Fuse Akira, Igarashi Yutaka, Tanaka Toshihiko, Kim Shiei, Tsujii Atsuko, Kawai Makoto, Yokota Hiroyuki
Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo, Japan.
J Nippon Med Sch. 2011;78(6):401-4. doi: 10.1272/jnms.78.401.
This report describes our onsite medical rounds and fact-finding activities conducted in the acute phase and medical relief work conducted in the subacute phase in Miyagi prefecture following the Great East Japan Earthquake and subsequent tsunami that occurred off northeastern Honshu on March 11, 2011. As part of the All-Japan Hospital Association medical team deployed to the disaster area, a Nippon Medical School team conducted fact-finding and onsite medical rounds and evaluated basic life and medical needs in the affected areas of Shiogama and Tagajo. We performed triage for more than 2,000 casualties, but in our medical rounds of hospitals, clinics, and nursing homes, we found no severely injured person but did find 1 case of hyperglycemia. We conducted medical rounds at evacuation shelters in Kesennuma City during the subacute phase of the disaster, from March 17 through June 1, as part of the Tokyo Medical Association medical teams deployed. Sixty-seven staff members (17 teams), including 46 physicians, 11 nurses, 3 pharmacists, and 1 clinical psychotherapist, joined this mission. Most patients complained of a worsening of symptoms of preexisting conditions, such as hypertension, respiratory problems, and diabetes, rather than of medical problems specifically related to the tsunami. In the acute phase of the disaster, the information infrastructure was decimated and we could not obtain enough information about conditions in the affected areas, such as how many persons were severely injured, how severely lifeline services had been damaged, and what was lacking. To start obtaining this information, we conducted medical rounds. This proved to be a good decision, as we found many injured persons in evacuation shelters without medication, communication devices, or transportation. Also, basic necessities for life, such as water and food, were lacking. We were able to evaluate these basic needs and inform local disaster headquarters of them. In Kesennuma City, we found that some evacuation shelters could not contact others even after 1 week after the earthquake. We realized from our experiences that, unlike our activities following more localized earthquake disasters, the first task following such large-scale disasters is to acquire information on basic life needs, including medication needs, and the number of persons requiring assistance. We must provide medical relief according to the unique characteristics of the disaster-affected areas as well as the specific nature of the disaster, in this case, a tsunami.
本报告描述了我们在2011年3月11日日本本州东北部海域发生东日本大地震及随后的海啸之后,在宫城县急性期开展的现场医疗巡查和实情调查活动,以及在亚急性期开展的医疗救援工作。作为全日本医院协会派往灾区的医疗队的一部分,日本医科大学的一个团队进行了实情调查和现场医疗巡查,并评估了盐釜市和多贺城市受灾地区的基本生活和医疗需求。我们对2000多名伤亡人员进行了检伤分类,但在对医院、诊所和养老院的巡查中,我们没有发现重伤人员,只发现了1例高血糖病例。在3月17日至6月1日灾难的亚急性期,作为东京医科协会医疗队的一部分,我们在气仙沼市的避难所进行了医疗巡查。包括46名医生、11名护士、3名药剂师和1名临床心理治疗师在内的67名工作人员(17个团队)参与了这项任务。大多数患者抱怨原有疾病的症状加重,如高血压、呼吸问题和糖尿病,而不是与海啸特别相关的医疗问题。在灾难的急性期,信息基础设施遭到严重破坏,我们无法获得受灾地区的足够信息,如重伤人数、生命线服务受损程度以及短缺情况。为了开始获取这些信息,我们进行了医疗巡查。事实证明这是一个明智的决定,因为我们在避难所发现了许多受伤人员,他们没有药品、通讯设备或交通工具。此外,水和食物等基本生活必需品也短缺。我们能够评估这些基本需求并告知当地灾害总部。在气仙沼市,我们发现一些避难所在地震1周后仍无法与其他避难所取得联系。从我们的经历中我们认识到,与我们在规模较小的地震灾害后的活动不同,在这种大规模灾害之后的首要任务是获取有关基本生活需求的信息,包括药品需求以及需要援助的人数。我们必须根据受灾地区的独特特点以及灾害的具体性质,在这种情况下是海啸,提供医疗救援。