Tamami N Shimada has worked for more than 20 years as a visiting nurse, and in 2011 graduated from the very first Master of Nurse Practitioner course held in Japan. In addition, she manages a visiting nurse station and day care for children and adults requiring intensive medical support, is a director of the Japanese Organization of Nurse Practioner Faculties (JONPF), director of the Kawasaki City Nursing association, and ambassador of TOUCH(Treat Observe and Understand Children with special Hope)
Abstract Background Progress in medical technology has benefited many children who can’t live without medical support, but there aren’t so many place to spent time by themselves and so we opened a day care and after-school program for children and adults who require medical support. In the context of this program I am using ultrasonography(US) to estimate these patients for a range of conditions, such as pulmonary congestion and edema, remains of a meal on epiglottic callecula, measuring the volume of urine, Methods Having completed the US course and competency examination at Tokyo University I used US to assess respiratory condition, swallowing, and measuring the amount of urine in the bladder by using SonoSite iVis Fuji Film and Vscan Dual Probe GE healthcare. Results The use of US is effective for evaluating pulmonary movement. Some patients have a firm thorax with poor movement together with an equally poor pulmonary movement, and we can evaluate the difference between right and left by the use of US. We can easily recognize pulmonary congestion and edema from a tissue like image and characteristic B line. We have provided pulmonary physical therapy, suction and positioning to improve their condition. This treatment has reduced respiratory rate and improved percutaneous oxygen saturation, however we can’t determine the effect of this treatment by US alone. On checking the pyriform sinusitis and epiglottic callecula, abnormalities present as a bright mass. Improving the method of cleaning the mouth and teeth after each meal reduced the fever that such patients were experiencing. Measuring the volume of urine by means of US was used to determine the need to use a catheter. Conclusion US was effective for understanding various conditions such as pulmonary congestion and edema, remains of a meal on epiglottic callecula, measuring the volume of urine, but wasn’t sufficiently sensitive to measure the effect of improvement in short-term care. Image Reference Publications (minimum 5) 1. Hiromi Sanada､Kouichi Haginaka,Motoichi Nishimura(2013) 看護に役立つエコーの読み方活かし方 照林社 2. Journal of Generalist Medicine 2016 Vol.26.No.9 医学書院. 3. Satoshi Kaneda 自信がつく研修医のための腹部超音波 2001 三輪書店.
NIPPON MEDICAL SCHOOL MUSASHI KOSUGI HOSPITAL