1.

その他

その他
太田, 圭亮 ; Ohta, Keisuke
出版情報: 博士学位論文要旨 論文内容の要旨および論文審査結果の要旨/金沢大学大学院医学研究科.  平成12年7月  2000-07-01.  金沢大学
URL: http://hdl.handle.net/2297/15571
概要: 取得学位 : 博士(医学), 学位授与番号 : 医博甲第1426号,学位授与年月日:平成12年3月31日,学位授与年:2000
2.

論文

論文
Takei, Yutaka ; Inaba, Hideo ; Yachida, Takahiro ; Enami, Miki ; Goto, Yoshikazu ; Ohta, Keisuke
出版情報: Resuscitation.  81  pp.1492-1498,  2010-11-01.  Elsevier
URL: http://hdl.handle.net/2297/30223
概要: Review: The interval between collapse and emergency call influences the prognosis of out-of-hospital cardiac arrest (OHCA). To reduce the interval, it is essential to identify the causes of delay. Methods: Basal data were collected prospectively by fire departments from 3746 OHCAs witnessed or recognised by citizens and in which resuscitation was attempted by emergency medical technicians (EMTs) between 1 April 2003 and 31 March 2008. EMTs identified the reasons for call delay by interview. Results: The delay, defined as an interval exceeding 2 min (median value), was less frequent in the urban region, public places and for witnessed OHCAs. Delay was more frequent in care facilities and for elderly patients and OHCAs with longer response times. Multiple logistic regression analysis indicated that urban regions, care facilities and arrest witnesses are independent factors associated with delay. The ratio of correctable causes (human factors) was high at care facilities and at home, compared with other places. Calling others was a major reason for delay in all places. Performing cardiopulmonary resuscitation (CPR) and other treatments was another major reason at care facilities. Large delay, defined as an interval exceeding 5 min (upper-quartile value), was an independent factor associated with a low 1-year survival rate. Conclusion: The incidence of correctable causes of delay is high in the community. Correction of emergency call manuals in care facilities and public relation efforts to facilitate an early emergency call may be necessary. Basic life support (BLS) education should be modified to minimise delays related to making an emergency call. © 2010 Elsevier Ireland Ltd. 続きを見る
3.

論文

論文
Takei, Yutaka ; Enami, Miki ; Yachida, Takahiro ; Ohta, Keisuke ; Inaba, Hideo
出版情報: Journal of Anesthesia.  24  pp.715-726,  2010-10-01.  日本麻酔学会 = Japan Society of Anesthesiology / Springer Verlag (Germany)
URL: http://hdl.handle.net/2297/30224
概要: PURPOSE: It is not clear whether advanced airway management (AAM) with an endotracheal tube (ET) by paramedics may improve the outcome of out-of-hospital cardiac arrest (OHCA) compared with the use of a bag-valve-mask device (BVMD) and other AAM devices. METHODS: We analyzed 2,586 adult cases of OHCA without administration of adrenaline, witnessed or recognized by citizens in subjects transported to hospital by paramedics between 1 July 2004 and 31 March 2008 in Ishikawa, Japan, to determine whether AAM with an ET used under limited indication criteria may improve the outcome of OHCA. RESULTS: The airway was managed with an ET in 263 cases, other AAM devices in 660 cases, and a BVMD in 1,539 cases. The AAM failed or was discontinued in 124 cases, which were excluded from the analysis. The incidence of sustained return of spontaneous circulation (ROSC) was significantly higher in cases of AAM with an ET (30%) than in AAM with other devices (20.2%) and in the standard procedure with a BVMD (21.3%). The AAM with an ET did not significantly affect 1-year survival. Multiple regression analysis indicated that tracheal intubation (odds ratio = 1.503, 95% confidence interval 1.081-2078), but not patient management by paramedics qualified for ET use, was an independent factor associated with sustained ROSC. CONCLUSION: When subjects with difficult airway are excluded, tracheal intubation according to the limited indication criteria and well-organized protocol in Japan may improve the short-term outcome of OHCA of noncardiac origin. A large prospective study is needed to determine the general effects of tracheal intubation on the long-term outcome of OHCA with disturbed ventilation. 続きを見る
4.

