改訂版　ステップビヨンドレジデント　1　救急診療のキホン編　Part1

出版社： 羊土社
著者：
発行日： 2018-01-01
分野： 臨床医学：一般  >  救命/救急
ISBN： 9784758118217
電子書籍版： 2018-01-01 （第2版第1刷）
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救急の神髄はLOVE&RESPECT! 大人気シリーズ第1巻を全面改稿した待望の改訂版！救急診療でまず身につけたい技と知識を，おなじみの“ハヤシ節”と最新の世界標準のエビデンスでやさしく伝授します！

目次

  • 1章　気道を制するものは，救急を制す！
    　1．救急のABCはだてじゃない（急性喉頭蓋炎）
    　2．気管挿管は用意周到，粒粒辛苦， 百錬成鋼がものをいう（重症喘息発作）
    　3．気道緊急の基本RSI（迅速導入）はすごい？ コワい？（気道緊急）

    2章　Step Beyond BLS & ACLS
    　1．システムは進化する（心室細動）
    　2．心肺蘇生ガイドライン2015：BLSの進化と真価（心肺停止）
    　3．ACLS2015で薬剤はどうなった？（心肺停止）
    　4．なんでもかんでもお作法通り…はダメ！（心室細動）
    　5．蘇生後治療のエビデンスとは？ 合言葉は“Cool & Cath！”（心室細動）
    　6．よいCPR？ ECPR！（心肺停止）
    　7．蘇生処置をすべきか，せざるべきか，やめるべきか，それが問題だ（院外心肺停止）

    3章　ECG アップグレード
    　1．胸痛のない心筋梗塞を見逃すな（非典型心筋梗塞）
    　2．ST上昇は簡単そうで簡単じゃない！（良性早期再分極）
    　3．心外膜炎の症状って難しい！（心外膜炎）
    　4．見逃した日には打ち首獄門，墓石心電図 tombstone appearance（心筋梗塞）
    　5．あわてる左脚ブロックか，あわてない左脚ブロックか，それが問題だ（完全左脚ブロック）
    　6．トッピングは何にいたしますか？ ～V4R，V5Rの追加注文～（右室梗塞）
    　7．忘れられたaVR，運命を握るaVR（心筋梗塞）
    　8．aVRのST上昇mimicker（発作性上室性頻拍）
    　9．まだまだわれわれは発展途上！（急性心筋梗塞，WPW症候群＋心房細動）
    　10．本当に心臓なの？（逆流性食道炎，くも膜下出血）

    4章　救急室の困ったチャン
    　1．医療ミスを起こしやすい疾患・患者群を知るべし（怒る患者家族）
    　2．医者の指示に反して帰りたい患者さんAMAの場合（不安定狭心症）
    　3．診療録記載なしは，診察なしに等しい（初診時にはわからなかった虫垂炎）
    　4．コンサルトした対診医に問題がある場合（プロブレムコンサルタント）
    　5．恐い患者のトリアージ！ 怒ったら負け！（恐い患者）
    　6．安全対策のTips ～暴れる患者を診るときは～（暴れそうな患者）
    　7．恐い患者の医療面接（ソセゴン®中毒）
    　8．自分の意思で暴れているとは限らない（過活動型せん妄）
    　9．被害に遭ってしまったら…（暴れて噛みついた患者）

    5章　うそか誠か？ とかくこの世は，騙し騙され…
    　1．うそっこ痙攣に騙されるな（ヒステリー性痙攣）
    　2．うそっこ神経障害の見分け方（ヒステリー性運動麻痺）
    　3．せがまれるままに打っちゃダメ ～麻薬中毒～（ソセゴン®中毒）
    　4．行旅病人 ～詐病は臨床家の腕の見せ所～（行旅病人）
    　5．器質的疾患を見逃すな（精神症状で来た脳炎患者）

