JP2010000163A - Instrument for securing intravenous line for patient in cardiopulmonary arrest, venipuncture method, and cardiopulmonary resuscitation treatment method for patient in cardiopulmonary arrest - Google Patents

Abstract

Provided are a venous passage securing device and a venipuncture method, and a cardiopulmonary resuscitation treatment method for a patient with cardiopulmonary arrest, which can easily and quickly secure a peripheral venous passage of the patient even in a situation of cardiopulmonary arrest and circulatory collapse.
A device for securing a venous passage 10 is inflated by applying pressure to a hollow tourniquet 1 attached to one limb of a limb in a cardiopulmonary arrest patient and a hollow portion 2 of the tourniquet 1. And a pneumatic feeder 3 that applies air pressure as an example. The tourniquet 1 includes a blood flow sealing portion 4 that fastens at least a part of the limb, and a blood flow seal. The limb part compression part 5 which fastens the peripheral part of the limb part of the peripheral side rather than the stop part 4 and the opening part 6 for puncture formed in the limb part compression part 5 are comprised.
[Selection] Figure 1

Description

  The present invention secures a venous passage at a puncture site when performing a puncture treatment for administering a drug to a superficial vein of a patient in a state where blood circulation is stopped, particularly for a device for securing a venous passage used for lifesaving emergency for a cardiopulmonary arrest patient The present invention relates to a device for securing a venous passage, a venipuncture method, and a cardiopulmonary resuscitation treatment method for patients with cardiopulmonary arrest.

  As a life-saving treatment for patients with cardiopulmonary arrest, heart function is performed by repeatedly blowing air from the oral cavity or nasal cavity to the lung in parallel with repeated conventional chest compressions, or in addition to administering drugs such as inotropic agents to other peripheral veins For example, a method for injecting adrenaline by puncturing a superficial vein of the forearm with a drug injection device has been adopted.

  Resuscitation for patients with cardiopulmonary arrest has become one of the specific actions that can be performed by a paramedic. In recent years, since adrenaline can be administered from the peripheral venous route under the direction of a doctor, the importance of the procedure has increased. It is growing.

  However, in patients with cardiopulmonary arrest, the circulation of blood has stopped, so veins are often collapsed even during chest compressions. In this state, it is difficult to secure peripheral venous tracts, and puncture of peripheral veins is difficult. Adrenaline infusion becomes impossible.

  Usually, when a syringe or needle is inserted into the superficial vein of the forearm to inject drug solution or blood, for example, the arm is clamped around the upper arm (central side) with a belt or the like against the forearm (peripheral side) of the arm. By sealing the blood flow at the central side of the cervical vein, it punctures the peripheral venous passage where the lumen is full.If the blood flow is stopped due to cardiopulmonary arrest as described above, this method There is no venous filling. In particular, when a lifesaving treatment is performed in a lifesaving field or an ambulance, it is in a state of confrontation, and there is a demand for securing a venous route for a cardiopulmonary arrest patient quickly and surely in the lifesaving field.

  The present invention has been made to solve the above-mentioned problems in the lifesaving field, and is a device for securing a venous passage that can easily and quickly secure a peripheral venous passage of a patient even in a situation of cardiopulmonary arrest and circulatory collapse, and An object of the present invention is to provide a venipuncture method and a cardiopulmonary resuscitation treatment method for patients with cardiopulmonary arrest.

  The present invention also provides a venous passage securing device and a venipuncture method that can be easily used in a life-saving site or an ambulance and can easily secure a venous passage for puncture and drug injection without interfering with the puncture technique. The purpose is to provide.

  A further object of the present invention is to provide a cardiopulmonary resuscitation treatment method for patients with cardiopulmonary arrest using the above-described venous passage securing device and venipuncture method.

  In order to achieve this object, a device for securing a venous passage for a cardiopulmonary arrest patient according to the present invention includes a hollow tourniquet attached to one limb of a limb in a cardiopulmonary arrest patient, and a hollow portion of the tourniquet Pressurizing means for applying a pressure to expand the blood tourniquet, and a blood flow sealing portion for fastening at least a part of the entire circumference of the limb, and a blood flow sealing portion. It has a limb compression part that fastens the peripheral part of the peripheral limb part, and a puncture opening formed in the limb compression part.

  In addition, the venipuncture method according to the present invention is a method in which one limb of a limb in a cardiopulmonary arrest patient is fluidized around the circumference except for the puncture site while compressing the entire circumference with fluid pressure, for example, air pressure, on the central side from the puncture site. Pressure is applied to concentrate blood around the vein at the puncture site, and a drug injection needle is punctured into the blood-filled venous passage and the pressure fluid pressure of the limb is released.

