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  • カンタン ニ テキセツ ナ ツヨサ デ ソウチャク デキル ジョウミャク センシヨウクケツタイ ノ カイハツ

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看護師が前腕に静脈穿刺をする際にゴム管駆血帯を用いた場合の駆血圧は70-95mmHgが適切と報告されているが、看護師が駆血帯を装着する強さは幅広く分散しており、高すぎる傾向にある。この原因の一つとして、駆血帯には適切な目安が無く、意図した強さで装着することが難しいことが考えられた。そこで、適切なく血圧の指標となるメモリを付けた駆血帯を開発し、その性能について検討した。60名の対象者(平均年齢40.5歳、範囲21-78歳)に駆血帯を上腕周囲径より1-4メモリ短く装着した時の駆血圧の平均はそれぞれ45,76,110,144 mmHgであり、静脈の断面積は3メモリまでは増加したが、4メモリまで短くするとやや減少した。静脈穿刺可能な怒張が得られた対象者はそれぞれ30%,80%,90%,85%で、3メモリまでは増加したが、4メモリ短くするとやや減少した。この駆血帯では上腕周囲径より2-3メモリ短く装着するのが適切と考えられた。

When nurses attempt venipuncture at the forearm, they apply a tourniquet at the upper arm to distend the forearm vein. Appropriate gum-tube tourniquet pressure is reported to be between 70-95mmHg. But tourniquet pressure applied by japanese nurses in clinical situations is often too high and widely distributed. One of the reason they do not apply tourniquets with appropriate pressure is that the tourniquets they use have no marks for applying the appropriate pressure. So, we developed a new tourniquet with marks for applying appropriate pressure, and we studied the effectiveness of this tourniquet. Sixty subjects (mean age40.5 years old, range:21-78 years old) were enrolled. When we applied tourniquets with tourniquet lengths 1, 2, 3, and 4 marks shorter than the circumference of the upper arm, mean tourniquet pressures were 45.1±6.7mmHg, 76.0±12.2mmHg,109.6±13.0mmHg, and 143.7±24.7mmHg respectively, and vein cross section area increased according to the stretch strength until 3 marks, then decreased slightly at 4 marks. The percentages of subjects with sufficient vein distention for venipuncture were about 30%, 80%, 90%, and 85% respectively. The results indicated that applying tourniquet with 2 marks or 3 marks shorter is appropriate for venipuncture, while 4 marks is too strong.



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