12 1 29
  • 12 1 29
  • ICU,"22%" ," ,"61% 17%" ,(6% ,(7%( PTD $ Priority, ,( 33%( $ $ 26%( ,( ,( (EMSQ)5432 28%(12 1 29
  • 12 1 29
  • 12 1 29
  • Pit-Fall • • → CT12 1 29
  • Pit-Fall • • → CT PTD12 1 29
  • 12 1 29
  • 12 1 29
  • →12 1 29
  • → →12 1 29
  • Primary Survey12 1 29
  • Primary Survey12 1 29
  • Secondary Survey12 1 29
  • Secondary Survey12 1 29
  • Fa st12 1 29
  • 12 1 29
  • 80 DPL high sensitivity 1997~ FAST 250ml Free Fluid Morison e(extended)FAST:FAST+12 1 29
  • CT12 1 29
  • CT12 1 29
  • FAST Focused Assessment with Sonography for Trauma12 1 29
  • FAST Focused Assessment with Sonography for Trauma12 1 29
  • 出血は腹腔内のどこに溜まるか?12 1 29
  • 出血は腹腔内のどこに溜まるか? 胸腔 横隔膜 腹腔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) Douglas12 1 29
  • FAST12 1 29
  • 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
  • FAST Focused Assessment with Sonography for Trauma12 1 29
  • FAST12 1 29
  • JATEC12 1 29
  • (^_^;)12 1 29
  • 12 1 29
  • 12 1 29
  • 12 1 29