    6章　酒の一滴は血の一滴？～アルコール救急のpitfall〜
    　1．アルコールのpitfall ～合併症を見逃すな！〜（急性アルコール中毒）
    　2．アルコール離脱症候群（アルコール離脱症候群）
    　3．ERは絶好のアルコール問題のスクリーニング・教育の機会（アルコール依存）
    　4．特殊なアルコール（メタノール中毒）

    7章　　知って得する薬の御法度
    　1．あぁ，ゲップ！ 高齢者のポリファーマシーならぬメガファーマシー（ポリファーマシー）
    　2．こんな薬は御法度ってか！？ Beers Criteria（ポリファーマシー）
    　3．STOPP/START：薬を止めるか，はじめるか，それが問題だ（ポリファーマシー）
    　4．薬の食い合わせ（相互作用）に要注意（キノロン＋NSAIDs→禁忌）
    　5．NSAIDsは慎重に（胃薬＋NSAIDs→消化器症状）
    　6．キシロカインアレルギー！？ キシロカインもペニシリンもダメなの？
    　　　（自称，キシロカインアレルギー）
    　7．漢方薬，生薬も自然だからといってリスクフリーではない
    　　　（ワルファリン＋朝鮮人参→作用減弱）
    　8．妊婦と薬剤 ～胎児も薬を飲んでいることに注意～（妊婦→× アスピリン ×）
    　9．造影剤アレルギーでの造影剤の使い方（造影剤アレルギー）

    8章　高齢者虐待，児童虐待，DV～虐待のエキスパートになる～
    　1．高齢者にはLOVE & RESPECTを ～高齢者虐待を発見する～（高齢者虐待）
    　2．こらっ！ 弱いものいじめするなぁ！ 児童虐待 ～大事な手がかりを見逃すな～（児童虐待）
    　3．疑わなければ見抜けない児童虐待（児童虐待）
    　4．DVはしない，させない，許さない（DV，偽DV）
    　5．DVに対峙する ～逃げるタイミングや手段が一番大事～（DV）

    9章　ERでの悲しい出来事 Grieving in ER
    　1．蘇生現場を家族に見せるべきか，見せざるべきか…それが問題だ（心肺停止）
    　2．家族に死亡を告げるのはどうして難しいのか ～悲報の秘法（来院時心肺停止）

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本参考文献は電子書籍掲載内容を元にしております。

1章 気道を制するものは, 救急を制す !

P.17 掲載の参考文献
WEB1) 輪状甲状靭帯切開→縦皮膚切開 https://www.youtube.com/watch?V-chBsYizalik https://www.youtube.com/watch?V-dvWy9NXiZZl https://www.youtube.com/watch?V-f6BjEHVOxH
 
WEB2)車副犬甲状靭帯切開→横皮膚切開 https://www.youtube.com/watch?V-Kg14kdlycDE https://www.youtube.com/watch?V-16wodB2SOuc
 
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P.42 掲載の参考文献
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2章 Step Beyond BLS & ACLS

P.50 掲載の参考文献
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文献3) Solomon RS, et al : Effectiveness of rapid response teams on rates of in-hospital cardiopulmonary arrest and mortality : A systematic review and meta-analysis. J Hosp Med, 2016 [Epub ahead of print]
 
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WEB1) 日本蘇生協議会HP : http://jrc.umin.ac.jp/
 
WEB2) アメリカ心臓病学会 : https://circ.ahajournals.org/content/132/18_suppL2.toc
 
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WEB4) European resuscitation Council Guidelines 2015 : http://www.cprguidelines.eu/
 
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文献47) Reardon PM & Magee K : Epinephrine in out-of-hospital cardiac arrest : A critical review. World J Emerg Med, 4 : 85-91, 2013
 
文献48) Olasveengen TM, et al : Outcome when adrenaline (epinephrine) was actually given vs. not given-post hoc analysts of a randomized clinlcal trial. Resuscitation, 83 : 327-332, 2012
 
