日本の二次救急病院における救急医療 : 福岡市民病院での経験
| Autor: | Toshiro, Okuyama, Katsuyuki, Hirakawa, Masanobu, Kishikawa, Hideaki, Uchiyama, Hirofumi, Kawanaka, Daisuke, Korenaga, Kenji, Takenaka |
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| Jazyk: | angličtina |
| Rok vydání: | 2012 |
| Předmět: | |
| Zdroj: | 福岡醫學雜誌. 103(12):241-247 |
| ISSN: | 0016-254X |
| Popis: | Objective : The transition of emergency departments and the current situation of emergency medicine (EM) in Fukuoka City Hospital (FCH) were reviewed. Methods : The data concerning emergency medicine, such as the transition of intra-hospital emergency systems, were obtained from annual reports published in our hospital. Additionally, the data regarding educational programs for emergency room staff, the number of patients taken to the emergency room by ambulances, the activities regarding the Fukuoka Medical Rally (FMR) and the disaster relief team (DRT) were also reviewed and analyzed. Results : Departments of neurology, neurosurgery, emergency, and cardiology were opened sequentially, starting in 2003, with an establishment of facilities of an emergency room (ER), intensive care unit (ICU), stroke care unit (SCU), and coronary care unit (CCU). Regarding educational programs, lectures and demonstrations on basic and advanced life support techniques were given to all staff annually starting in 2004, and resident doctors completed rotations in the ER and the ICU for three months. FCH staff consistently obtained excellent results at the FMR. Ambulance crews attended lectures and received training on EM and intra-tracheal intubation. The numbers of patients taken by ambulance to FCH increased from 129 in 2002 to 2,316 in 2011. The DRT was dispatched to respond to disasters that occurred in Japan. Conclusions : As a secondary emergency hospital, FCH has developed a system to accept emergency patients. This project will contribute to the improvement of the EM system in the area. 日本の救急医療体制は,救急科専門医師数の不足,不十分な財源支援,社会的認知度の低さ等が指摘されており,搬送患者の病院収容時間の遅延,二次病院の救急医療からの離脱などが生じ停滞状況にあると考えられる.病床数200床の二次救急病院である当院では,地域の救急医療に貢献するために,2003年以来救急患者受け入れ体制の充実を図って来た.救急疾患に対応するために,神経内科,脳外科,循環器内科の各診療科を新設し,救急部,集中治療部,脳卒中集中治療室,冠動脈疾患集中治療室等の設備を拡充した.また,全医師,看護師に対する一次,二次心肺蘇生法講習会開催や,研修医に対する救急患者の診療,救急関連学会での発表,メデイカルラリー出場の指導,また全職員に向けた救急症例検討会の開催等の教育活動を行って来た.地域の救急隊員へは,メデイカルコントロール事後検証,救急ワークステーションでのドクターカー出動,救急疾患の講義,手術場での気管挿管実習などを行い,また災害救助活動としてJR福知山線事故や,東北太平洋沖地震被災地への出動,新型インフルエンザ流行時の全病院挙げての患者受け入れ等を行って来た.これら救急診療体制の充実により,救急搬送患者の受け入れが進み,その数は2002年の年間129名から,2011年には2,316名に増加した.二次病院において,救急診療体制の進展を図り,急性期重症患者に対する高度な治療を行うことにより,地域内の三次救急病院の負担を減らすこと,ひいては我が国の救急医療体制の維持,発展に寄与することが可能ではないかと考える. |
| Databáze: | OpenAIRE |
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