著者

富永 あや子 冨田 晴樹 石田 岳史

出版者

一般社団法人 日本プライマリ・ケア連合学会

雑誌

日本プライマリ・ケア連合学会誌 (ISSN:21852928)

巻号頁・発行日

vol.38, no.4, pp.383-385, 2015 (Released:2015-12-25)

参考文献数

6

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昨今モニタ・アラーム関連事故報道が後を絶たたず, 我々はこの原因をアラーム疲労と考えている. この問題を解決するために当院では多職種で構成したモニタ・アラーム・コントロールチーム (以下MACT) を発足し, 循環器内科病棟を対象に介入を行った. その効果を介入前後のアラーム数で評価し, 介入前1,263.4±453.4件あったアラームが介入後264.1±128.4件となったので報告する.

著者

石田 岳史 松田 昌三 小山 隆司 栗栖 茂 大藪 久則 柴田 正樹

出版者

Japanese Association for Acute Medicine

雑誌

日本救急医学会雑誌 (ISSN:0915924X)

巻号頁・発行日

vol.6, no.4, pp.362-365, 1995-08-15 (Released:2009-03-27)

参考文献数

12

被引用文献数

2 1

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We report an unusual case of a 63-year-old man supposedly bitten by a mamushi, who developed shock, bleeding diathesis and serious hematemesis at an early stage. About 10 minutes after the mamushi bite, he fell into shock transiently, and 2 hours later, continious bleeding from the bite wound and an injection site was observed. This platelet count decreased markedly to 1.3×104/mm3 resulting in serious hematemesis. Four hours after the bite, we injected Agkistrodon halys antivenin (6, 000U) with methylpredonisolone sodium succinate 500mg and the bleeding from the bite wound and hematemesis improved remarkably. Twelve hours after the bite, the platelet count had increased to 27.1×104/mm3, and the patient had recovered from the bleeding diathesis. Mamushi bites are sometimes complicated by DIC (disseminated intravascular coagulation) as a result of massive tissue necrosis, however, there was severe thrombocytopenia and bleeding diathesis in this case, even though the local swelling and muscle necrosis were not serious. It is very important to closely monitor patients after mamushi bites, and mamushi antivenin should be used early without hesitation when these complications are observed.

著者

石田 岳史 松田 昌三 小山 隆司 栗栖 茂 大藪 久則 柴田 正樹

出版者

Japanese Association for Acute Medicine

雑誌

日本救急医学会雑誌 (ISSN:0915924X)

巻号頁・発行日

vol.6, no.4, pp.362-365, 1995-08-10

被引用文献数

4 1

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We report an unusual case of a 63-year-old man supposedly bitten by a mamushi, who developed shock, bleeding diathesis and serious hematemesis at an early stage. About 10 minutes after the mamushi bite, he fell into shock transiently, and 2 hours later, continious bleeding from the bite wound and an injection site was observed. This platelet count decreased markedly to 1.3×10⁴/mm³ resulting in serious hematemesis. Four hours after the bite, we injected Agkistrodon halys antivenin (6, 000U) with methylpredonisolone sodium succinate 500mg and the bleeding from the bite wound and hematemesis improved remarkably. Twelve hours after the bite, the platelet count had increased to 27.1×10⁴/mm³, and the patient had recovered from the bleeding diathesis. Mamushi bites are sometimes complicated by DIC (disseminated intravascular coagulation) as a result of massive tissue necrosis, however, there was severe thrombocytopenia and bleeding diathesis in this case, even though the local swelling and muscle necrosis were not serious. It is very important to closely monitor patients after mamushi bites, and mamushi antivenin should be used early without hesitation when these complications are observed.