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February 13, 2010

挿管の練習しなかったのは褒めるべき

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「死亡」ホームレス男性まばたき 救急隊員が判断ミス

 さいたま市消防局は10日、冷たく硬直していたため救急隊員が「死亡」と判断したホームレスの男性(51)が、搬送先の警察署で検視を受ける直前に意識を取り戻したと発表した。男性はその後、病院に運ばれ、命に別条はないという。

 救急隊員はキャリア20年の救急隊長(52)と同12年で救急救命士の資格も持つ隊員(41)の2人。小池健一消防局長は「救急隊員が呼吸、脈拍の観察を怠り予断を持って判断した。あってはならないこと」と陳謝した。

 市や埼玉県警大宮西署によると、10日午前9時40分ごろ、さいたま市西区飯田新田のゲートボール場で「男性が布団にくるまり、意識はなく冷たくなっている」と110番があった。

 駆け付けた救急隊員2人は、男性が顔面蒼白で体も冷たく硬直していたため、呼吸や脈拍を十分確認せずに死亡と判断。男性は病院に搬送されずに、警察車両で大宮西署に運ばれた。

 検視をしようとした警察官が午前11時10分ごろ、ベッドにあおむけに寝かせた男性がまばたきし、浅く呼吸もしていることに気付き、同署が119番した。入院した男性は「(搬送の経緯など)途中のことは覚えていない」と話したという。
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今後はミイラ化した遺体も念のため病院へ搬送し,医師に死亡確認してもらうわけですね。わかります。ミイラがまばたきしたら恐いですからね。

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Comments

冬眠と死後硬直を見分けるのは難しいですね。

Posted by: kame | February 14, 2010 at 05:57 AM

温暖化とはいえ,冬は寒いです。
公園や河原のブルーシートテントを見ると,ホームレスの人たちはよく冬が越せるなとマジで思います。

Posted by: 管理人 | February 14, 2010 at 03:44 PM

似たような経験を知人が体験していました。

低体温で、心肺停止で運ばれCPRを30分以上したが反応せず。
死後の処置をしようと詰め物をしようとしたら、僅かに呼吸しているのを発見。
あやうく、殺人未遂をおこしかけたとぼやいていました。恐るべし、低体温・・・。

Posted by: キケロ | February 15, 2010 at 03:00 PM

”救急業務規定”でGoogle検索すると各地域(消防)でのきまりが見られます。大枠は同じテンプレですが、細い点は異なっていました。
不搬送の文言は通常「救急隊員は、傷病者が明らかに死亡している場合又は医師が死亡していると診断した場合は、これを搬送しないものとする。」で細則が付いていないことが多いようです。
西条市救急、見附救急などは具体的に「明らかな死亡」を定めているようです。
”2 前項に規定する明らかに死亡している場合とは、次に定めるところによる。
(1) 体幹及び頭頚部等が断裂している社会死の場合
(2) 死斑、死後硬直、角膜の混濁が認められる場合
(3) 晩期死体現象の場合”

”2 前項に規定する明らかに死亡している場合とは、次に定めるところによるものとする。
(1) 頸部又は体幹部が離断している場合
(2) 以下の7項目すべてに該当する場合
ア 意識レベルが3―3―9度分類(ジャパンコーマスケール)で、300であること。
イ 呼吸が全く感じられないこと。
ウ 総頸動脈で、脈拍が全く触知できないこと。
エ 瞳孔の散大が認められ、対光反射が全くないこと。
オ 体温が感じられず、冷感が認められること。
カ 死後硬直が認められること。
キ 死斑が認められること。”

家族が「死後硬直している」といったがために出動しなかったケースがあるようですね。
http://ryukyushimpo.jp/news/storyid-157455-storytopic-1.html
死後硬直の有無は出動しない限りわからない方向に流れができていくんでしょうか

Posted by: 匿名 | February 15, 2010 at 06:03 PM

キケロさん,こんにちは。

蘇生をあきらめて心電計などをはずしてからの復活ですね。そんな経験をすると,次からCPR終了のタイミングが難しくなりそうです。

Posted by: 管理人 | February 16, 2010 at 12:36 AM

匿名さん,こんにちは。

家族に「死んでいる」と言われたら,救急隊も困りますね。

今後「AEDを使えば死人も蘇る」と信じる人が増えそうですから,明らかなご遺体での119番通報もルーチン化するかもしれません。

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