文献49) Hagihara A, et al : Prehospital epinephrine use and survival among patients with out-of-hospital cardiac arrest. JAMA, 307 : 1161-1168, 2012
 
文献50) Nolan JP & Perkins GD : Is there a role for adrenaline during cardiopulmonary resuscitation? Curr Opin Crit Care, 19 : 169-174, 2013
 
文献51) Lin S, et al : Adrenaline for out-of-hospital cardiac arrest resuscitation : a systematic review and meta-analysis of randomized controlled trials. Resuscitation, 85 : 732-740, 2014
 
文献52) Mentzelopoulos SD, et al : Vasopressin, steroids, and epinephrine and neurologically favorable survival after in-hospital cardiac arrest : a randomized clinical trial. JAMA, 310 : 270-279, 2013
 
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文献54) Goldberger ZD, et al : Duration of resuscitation efforts and survival after in-hospital cardiac arrest : an observational study. Lancet, 380 : 1473-1481, 2012
 
文献55) Jacobs IG, et al : Effect of adrenaline on survival in out-of-hospital cardiac arrest : A randomised double-blind placebo-controlled trial. Resuscitation, 82 : 1138-1143, 2011
 
文献56) Dumas F, et al : Is epinephrine during cardiac arrest associated with worse outcomes in resuscitated patients? J Am Coll Cardiol, 64 : 2360-2367, 2014
 
文献57) Nakahara S, et al : Association between timing of epinephrine administration and intact neurologic survival following out-of-hospital cardiac arrest in Japan : a population-based prospective observational study. Acad Emerg Med, 19 : 782-792, 2012
 
文献58) Goto Y, et al : Effects of prehospital epinephrine during out-of-hospital cardiac arrest with initial non-shockable rhythm : an observational cohort study. Crit Care, 17 : R188, 2013
 
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文献61) Stiell IG, et al : Advanced cardiac life support in out-of-hospital cardiac arrest. N Engl J Med, 351 : 647-656, 2004
 
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文献68) Driver BE, et al : Use of esmolol after failure of standard cardiopulmonary resuscitation to treat patients with refractory ventricular fibrillation. Resuscitation, 85 : 1337-1341, 2014
 
文献69) Landry A, et al : Does calcium administration during cardiopulmonary resuscitation improve survival for patients in cardiac arrest? Ann Emerg Med, 64 : 187-189, 2014
 
文献70) Laina et al : Amiodarone and Cardiac Arrest : Systematic review and Meta-Analysis. Int J Cardiol, 221 : 780-788, 2016
 
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文献72) Fernandez Castelao E, et al : Effects of team coordination during cardiopulmonary resuscitation : a systematic review of the literature. J Crit Care, 28 : 504-521, 2013
 
文献73) Panesar SS, et al : Errors in the management of cardiac arrests : an observational study of patient safety incidents in England. Resuscitation, 85 : 1759-1763, 2014
 
文献74) Kleinman ME, et al : Part 5 : Adult Basic Life Support and Cardiopulmonary Resuscitation Quality : 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation, 132 : S414-435, 2015
 
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文献75) Kudenchuk PJ, et al : Amiodarone, Lidocaine, or Placebo in Out-of-Hospital Cardiac Arrest. N Engl J Med, 2016
 
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文献79) Zafren K, et al : Wilderness Medical Society practice guidelines for the out-of-hospital evaluation and treatment of accidental hypothermia : 2014 update. Wilderness Environ Med, 25 (4 Suppl) : S66-85, 2014
 
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文献83) Gaspari R et al : Emergency Department Point-Of-Care Ultrasound in Out-Of-Hospital and in-ED Cardiac Arrest. Resuscitation, 109 : 33-39, 2016
 
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文献84) Hypothermia after Cardiac Arrest Study Group : Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. N Engl J Med, 346 : 549-556, 2002
 