  A cardiopulmonary resuscitation treatment method for cardiopulmonary arrest patients according to the present invention comprises attaching the venous passage securing device to one limb of a limb in a cardiopulmonary arrest patient at a lifesaving site or an ambulance, and applying fluid pressure to the venous passage securing device, For example, by introducing air pressure to concentrate blood from around the puncture site of the limb to the superficial vein of the puncture site, the vein is expanded, and in this state, the drug injection needle is punctured into the vein and the venous path is secured It is characterized by contributing to cardiopulmonary resuscitation by releasing the air pressure of the device and injecting a cardiopulmonary resuscitation drug.

  According to the present invention, while compressing the upper limb other than the vascular puncture site as much as possible, the blood in that portion is concentrated on the superficial vein of the vascular puncture site, and the blood vessel that has collapsed the lumen is filled with blood. As a result, the venous passage can be ensured and facilitated, and the resuscitation of the cardiopulmonary arrest patient can be quickly performed in the lifesaving place or in the ambulance by the necessary drug administration by the venous puncture.

  Next, a device for securing a venous passage for a cardiopulmonary arrest patient according to various embodiments of the present invention will be described with reference to the drawings. The following embodiments are exemplifications of the present invention, and the present invention is not limited to these embodiments, and various variations and modifications can be made within the scope of the present invention.

Embodiment 1

  FIG. 1 is a schematic plan view showing a state in which a device for securing a venous passage according to Embodiment 1 of the present invention is applied to one limb of a cardiopulmonary arrest patient, specifically, the arm of a patient. 2 is a cross-sectional view taken along line AA in FIG. 1, and FIG. 3 is a cross-sectional view taken along line BB in FIG. The arm part, which is one of the limbs, as a whole is composed of the upper arm above the arm joint part (referred to as the central side) and the forearm below the arm joint part (referred to as the peripheral side). The form is an example of wearing from the upper arm to the forearm across the joint. Of course, the application of the present invention is not limited to such a part, and can be similarly applied to any part of the extremities of the human body, such as the leg, thigh, and shin.

  The device 10 for securing a venous passage according to the first embodiment as a whole has a sheath-like tourniquet zone 1 in which a sealed hollow portion 2 is formed, and the inside of the tourniquet zone hollow portion 2 connected to the tourniquet zone 1. In this embodiment, there is a pneumatic feeder 3 for introducing air pressure into the hollow portion 2. The tourniquet 1 is made of a flexible material such as a cloth member, natural or synthetic rubber member as a whole, and has an annular blood flow sealing portion so as to surround the entire circumference of the upper arm 11 near the joint portion. 4 and a forearm compression part (limb compression part) 5 connected to the blood flow sealing part 4 and attached to the forearm 12 including the joint part. Note that the hollow portion 2 of the tourniquet 1 communicates from the blood flow sealing portion 4 to the forearm compression portion 5. As the pressurizing means, a pressurized water supply device that applies water pressure in addition to the pneumatic feeder, a hydraulic device that applies hydraulic pressure and expands the hollow portion, and the like can also be employed.

  In the first embodiment, the forearm compression section 5 extends to the vicinity of the palm-side wrist 13 or slightly above (joint side), and as shown in FIG. Thus, the puncture opening 6 is defined in a portion corresponding to the front side of the forearm 12. A stop band 7 for securely holding the forearm compression part 5 on the forearm is attached to the tip of the forearm compression part 5 so as to straddle the puncture opening 6. In order to make it easy to attach the tourniquet 1 to the human body arm, one end 7a of the stopper band 7 is fixed to one side of the distal end of the forearm compression part 5 and the other end is the other one side of the distal end of the compression part. For example, it may be configured to be attached via a cloth attaching / detaching portion (fabric fastener) 8 called a magic attaching / detaching cloth.

  The tourniquet 1 has a double structure in which an outer member 9 constituting an outer shell and an inner member 15 constituting an inner shell are separated from each other, and is sealed between the outer member 9 and the inner member 15. A hollow portion 2 is configured. An air inflow port 17 communicating with the hollow portion 2 is formed in a part of the tourniquet 1, and the air inflow port 17 is communicated with an external pneumatic feeder 3 through an air supply pipe 19. The pneumatic feeder 3 may be a manual pump type equipped with a check valve, an electric type air feed pump, or any other known simple portable structure.

