新版 急性中毒標準診療ガイド

出版社: へるす出版
著者:
発行日: 2023-07-14
分野: 臨床医学:一般  >  救命/救急
ISBN: 9784867190715
電子書籍版: 2023-07-14 (第1版第1刷)
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中毒診療もチーム医療・多職種連携が大切――との観点から、院内体制、各職種の役割、整備すべき資器材や設備について具体的に記載しました。
安全確保、ABCDE に沿ったprimary surveyを重視する考え方については前版を継承しつつ、現在の医療環境に合わせてモニタリング手法や検査方法などについてアップデートを行いました。
複数の解毒・拮抗薬が新たに承認され、わが国における解毒・拮抗薬の状況も大きく変化してきました。現在わが国で使用されている解毒・拮抗薬について、最新の知見をふまえ、標準的な使用方法を示しました。
わが国の臨床現場で主に用いられる5つのトキシドロームについて、イラストや表で示してわかりやすく解説しました。
簡易分析法について、キットの種類やそれぞれの特徴について詳述しました。
そのほか、中毒学教育の現状と展望、中毒診療と災害対応、症例報告の方法なども、今回の改訂で新たに取り上げました。

目次

  • 第I章 急性中毒初期診療総論
     1 急性中毒初期診療総論

    第II章 診療体制の構築
     1 チーム医療
     2 院内体制
     3 日本中毒情報センターの概要

    第III章 急性中毒の標準治療
     1 全身管理
     2 吸収阻害
     3 排泄促進
     4 解毒・拮抗薬

    第IV章 トキシドロームと検査・分析
     1 情報確認
     2 トキシドローム:toxidrome
     3 簡易尿中薬物検査キット
     4 実用的分析法

    第V章 教 育
     1 卒前教育
     2 卒後教育

    第VI章 中毒診療と災害対応
     1 現場での初期対応と安全確保
     2 C(化学)災害・テロ対応(薬剤含む)
     3 多数傷病者発生時のトリアージ
     4 中毒災害時の診療への備え

    第VII章 中毒情報と臨床研究
     1 日本中毒情報センター受信報告からみた疫学
     2 情報源
     3 症例報告・臨床研究の方法

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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。

第I章 急性中毒初期診療総論

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第II章 診療体制の構築

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第III章 急性中毒の標準治療

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第IV章 トキシドロームと検査・分析

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2) 坂本哲也監訳 : 中毒ハンドブック, メディカル・サイエンス・インターナショナル, 東京, 1999, pp177-8.
3) 大橋教良 : メタノール. 日本中毒情報センター編 : 症例で学ぶ中毒事故とその対策, 改定版, じほう, 東京, 2000, pp360-3.
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7) 広島大学医学部法医学講座編 : アルコール. 薬毒物の簡易検査法 ; 呈色反応を中心として, じほう, 東京, 2001, pp77.
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2) 吉岡敏治総監, 日本中毒情報センター編 : 冷却剤類. 発生状況からみた急性中毒初期対応のポイント ; 家庭用品編, へるす出版, 東京, 2016, pp322-6.
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2) 広島大学医学部法医学講座編 : 薬毒物の簡易検査法 ; 呈色反応を中心として, じほう, 東京, 2001, pp3-20.
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2) 広島大学医学部法医学講座編 : 薬毒物の簡易検査法 ; 呈色反応を中心として, じほう, 東京, 2001, pp21-30.
3) 日本薬学会編 : 衛生試験法・注解 2000, 金原出版, 東京, 2000, pp905-7.
4) 角田紀子 : ヒ素中毒と毒物鑑定. ファルマシア 1998 ; 34 : 1237-41.
5) 奈女良昭, 並木健二 : 最近の分析機器 3 (各論2) 蛍光X線分析装置. 中毒研究 2000 ; 13 : 91-7.
6) 鈴木修, 屋敷幹雄編 : 薬毒物分析実践ハンドブック ; クロマトグラフィーを中心として, じほう, 東京, 2002, pp557-66.
7) 小山和弘, 田中啓司, 坂本奈美子, 他 : 救命できた急性ヒ素中毒患者における血清および尿中総ヒ素濃度の動態. 中毒研究 2002 ; 15 : 167-70.
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9) 尾造由美子, 吉澤美枝, 村田厚夫, 他 : ラインシュ法を利用したエネルギー分散型蛍光X線分析装置によるヒ素の簡易定量法. 中毒研究 2004 ; 17 : 359-64.
10) 内藤裕史, 横手規子監訳 : 化学物質毒性ハンドブック ; 臨床編 II, 丸善, 東京, 2003, pp848-53.