文献85) Bernard SA, et al : Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia. N Engl J Med, 346 : 557-563, 2002
 
文献86) Nielsen N, et al : Targeted temperature management at 33℃ versus 36℃ after cardiac arrest. N Engl J Med, 369 : 2197-206, 2013
 
文献87) Fukuda T : Targeted temperature management for adult out-of-hospital cardiac arrest : current concepts and clinical applications. J Intensive Care, 4 : 30, 2016
 
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文献92) Camuglia AC, et al : Cardiac catheterization is associated with superior outcomes for survivors of out of hospital cardiac arrest : review and meta-analysis. Resuscitation, 85 : 1533-1540, 2014
 
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文献99) Janz DR,et al : Hyperoxia is associated with increased mortality in patients treated with mild therapeutic hypothermia after sudden cardiac arrest. Crit Care Med, 40 : 3135-3139, 2012
 
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文献102) Goto Y, et al : Neurological outcomes in patients transported to hospital without a prehospital return of spontaneous circulation after cardiac arrest. Crit Care, 17 : R274, 2013
 
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文献116) American College of Surgeons Committee on Trauma, et al : Withholding or Termination of Resuscitation in Pediatric Out-of-Hospital Traumatic Cardiopulmonary Arrest. Pediatrics,133 : e1104-1116,2014
 
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文献130) Kim HB, et al : Can serial focussed echocardiographic evaluation in life support (FEEL) predict resuscitation outcome or termination of resuscitation (TOR) -A pilot study. Resuscitation, 101 : 21-26, 2016
 

3章 ECG アップグレード

P.104 掲載の参考文献
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文献9) Huang, H. D. & Birnbaum, Y. : ST elevation : differentiation between ST elevation myocardial infarction and nonis chemic ST elevation. J Electrocardiol, 44 : 494.e1-494.e12, 2011
 
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文献15) Adler, A., et al. : What do we know about the "malignant form" of early repolarization? J Am Coll Cardiol, 62 : 863-868, 2013
 
文献16) Tikkanen, J. T., et al. : Early repolarization : electrocardiographic phenotypes associated with favorable long-term outcome. Circulation, 123 : 2666-2673, 2011
 
文献17) Walsh, J. A. 3rd, et al. : Natural history of the early repolarization pattern in a biracial cohort : CARDIA (Coronary Artery Risk Development in Young Adults) Study. J Am Coll Cardiol, 61 : 863-869, 2013
 
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文献19) Kawata, H., et al. : Prognostic significance of early repolarization in inferolateral leads in Brugada patients with documented ventricular fibrillation : A novel risk factor for Brugada syndrome with ventricular fibrillation. Heart Rhythm 10 : 1161-1168, 2013
 
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文献20) Smith SW, et al : T/QRS ratio best distinguishes ventricular aneurysm from anterior myocardial infarction. Am J Emerg Med, 23 : 279-287, 2005
 
文献21) Guerra F, et al : The ECG in the differential diagnosis between takotsubo cardiomyopathy and acute coronary syndrome. Expert Rev Cardiovasc Ther, 15 : 137-144, 2017
 
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文献22) Bainey KR & Bhatt DL : Acute Pericarditis : Appendicitis of the Heart? Mayo Clin Proc, 84 : 5-6, 2009
 
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文献25) Hooper AJ & Celenza A : A descriptive analysis of patients with an emergency department diagnosis of acute pericarditis. Emerg Med J, 30 : 1003-1008, 2013
 
文献26) Balta S, et al : Fragmented QRS in patients with acute myocardial infarction. Heart Lung, 42 : 448, 2013
 
文献27) Lorgis L, et al : Prognostic value of fragmented QRS on a 12-lead ECG in patients with acute myocardial infarction. Heart Lung, 42 : 326-331, 2013
 
文献28) Rossello X, et al : New electrocardiographic criteria to differentiate acute pericarditis and myocardial infarction. Am J Med, 127 : 233-239, 2014
 