The inner member 15 of the tourniquet 1 is formed of a material that is less rigid or rigid than the outer member 9. The elasticity of the inner member 15 is preferably higher than that of the outer member 9.
In such a configuration, the tourniquet 1 is attached to the arm of a patient with cardiopulmonary arrest so that the blood flow sealing portion 4 is positioned more centrally than the forearm 12, that is, on the upper arm 11, and the pneumatic feeder 3 is The compressed air is pumped into the hollow portion 2 in the tourniquet 1 by operating. The hollow portion 2 expands in internal volume due to air pressure. However, as described above, the outer member 9 is a relatively strong member, and the inner member 15 of the hollow portion 2 is softer than the outer member 9. The blood band itself has a small outward spread and the inner member 15 is contracted toward the inner side (the volume of the hollow portion is increased). As a result, the inner member 15 presses the arm portion.

  Since the blood flow sealing portion 4 of the tourniquet 1 tightens the entire circumference of the upper arm 11, blood in the blood vessel is stopped at this portion, and blood in the forearm 12 does not flow to the central side. Therefore, even if the superficial venous blood vessels are in a collapsed state due to the compression of this arm part excluding the puncture opening 6, the site where the blood in the vein is not compressed, that is, the superficial vein of the puncture opening 6 Collected in the blood vessel, the vein lumen at the position of the opening is filled with blood, and the venous path 20 can be confirmed visually.

  While injecting a cardiopulmonary resuscitation drug into the superficial vein exposed in the puncture opening 6 and injecting a cardiopulmonary resuscitation drug, the air in the tourniquet hollow portion 2 is extracted from the exhaust port 21 to provide the upper arm tourniquet 1 The pressure by the blood flow sealing part 4 is released. In this case, the puncture needle of the injector is punctured from the distal side toward the central side along the vein extending in the forearm length direction, but the stop band 7 provided at the opening position of the tourniquet tip is Since it is thin and does not swell due to the air pressure of the hollow portion 2, it is possible to position the injector along the skin of the forearm without obstructing the puncture technique.

Embodiment 2

  FIG. 4 is a schematic plan view of a venous passage securing device according to Embodiment 2 of the present invention. In the first embodiment described above, the opening 6 formed in the limb compression part 5 of the tourniquet 1 is opened on the distal end side (peripheral side), and the limb compression part 5 of this part is fastened with the stop band 7. In the second embodiment, in addition to the blood flow sealing portion 4 on the central side, a blood flow sealing portion 22 that tightens the entire circumference of the limb is also formed on the distal side, that is, the distal end of the limb compression portion 5. Has been.

  Specifically, the central blood flow sealing part 4 that tightens a part of the upper arm 11 of the arm part over the entire circumference and the peripheral blood that tightens the entire circumference of the forearm 12 (that is, the entire circumference of the wrist side part). Limb compression that is formed between the flow sealing portion 22 and both the central side and the peripheral side sealing portions 4 and 22 and tightens the back portion of the forearm and the peripheral portion from both sides to a part of the front portion. The sheath-like tourniquet 1 having the sealed hollow portion 2 is configured by the portion 5 and the puncture opening 6 formed in the portion corresponding to the front portion of the forearm of the limb compression portion 5.

A part of the tourniquet 1 is provided with an air inlet 17 with a check valve connected to the external pneumatic feeder 3 and an exhaust port 21 for discharging pressurized air in the tourniquet hollow portion 2. This is the same as the first embodiment. Further, the entire tourniquet has a double structure of the inner member 15 and the outer member 9, and the material of the inner member 15 is softer and more elastic than the outer member 9, and the inner member 15 and the outer member 9 Pressurized air is introduced between them, and the inner member 15 presses the arm portion by the air pressure at this time.
In the illustrated embodiment 1, an example in which the air inlet 17 with a check valve for supplying pressurized air and the exhaust port 21 for discharging pressurized air are separately provided has been described. It is good also as an air inflow port which served as the supply function and exhaust function of pressurized air at the inlet. For example, it is possible to provide a plug structure in which a screw type nozzle is built in and air can be supplied with the screw tightened, and the air supply port is automatically opened to the atmosphere by loosening the screw.

  In the second embodiment, the blood flow collected at the position of the opening 6 by the limb compression part 5 of the tourniquet 1 does not escape to the upper arm central side and the forearm distal side, and a more effective venous path 20 is ensured. it can. Also in the second embodiment, it is preferable to set so that the compression force by the limb compression unit 5 is stronger than the compression force of the blood flow sealing portions 4 and 22 on both ends. As one means for this, for example, the limb This can be realized by making the inner member 15 in the partial compression part 5 somewhat softer and stretchable than that of the blood flow sealing parts 4 and 22.