論文

論文
Enami, Miki ; Takei, Yutaka ; Inaba, Hideo ; Yachida, Takahiro ; Ohta, Keisuke ; Maeda, Testuo ; Goto, Yoshikazu
出版情報: Resuscitation.  82  pp.577-583,  2011-05-01.  Elsevier
URL: http://hdl.handle.net/2297/30222
概要: Purpose of study: To determine the effects of ageing and training experience on attitude towards performing basic life support (BLS). Methods: We gave a questionnaire to attendants of the courses for BLS or safe driving in authorised driving schools. The questionnaire included questions about participants' backgrounds. The questionnaire explored the participant's willingness to perform BLS in four hypothetical scenarios related to early emergency call, cardiopulmonary resuscitation (CPR) under their own initiative, telephone-assisted compression-only CPR and use of an automated external defibrillator (AED), respectively. Results: There were significant differences in gender, occupation, residential area, experience of BLS training, and knowledge of AED use among the young (17-29. y, N=6122), middle-aged (30-59. y, N=827) and elderly (>59. y, N=15,743) groups. In all four scenarios, the proportion of respondents willing to perform BLS was lowest in the elderly group. More respondents in the elderly group were willing to follow the telephone-assisted instruction rather than performing CPR under their own initiative. Multiple logistic regression analysis confirmed ageing as an independent factor related to negative attitude in all scenarios. Gender, occupation, resident area, experience with BLS training and knowledge about AED use were other independent factors. Prior BLS training did not increase willingness to make an emergency call. Conclusion: The aged population has a more negative attitude towards performing BLS. BLS training should be modified to help the elderly gain confidence with the essential elements of BLS, including making early emergency calls. © 2011 Elsevier Ireland Ltd. 続きを見る
5.

論文

論文
Enami, Miki ; Takei, Yutaka ; Goto, Yoshikazu ; Ohta, Keisuke ; Inaba, Hideo
出版情報: Resuscitation.  81  pp.562-567,  2010-05-01.  Elsevier
URL: http://hdl.handle.net/2297/30225
概要: Background: There is no study regarding the influence of cardiopulmonary resuscitation (CPR) guideline renewal on citizen's attitude towards all basic life support (BLS) actions. Methods and results: We conducted a questionnaire survey to new driver licence applicants who participated in the BLS course at driving schools either before (January 2007 to April 2007) or after (October 2007 to April 2008) the revision of the textbook. Upon completion of the course, participants were given a questionnaire concerning willingness to participate in CPR, early emergency call, telephone-assisted chest compression and use of an automated external defibrillator (AED). After the revision, the proportions of positive respondents to use of AED as well as to all the four scenarios significantly increased from 2331/3564 to 3693/5156 (odds ratio (OR)=1.34) and from 1889/3443 to 3028/5126 (OR=1.18), respectively. However, the new guideline slightly but significantly augmented the unwillingness to make an early call (236/3568 vs. 416/5283, OR = 0.83). Approximately 95% of respondents were willing to follow the telephone-assisted instruction of chest compression, while approximately 85% were eager to perform CPR on their own initiative. Multiple logistic regression analysis confirmed the results of mono-variate analysis, and identified previous CPR training, sex, rural area and student as other significant factors relating to attitude. Conclusions: Future guidelines should emphasise the significance and benefit of early call in relation to telephone-assisted instruction of CPR or chest compression. The course instructors should be aware of the backgrounds of participants as to how this may relate to their willingness to participate. © 2010 Elsevier Ireland Ltd. 続きを見る
6.

論文

論文
Sakai, Kenji ; Ono, Kenjiro ; Ohta, Keisuke ; Yamada, Masahito
出版情報: Internal Medicine.  49  pp.1261-1262,  2010-01-01.  Japanese Society of Internal Medicine = 日本内科学会
URL: http://hdl.handle.net/2297/24814
概要: 金沢大学附属病院神経内科