文献29) Imazio M, et al : A Randomized Trial of Colchicine for Acute Pericarditis. N Engl J Med, 369 : 1522-1528, 2013
 
文献30) Snyder MJ, et al : Acute Pericarditis : Diagnosis and Management. Am Fam Physician, 89 : 553-560, 2014
 
WEB1) Amal Mattu's ECG Case of the Week : Feb 10, 2014 : http://www.youtube.com/watch?feature=player_embedded&v=IKPuaI0CmF8
 
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文献31) Sovari AA, et al : Hyperacute Twave, the early sign of myocardial infarction. Am J Emerg Med, 25 : 859.e1-859.e7, 2007
 
文献32) Somers MP, et al : The prominent T wave : Electrocardiographic differential diagnosis. Am J Emerg Med, 20 : 243-251, 2002
 
文献33) Genzlinger MA & Eberhardt M : Analyzing prominent T waves and ST-segment abnormalities in acute myocardial infarction. J Emerg Med, 43 : e811e85, 2012
 
文献34) Chaudhry M, et al : Tombstone ST Elevations : …Not Necessarily a Harbinger of Doom! Am J Med, 126 : e5-e6, 2013
 
文献35) Littmann L & Monroe MH : The "Spiked Helmet" sign : A New Electrocardiographic Marker of Critical Illness and High Risk of Death. Mayo Clinic Proceedings, 86 : 1245-1246, 2011
 
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文献38) Cai Q,etal : The left bundle-branch block puzzle in the 2013 ST-elevation myocardial infarction guideline : from falsely declaring emergency to denying reperfusion in a high-risk population. Are the Sgarbossa Criteria ready for prime time? Am Heart J, 166 : 409-413, 2013
 
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文献40) Jain S, et al : Utility of left bundle branch block as a diagnostic criterion for acute myocardial infarction. Am J Cardiol, 107 : 1111-1116, 2011
 
文献41) Mehta N, et al : Prevalence of acute myocardial infarction in patients with presumably new left bundle-branch block. J Electrocardiol, 45 : 361-367, 2012
 
文献42) Tabas JA, et al : Electrocardiographic criteria for detecting acute myocardial infarction in patients with left bundle branch block : a meta-analysis. Ann Emerg Med, 52 : 329-336, 2008
 
文献43) Smith SW, et al : Diagnosis of ST-elevation myocardial infarction in the presence of left bundle branch block with the ST-elevation to S-wave ratio in a modified Sgarbossa rule. Ann Emerg Med, 60 : 766-776, 2012
 
文献44) Gregg RE, et al : Combining Sgarbossa and Selvester ECG criteria to improve STEMI detection in the presence of LBBB. Comput Cardiol, 37 : 277-280, 2010
 
文献45) Gregg RE, et al : New ST-segment elevation myocardial infarction criteria for left bundle branch block based on QRS area. J Electrocardiol, 46 : 528-534, 2013
 
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文献46) Aqel RA, et al : Usefulness of three posterior chest leads for the detection of posterior wall acute myocardial infarction. Am J Cardiol, 103 : 159-164, 2009
 
文献47) Khan JN, et al : Posterior myocardial infarction : are we failing to diagnose this? Emerg Med J, 29 : 15-18, 2012
 
文献48) van Gorselen EO, et al : Posterior myocardial infarction : the dark side of the moon. Neth Heart J, 15 : 16-21, 2007
 
文献49) Waldo SW, et al : Reperfusion times and in-hospital outcomes among patients with an isolated posterior myocardial infarction : Insights from the National Cardiovascular Data Registry (NCDR). Am Heart J, 167 : 350-354, 2014
 
文献50) Wei EY, et al : Pitfalls in diagnosing ST elevation among patients with acute myocardial infarction. J Electrocardiol, 46 : 653-659, 2013
 
