亀田 徹

Toru KAMEDA

安曇野赤十字病院　救急科

Department of Emergency Medicine, Red Cross Society Azumino Hospital

キーワード : point-of-care ultrasound, emergency and critical care, clinical reasoning, framework, educational system

ベッドサイドで臨床医によって施行されるPoint-of-Care超音波（POCUS）は，欧米の救急・集中治療領域で発展し，現在そのコンセプトは他の専門領域へ広がっている．POCUSは系統的超音波検査といくつかの点で異なる．POCUSでは臨床推論に基づき関心部位は絞られ，定性的，半定量的に評価される．急性期診療におけるPOCUSは，全身各部位の解剖学的評価，循環器系の生理学的評価に利用される．また心肺蘇生の一環，緊急度・重症度評価，モニタリング，様々な手技のガイドとして施行される．今後我が国でもPOCUSが発展し，患者ケアの改善のために利用されるためには，POCUSユーザーと超音波の専門家との協働，質の高い臨床研究の実施，領域別のフレームワークの設定，および教育システムの構築が必要である．

Point-of-care ultrasound (POCUS), which is performed by clinicians at the bedside, has been developed in emergency and critical care medicine in Western countries. In recent years, the concept of POCUS has also been accepted in other specialties. POCUS differs from comprehensive ultrasound in several aspects. POCUS exams focus on regions of interest in an organ system based on clinical reasoning. The regions are assessed qualitatively or semi-quantitatively. POCUS in acute care settings is used for anatomical evaluation in each part of the body and physiological evaluation in the circulatory system. On top of that, POCUS is performed for resuscitation, assessment of urgency and severity, monitoring, and guidance for various procedures. Collaboration between POCUS users and ultrasound specialists, implementation of high-quality clinical research, construction of the framework in each specialty, and development of educational systems are needed to develop POCUS and utilize it for improvement of patient care in Japan.