Furthermore, it is preferable that the compressive force of the blood flow sealing portions 4 and 22 is stronger on the central side than on the peripheral side. Therefore, the order of the strength of the compression force is preferably limb compression part 5> central blood flow seal part 4> peripheral blood flow seal part 22.
As a specific example, the air pressure applied to the hollow portion 2 of the tourniquet 1 when worn on the arm is about 70 to 200 torr.

  In the second embodiment in which the blood flow sealing portions 4 and 22 are formed on the central side and the distal side, the puncture opening 6 formed in the limb compression portion 5 is formed as long as possible along the direction of the venous passage. preferable. Thereby, when puncturing the raised superficial vein 20, the bulge of the blood flow sealing part 22 on the peripheral side does not get in the way, and the puncture technique becomes easier.

  In this way, emergency treatment such as puncturing the vein of a cardiopulmonary arrest patient and injecting a drug at a lifesaving site or in an ambulance, and then transporting it to the hospital, performing intravenous infusion etc. according to the symptoms, cardiopulmonary Enter resuscitation treatment.

Embodiment 3

  FIG. 5 is a plan view showing a vein securing device according to Embodiment 3 of the present invention attached to the arm of a cardiopulmonary arrest patient, and FIG. 6 is a cross-sectional view taken along the line CC in FIG. The third embodiment is different from the first embodiment only in the configuration of the blood flow sealing part for tightening the upper arm, and the other parts are the same as those in the first embodiment. Therefore, in FIGS. The same reference numerals are given to the parts, and the duplicate description of the same parts is omitted as much as possible.

In the third embodiment, the blood flow sealing part 4 of the tourniquet 1 constituting the venous passage securing device is divided along the extending direction of the tourniquet 1, that is, the length direction of the arm part to be attached. . At the divided end portions 4a and 4b, the outer member 9 and the inner member 15 are joined in an airtight state. Therefore, even in this divided state, the blood flow sealing portion 4 has a sealed hollow portion 2 therein. It is formed. As shown in FIG. 6, one end 4a of the split end extends somewhat so as to overlap the outer side of the other end 4b, and the back surface of the one end 4a and the other end of the other end On the outer surface of 4b, attaching / detaching means that can be fixed to and detached from each other, for example, the aforementioned cloth attaching / detaching portion 25 called a magic attaching / detaching cloth is attached.
As shown in FIG. 6, a knob piece 23 is provided at the outer divided end portion, and the fixed end portions 4a and 4b can be easily removed by holding the knob piece 23 by hand and pulling it up. be able to.

  In this way, by dividing the blood flow sealing portion 4 in the longitudinal direction, the cloth attachment / detachment portion is unfixed to open the overlapping end portions 4a and 4b of the division portion, and is positioned on the forearm 12. By removing the stop band 7 at the end of the limb compression section 5, the entire tourniquet becomes flat or somewhat arcuate, and therefore when worn on the arm of a cardiopulmonary arrest patient. Is attached so that the tourniquet 1 is wrapped around the arm from the side of the arm without passing the arm through the annular tourniquet. , 4b are joined to each other in a superposed state, and the limb compression portion 5 is fixed with a stop band 7, so that it can be quickly and easily mounted in an emergency.

Even when the superficial venous tract is secured by attaching the tourniquet and pressing the arm with pressurized air and the infusion line is connected through the puncture opening, the above-described divided form can be used. Removal of the blood strip can be easily removed without affecting the infusion line.
In the above-described embodiment, the cloth attachment / detachment member is used for joining and fixing with the stop band and joining and fixing of the divided end portion of the blood flow sealing portion. However, the embodiment is not necessarily limited to such cloth attaching / detaching means. Alternatively, a general hook and hook, a stop button, and other openable fixing means may be employed.

Embodiment 4

  The tourniquet is appropriately selected for the inner diameter and length, or the size and shape of the puncture opening corresponding to the application location on the human body, for example, when the length of the puncture opening is long, The opening for puncture opens in the opening width direction, and there is a possibility that sufficient limb compression may not be obtained even by sending pressurized air to the tourniquet hollow portion. In order to prevent this, as a fourth embodiment, as shown in FIG. 5, a stop band 26 may be mounted so as to straddle the opening 6 in the middle in the longitudinal direction of the puncture opening 6. One end 26a of the retaining band 26 is fixed to one side of the puncture opening 6, and the other end 26b is detachably attached to the other side of the puncture opening 6. In this case, it is preferable to make the band as narrow as possible so as not to hinder the puncture technique for the vein.