P.136 掲載の参考文献
文献51) Zalenski RJ, et al : Assessing the diagnostic value of an ECG containing leads V4R, V8, and V9 : the 15 lead ECG. Ann Emerg Med, 22 : 786-793,1993
 
文献52) Tragardh E, et al : How many ECG leads do we need? Cardiol Clin, 24 : 317-330, 2006
 
文献53) Khosoosi N, et al : Clinical manifestations of right ventricle involvement in inferior myocardial infarction. Caspian J Intern Med, 5 : 13-16, 2014
 
文献54) Barsheshet A, et al : Right precordal lead (V4R) ST-segment elevation is associated with worse prognosis in patients with acute anterior myocardial infarction. J Am Coll Cardiol, 58 : 548-549, 2011
 
文献55) Wellens HJ : The ECG in localizing the culprit lesion in acute inferior myocardial infarction : a plea for lead V4R? Eurospace, 11 : 1421-1422, 2009
 
文献56) Brady WJ, et al : A comparison of 12- and 15-lead ECGS in ED chest pain patients : impact on diagnosis, therapy, and disposition. Am J Emerg Med, 18 : 239-243, 2000
 
文献57) Wung SF, et al : Discriminating between right coronary artery and circumflex artery occlusion by using a noninvasive 18-lead electrocardiogram. Am J Critical Care, 16 : 63-71, 2007
 
文献58) Kim SS, et al : Clinical outcomes of acute myocardial infarction with occluded left circumflex artery. J Cardiol, 57 : 290-296, 2011
 
文献59) Kosuge M, et al : Posterior wall involvement attenuates predictive value of ST-segment elevation in leadV4R for right ventricular involvement in inferior acute myocardial infarction. J Cardiol, 54 : 386-393, 2009
 
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文献60) Kosuge M, et al : An early and simple predictor of severe left main and/or threevessel disease in patients with non-st-segment elevation acute coronary syndrome. Am J Cardiol, 107 : 495-500, 2011
 
文献61) Alherbish A, et al : The forgotten lead : Does aVR ST-deviation add insight into the outcomes of ST-elevation myocardial infarction patients? Am Heart J, 166 : 333-339, 2013
 
文献62) Kossaify A : ST segment elevation in aVR : Clinical significance in acute coronary syndrome. Clin Med Insights Case Rep, 6 : 41-45, 2013
 
文献63) Knotts RJ, et al : Diffuse ST depression with ST elevation in aVR : Is this pattern specific for global ischemia due to left main coronary artery disease? J Electrocardiology, 46 : 240-248, 2013
 
文献64) Gorgels AP : ST-elevation and non-ST-elevation acute coronary syndromes : Should the guidelines be changed? J Electrocardiol, 46 : 318-323, 2013
 
文献65) Yamaji S, et al : Prediction of acute left main coronary artery obstruction by 12-lead electrocardiography. ST segment elevation in lead aVR with less ST segment elevation in lead V (1). J Am Coll Cardiol, 38 : 1348-1354, 2001
 
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4章 救急室の困ったチャン

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5章 うそか誠か ? とかくこの世は, 騙し騙され…

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6章 酒の一滴は血の一滴 ? ～アルコール救急のpitfall～

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7章 知って得する薬の御法度

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8章 高齢者虐待, 児童虐待, DV ～虐待のエキスパートになる～

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WEB9) 内閣府男女共同参画局 : 配偶者からの暴力の根絶を目指して～配偶者暴力防止法のしくみ～ https://www.youtube.com/watch?v=ziWrMEq_VLs&t=53s
 
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WEB14) Safety Packing List (緊急避難バッグリスト) : https://www.womenshealth.gov/files/assets/docs/charts-checklists-guides/safetypacking-list.pdf
 
WEB15) 性虐待チェックリスト http://www.jaog.or.jp/sep2012/diagram/notes/check_2012.pdf
 

9章 ERでの悲しい出来事 Grieving in ER

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