第V章 教育

P.276 掲載の参考文献
1) 山川浩司 : 日本の薬学, 薬剤師教育の150年 ; 過去・現代・未来. 薬史学雑誌 2009 ; 44 : 88-94.
2) 望月正隆 : 薬学教育改革への薬学部の取組み. 薬史学雑誌 2010 ; 45 : 7-14.
3) 福本真理子 : 医学系教育機関における中毒学教育のあり方 ; 薬学部における中毒学教育. 中毒研究 2015 ; 28 : 7-12.
P.281 掲載の参考文献
1) 医療系大学間共用試験実施評価機構 (CATO) : 共用試験ガイドブック, 第18版 (令和2年), 2020.
2) 医療系大学間共用試験実施評価機構 (CATO) : 臨床実習開始前の「共用試験」, 第17版 (令和元年), 2019.
3) 厚生労働省医政局医事課 : 医師国家試験出題基準, 平成30年版.
4) 清田和也 : 中毒症候 ; トキシドローム. 中毒研究 2010 ; 23 : 54-7.
P.285 掲載の参考文献
1) 日本臨床検査学教育協議会ホームページ. https://nitirinkyo.jp/member_facilities
2) 臨床検査技師養成所指導ガイドラインについて (平成27年3月31 日) (医政発0331 第27号) (各都道府県知事あて厚生労働省医政局長通知). https://www.mhlw.go.jp/web/t_doc?dataId=00tc1394&dataType=1&pageNo=1
3) 厚生労働省医政局医事課 : 臨床検査技師国家試験出題基準 ; 令和7年版. https://www.mhlw.go.jp/content/10800000/001080954.pdf
4) 第65回臨床検査技師国家試験. https://www.mhlw.go.jp/seisakunitsuite/bunya/kenkou_iryou/iryou/topics/dl/tp190415-07a_01.pdf
5) 宮城博幸 : 毒物. 金井正光監修, 奥村伸生, 戸塚実, 本田孝行, 他編, 臨床検査法提要, 改訂第35版, 金原出版, 東京, 2020, pp705-19.
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1) 日本救急医療財団 : 救急救命士国家試験出題基準 ; 令和4年度版, 2022.
2) 救急救命士標準テキスト編集委員会編 : 救急救命士標準テキスト, 改訂第10版, へるす出版, 東京, 2020年.
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2) 日本中毒学会 : 日本中毒学会認定制度 (認定クリニカル・トキシコロジスト) とは. http://jsct-web.umin.jp/nintei_toxicologist/nintei/
3) 日本救急医学会監修, 日本外傷学会外傷初期診療ガイドライン改訂第6版編集委員会編 : 外傷初期診療ガイドラインJATEC, 改訂第6版, へるす出版, 東京, 2021.