Embodiment 5

  In Embodiments 1 to 4 described above, a hollow portion communicating from the blood flow sealing portion to the limb compression portion is formed in the tourniquet. However, in Embodiment 5, a plurality of tourniquets are formed in the tourniquet. It divides | segments into a division, forms the hollow part independent in each division, and you may make it introduce | transduce an air pressure so that each required compression force may be applied to these hollow parts. The configuration is appropriately selected according to the place where the human body applies.

  As described above, according to the present invention, while compressing the upper limb other than the vascular puncture site as widely as possible, the blood in that portion is concentrated in the superficial vein of the vascular puncture site, and the blood vessel in the lumen collapse state is blood. In this state, the venous passage can be ensured and facilitated, and the resuscitation of the cardiopulmonary arrest patient can be quickly performed in the lifesaving place or in the ambulance by administration of the necessary medicine by venous puncture.

1 is a schematic plan view of a device for securing a venous passage for a cardiopulmonary arrest patient according to Embodiment 1 of the present invention. It is a cross-sectional view along the AA line of FIG. It is a cross-sectional view along the BB line of FIG. It is a schematic plan view of a device for securing a venous passage for a cardiopulmonary arrest patient according to Embodiment 2 of the present invention. It is a schematic plan view of a device for securing a venous passage for a cardiopulmonary arrest patient according to Embodiment 4 of the present invention. FIG. 6 is a cross-sectional view taken along line CC in FIG. 5.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Tourniquet 2 Hollow part 3 Pneumatic feeder 4,22 Blood flow sealing part 5 Forearm compression part (limb compression part)
6 Puncture openings 7, 26 Retaining bands 8, 25 Cloth attachment / detachment part 9 Outer member 10 Venous channel securing instrument 11 Upper arm 12 Forearm 13 Wrist 15 Inner member 17 Air inlet 19 Air supply tube 20 Superficial venous channel 21 Exhaust port 23 Knob

Claims (8)

  A hollow tourniquet attached to one limb of a limb in a cardiopulmonary arrest patient, and a pressurizing means for applying pressure to expand the hollow portion of the tourniquet and expanding the tourniquet A blood flow sealing portion that fastens at least a part of the circumference of the limb, a limb compression portion that fastens a peripheral portion of the limb on the distal side of the blood flow sealing portion, and the limb compression portion A device for securing a venous passage for a cardiopulmonary arrest patient, characterized in that the device has a puncture opening formed on the cardiopulmonary artery.   The device for securing a venous path of a cardiopulmonary arrest patient according to claim 1, wherein the pressurizing means is a pneumatic feeder that applies an air pressure to the hollow portion of the tourniquet.   The tourniquet is formed by a double structure of an inner member and an outer member, the hollow portion is formed between the inner member and the outer member, and the inner member is softer and more elastic than the outer member. The device for securing a venous passage for a cardiopulmonary arrest patient according to claim 1 or 2, wherein the device is made of a high material.   The blood flow sealing part and the limb compression part of the tourniquet are adapted to compress the fastening part of the limb part of a cardiopulmonary arrest patient by expansion of the hollow part by air pressure, and the limb The device for securing a venous passage of a cardiopulmonary arrest patient according to any one of claims 1 to 3, wherein the compression force is set to be stronger on the distal side than on the central side of the part.   The blood flow sealing portion of the tourniquet is divided in the tourniquet length direction, and ends of the divided portions are overlapped and detachably coupled. The device for securing a venous passage of a cardiopulmonary arrest patient according to any one of the above.   The puncture opening extends to the distal end of the limb compression section, and a detachable stop band is attached to the distal end of the limb compression section so as to straddle the puncture opening. The device for securing a venous path of a cardiopulmonary arrest patient according to any one of claims 1 to 5, wherein   While one limb of the limb in a cardiopulmonary arrest patient is compressed with fluid pressure all around the center of the puncture site with fluid pressure, the surrounding blood is compressed with fluid pressure except the puncture site, and the surrounding blood is venous at the puncture site A method of puncture the vein, wherein the drug injection needle is punctured into the venous passage filled with blood and the pressure fluid pressure of the limb is released.   A device for securing the venous passage is attached to one of the limbs of a cardiopulmonary arrest patient at a lifesaving site or an ambulance, and fluid pressure is introduced into the venous passage securing device to draw blood from around the puncture site of the limb. The vein is inflated by concentrating on the superficial vein at the puncture site, and in this state, a drug injection needle is punctured into the vein and the fluid pressure of the venous passage securing device is released to inject a drug for cardiopulmonary resuscitation. A cardiopulmonary resuscitation treatment method for patients with cardiopulmonary arrest characterized by contributing to cardiopulmonary resuscitation.