臨牀透析 Vol.30 No.4(5)


特集名 透析診療のリスク・セーフティマネジメント
題名 環境管理・災害対策(火事・地震)
発刊年月 2014年 04月
著者 篠田 俊雄 河北総合病院透析センター
【 要旨 】 透析医療は火事や地震による災害時に,治療中の患者の迅速な避難が困難なため,平時からの災害対策(設備やマニュアル)の実施と避難訓練が重要である.火災に対しては消防法により防火管理者をおき,消防用設備の設置と消防訓練を行うことが定められている.震度6程度の地震に対する透析設備の防災方法4項目が提唱され,最近の大震災でその有効性が示された.治療中の災害時の避難に際しては血液透析からの離脱を安全に行い,安全な場所へスタッフが誘導することが重要である.治療中の被災でなくても,建物や設備,ライフラインの損壊が大きい場合には透析医療の継続が不可能になるため,患者の治療の場を確保する必要がある.遠隔地への患者搬送には,行政の協力が必要である.
Theme Preventing medication errors in the dialysis unit
Title Management of medical situations in major disasters
Author Toshio Shinoda Dialysis Center, Kawakita General Hospital
[ Summary ] It is important to take countermeasures to cope with disasters such as major fires or great earthquakes. Patients receiving hemodialysis are not able to take refuge promptly in these situations. Due to the Japanese fire laws, it is the obligation of hemodialysis institutions' administrators to assign personnel to manages fire-prevention devices and practice fire drills. Four measures have been proposed to provide protection to dialysis equipment from damage caused by earthquake levels of approximately six. The effectiveness of these measures has been illustrated in recent major earthquakes. It is necessary for medical staffs to safely disconnect patients from extracorporeal blood circuits and lead them to safety during disasters which occur during hemodialysis treatment. In case of disasters not occuring during hemodialysis treatment but where severe damage has occured to dialysis institutions, including equipment, as well as infrastructure in the area, it is necessary to provide hemodialysis treatment in other locations. Transportation of hemodialysis patients should be provided through measures devised by administrative personnel.
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