教育講演「Fast」 のコピー

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教育講演「Fast」 のコピー

  1. 1. 2012.1.28 FAST12 1 29
  2. 2. Fa st12 1 29
  3. 3. 12 1 29
  4. 4. 12 1 29
  5. 5. 12 1 29
  6. 6. 2 " 3 " 195 " 17 " "12 1 29
  7. 7. 62 # # (AM2:22) ! SpO2:97%! BP!149/97mmHg! ! JCS!I51, !4mm/4mm! ! !12 1 29
  8. 8. X"P, X"P order) 4~7 $ (AM4:00)12 1 29
  9. 9. ! AM10:00 ! BP149/97mmHg,!HR99/min,SpO2!96%(room!air)!12 1 29
  10. 10. ! AM10:00 ! BP149/97mmHg,!HR99/min,SpO2!96%(room!air)! CT#order12 1 29
  11. 11. ! AM10:00 ! BP149/97mmHg,!HR99/min,SpO2!96%(room!air)! CT#order PM2:30CT call12 1 29
  12. 12. ! ! 32/min), ! : ! SpO2!100%(O2!3l ! BP146/102mmHg,HR110/min! GCS:15 4mm/4mm, ! BT37.1 !12 1 29
  13. 13. CT12 1 29
  14. 14. MAP $ $ ICU $ 2ℓ,MAP4U BP90/50mmHgHR130/min FAST ! ! RBC 307 Hb10.3g/dl! MAP4 ! RBC 271 Hb!9.2g/dl12 1 29
  15. 15. MAP $ $ ICU $ 2ℓ,MAP4U BP90/50mmHgHR130/min FAST ! ! RBC 307 Hb10.3g/dl! MAP4 ! RBC 271 Hb!9.2g/dl12 1 29
  16. 16. FAST12 1 29
  17. 17. !(S3~4,S6~7)! b ! OPE !1h44min! 1950ml!12 1 29
  18. 18. 12 1 29
  19. 19. ICU,"22%" ," ,"61% 17%" ,(6% ,(7%( PTD $ Priority, ,( 33%( $ $ 26%( ,( ,( (EMSQ)5432 28%(12 1 29
  20. 20. 12 1 29
  21. 21. 12 1 29
  22. 22. Pit-Fall • • → CT12 1 29
  23. 23. Pit-Fall • • → CT PTD12 1 29
  24. 24. 12 1 29
  25. 25. 12 1 29
  26. 26. →12 1 29
  27. 27. → →12 1 29
  28. 28. Primary Survey12 1 29
  29. 29. Primary Survey12 1 29
  30. 30. Secondary Survey12 1 29
  31. 31. Secondary Survey12 1 29
  32. 32. Fa st12 1 29
  33. 33. 12 1 29
  34. 34. 80 DPL high sensitivity 1997~ FAST 250ml Free Fluid Morison e(extended)FAST:FAST+12 1 29
  35. 35. CT12 1 29
  36. 36. CT12 1 29
  37. 37. FAST Focused Assessment with Sonography for Trauma12 1 29
  38. 38. FAST Focused Assessment with Sonography for Trauma12 1 29
  39. 39. 出血は腹腔内のどこに溜まるか?12 1 29
  40. 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. 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. 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. 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. 44. FAST Focused Assessment with Sonography for Trauma (1) (2)Morison (3) + (4) Douglas12 1 29
  45. 45. FAST12 1 29
  46. 46. 12 1 29
  47. 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. 48. FAST Focused Assessment with Sonography for Trauma12 1 29
  49. 49. FAST12 1 29
  50. 50. JATEC12 1 29
  51. 51. (^_^;)12 1 29
  52. 52. 12 1 29
  53. 53. 12 1 29
  54. 54. 12 1 29

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