24低出生体重児のためのチャイルドシート改良を試みて : 搬送時の適切でより安全な装着方法の検討と工夫 <報告>

Efforts Towards Modifying Child Restraint Systems for Low Birth Weight Infants : In Pursuit of Appropriate and Safer Ways to Use the CRS During Transport of the above Infants

Tadenuma Mika

Kumaki Cohko

Liu Yamei

日本新生児看護学会誌

Journal of Japan Academy of Neonatal Nursing

本研究は、低出生体重児のチャイルドシート(Child RestraintSystems:CRS)着用姿勢の検討をし、低出生体重児のためのCRS改良を試みることを目的とした。修正34週～42週、CRS着用時体重1850～3600gの児を対象とし、搬送中の経皮的動脈血酸素飽和度、体温の変動、着用姿勢を調査および分析した。その結果次の点が明らかになった。1.運輸省装置型式基準の基準適合品CRSは、低出生体重児の規格に合わないため、タオル等でCRSの隙間を工夫した。よりCRS着用姿勢を保つことが不可欠である。2.タオル等で隙間を工夫したCRSは、児の体動や振動によりタオルが崩れて隙間が生じてしまう。また身体が丸まり、下顎が下がったり首がやや屈曲した時振動時(踏み切りや道路の段差など)に酸素飽和皮の低下があった。3.ウレタン等の縫製クッション部材で隙間を工夫したCRSは身体が丸まり、下顎が下がったり首がやや屈曲した姿勢の崩れが認められたが異常な酸素飽和度の低下は比較的少なかった。4.頚部真皮膚温測定より体温の変化は、統計的に0.1度程度の体温上昇が見られた。5.低出生体重児のためのCRS改良し安全に搬送するための指標を得た。

The objective of this research is to devise methods to modify the CRS for low birth weight infants from the perspective of the posture of low birth weight infants when the CRS is used. The study was carried out using the infants who weigh 1.850 grams to 3.600 grams at the time when the CRS was used and whose corretive age were thirty-four to forty-two weeks. We checked and analyzed the oxygen saturation, the body temperature. and the posture of the infant in the CRS. The results of the study revealed the following: 1. As the CRS which conforms to the standards of the Japanese model standand by the Ministry of Transport is not suitable for the physique of the low birth weight infants, it is necessary to use towels and such to fill the void in the CRS. 2. When towels and such are used to fill the void in the CRS. it was found that the movement of the infants and the vibratory motion generated during transport create the void which had initially been filled. Furthermore. the deterioration in oxygen saturation was observed in such instances as when the body of the infant hunched, when the jaw lowered. when the neck bent slightly. or when some vibration was caused by railroad crossings or road bumps. 3. As for the CRS the void of which was filled with the sewn cushion material such as urethane foam, it caused the body to hunch. which then caused a worsening of the posture with the lowered jaw and the slightly bent neck. However. the level of deterioration in oxygen saturation was not significant. 4. About the change in the skin temperature measured at the back of the neck. about 0.1 degree rise in the body temperature was observed statistically. 5. We were able to gain from the study the indicators that would help us modify the CRS. which conform to the standards. for the low birth weight infants to ensure safer transport.

低出生体重児

酸素飽和度

着用姿勢

チャイルドシート

LBW

Oxygen saturation

The body temperature

Child Restraint Systems

Medical sciences [ 490 ]

jpn

日本新生児看護学会

Copyright (c) 2003 日本新生児看護学会

[ISSN] 1343-9111

[NCID] AA11269499