第VI章 中毒診療と災害対応

P.302 掲載の参考文献
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2) U.S. Department of Health & Human Services : Chemical Hazards Emrgency Medical Management. https://www.chemm.nlm.hhs.gov
3) 奥村徹, 小井土雄一, 作田英成, 他編著 : NBCテロ・災害対処ポケットブック ; 核・放射線, 生物剤, 化学剤, 爆弾, 診断と治療社, 東京, 2013.
4) 井上貴昭 : 中毒事例に対する病院前診療. 中毒研究 2015 ; 28 : 374-82.
5) United States Department of Labor : General description and discussion of the levels of protection and protective gear. https://www.osha.gov/laws-regs/regulations/standardnumber/1910/1910.120AppB
6) Hick JL, Hanfling D, Burstein JL, et al : Protective equipment for health care facility decontamination personnel : Regulations, risks, and recommendations. Ann Emerg Med 2003 ; 42 : 370-80.
7) Occupational Safety and Health Administration, U.S. Department of Labor : Best Practices for Hospital-Based First Receivers of Victims from Mass Casualty Incidents Involving the Release of Hazardous Substances. 2005. https://www.osha.gov/sites/default/files/publications/osha3249.pdf
8) Chilcott RP, Larner J, Matar H eds : Primary Response Incident Scene Management (PRISM) : Guidance for the Operational Response to Chemical Incidents, Volume 1 : Strategic Guidance for Mass Casualty Disrobe and Decontamination. 2nd ed, Second Edition, Office of the Assistant Secretary for Preparedness and Response, Biomedical Advanced Research and Development Authority, 2018. https://www.medicalcountermeasures.gov/BARDA/Documents/PRISM%20Volume%201_Strategic%20Guidance%20Second%20Edition.pdf
9) 日本外傷学会, 日本救急医学会監修, 日本外傷学会外傷初期診療ガイドライン改訂第6版編集委員会編 : 外傷初期診療ガイドラインJATEC, 改訂第6版, へるす出版, 東京, 2021.
10) Sugita M, Higami S, Inoue S, et al : Characteristic of the acute drug intoxication conveyed by Kanagawa helicopter emergency medical service. Acute Med Surg 2017 ; 4 : 246-50.
11) 竹川良介, 大西光雄, 廣瀬智也, 他 : 吸入により二次被害を起こし得る化学物質を摂取した傷病者の搬送に関する, ドクターヘリ機内および救急車内におけるリスクアセスメント. 中毒研究 2016 ; 29 : 16-20.
12) 厚生労働科学研究事業「健康危機管理における効果的な医療体制のあり方に関する研究」班編 : 救急医療機関におけるCBRNEテロ対応標準初動マニュアル, 永井書店, 大阪, 2009.
P.309 掲載の参考文献
1) 向出貴裕, 稲寺秀邦 : わが国における化学物質管理の現状と課題. 産衛誌 2010 ; 52 : 157.
2) Henretig FM, Kirk MA, McKay CA Jr : Hazardous chemical emergencies and poisonings. N Engl J Med 2019 ; 380 : 1638-55.
3) Ciottone GR : Toxidrome recognition in chemical-weapons attacks. N Engl J Med 2018 ; 378 : 1611-20.
4) Okumura T, Takasu N, Ishimatsu S, et al : Report on 640 victims of the Tokyo subway sarin attack. Ann Emerg Med 1996 ; 28 : 129-35.
5) Pita R, Domingo J : The use of chemical weapons in the Syrian conflict. Toxics 2014 ; 2 : 391-402.
6) Nakagawa T, Tu AT : Murders with VX : Aum Shinrikyo in Japan and the assassination of Kim Jong-Nam in Malaysia. Forensic Toxicol 2018 ; 36 : 542-4.
7) NBCテロ対策会議幹事会 : NBCテロその他大量殺傷型テロ対処現地関係機関連携モデル (令和3年3月5日改訂2版). 2021.
8) National Institutes of Health : The Wireless Information System for Emergency Responders (WISER). https://webwiser.nlm.nih.gov/getHomeData
9) United States Environmental Protection Agency : Acute Exposure Guideline Levels for Airborne Chemicals. https://www.epa.gov/aegl
10) Chilcott RP, Larner J, Matar H eds : Primary Response Incident Scene Management (PRISM) : Guidance for the Operational Response to Chemical Incidents, Volume 1 : Strategic Guidance for Mass Casualty Disrobe and Decontamination. 2nd ed, Office of the Assistant Secretary for Preparedness and Response, Biomedical Advanced Research and Development Authority, 2018. https://www.medicalcountermeasures.gov/BARDA/Documents/PRISM%20Volume%201_Strategic%20Guidance%20Second%20Edition.pdf
11) 厚生労働省化学災害・テロ対策に関する検討会 : 化学災害・テロ時における医師・看護職員以外の現場対応者による解毒剤自動注射器の使用に関する報告書, 2019.
12) U.S. Department of Health & Human Services : Fourth generation agent : Medical management guidelines. Chemical Hazards EmergencyMedicalManagement (CHEMM). https://chemm.hhs.gov/index.html
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1) SALT mass casualty triage : Concept endorsed by the American College of Emergency Physicians, American College of Surgeons Committee on Trauma, American Trauma Society, National Association of EMS Physicians, National Disaster Life Support Education Consortium, and State and Territorial Injury Prevention Directors Association. Disaster Med Public Health Prep 2008 ; 2 : 245-6.
2) 日本中毒情報センター : 化学災害・テロ2次トリアージ早見表. https://www.j-poison-ic.jp/wordpress/wpcontent/uploads/secondtriage.pdf

第VII章 中毒情報と臨床研究

P.324 掲載の参考文献
1) 日本中毒情報センター : 受信報告. https://www.j-poison-ic.jp/jyushin/
2) 森博美 : 急性薬毒物中毒の診療における薬剤師による情報提供のポイント. 薬局 2015 ; 66 : 2861-6.