Department of Acute Critical Care and Disaster Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
Department of Disaster Medicine and Management, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, Okayama City, Okayama, Japan.
Prehosp Disaster Med. 2020 Apr;35(2):160-164. doi: 10.1017/S1049023X20000138. Epub 2020 Feb 14.
The Nankai Trough, which marks the boundary between the Eurasian and Philippine Sea plates, is forecasted to create a catastrophic earthquake and tsunami within 30 years. The Japanese government believes that the number of casualties would be huge. However, the exact number of severely injured (SI) people who would need emergency and intensive care has not been identified.
This study, therefore, aimed to clarify the gap between medical supplies and forecasted demand.
The official data estimating the number of injured people were collected, together with the number of intensive care unit (ICU) and high care unit (HCU) beds from each prefecture throughout Japan. The number of SI cases was recalculated based on official data. The number of hospital beds was then compared with the number of SI people.
The total number of hospitals in Japan is 8,493 with 893,970 beds, including 6,556 ICU and 5,248 HCU beds. When the Nankai Trough earthquake occurs, 187 of the 723 disaster base hospitals (DBHs) would be located in the areas with a seismic intensity of an upper six on the Japanese Seismic Intensity Scale (JSIS) of seven, and 79 DBHs would be located in the tsunami inundation area. The estimated total number of injured people would be 661,604, including 26,857 severe, 290,065 moderate, and 344,682 minor cases.
Even if all ICU and HCU beds were available for severe patients, an additional 15,053 beds would be needed. If 80% of beds were used in non-disaster times, the available ICU and HCU beds would be only 2,361. The Cabinet Office of Japan (Chiyoda City, Tokyo, Japan) assumes that 60% of hospital beds would be unavailable in an area with an upper six on the JSIS. The number of ICU and HCU beds that would be usable during a disaster would thus further decrease. The beds needed for severe patients, therefore, would be significantly lacking when the Nankai Trough earthquake occurs. It would be necessary to start the treatment of those severe patients who are "more likely to be saved."
位于欧亚板块和菲律宾海板块边界的南海海槽预计将在 30 年内引发灾难性地震和海啸。日本政府认为，届时的伤亡人数将会巨大。然而，目前尚未确定需要紧急和重症护理的重伤（SI）人数。
本研究旨在明确医疗资源供应与预测需求之间的差距。
收集了受伤人数的官方数据，以及日本各地每个县的重症监护病房（ICU）和高护理病房（HCU）床位数量。根据官方数据重新计算了 SI 病例数。然后将医院床位数量与 SI 人数进行比较。
日本共有 8493 家医院，拥有 893970 张床位，包括 6556 张 ICU 和 5248 张 HCU 床位。南海海槽地震发生时，723 家灾害基地医院（DBH）中有 187 家将位于日本地震烈度表（JSIS）七级的六级以上地震区域，79 家 DBH 将位于海啸淹没区。预计受伤总人数将达到 661604 人，其中 26857 人伤势严重，290065 人中度受伤，344682 人轻度受伤。
即使所有的 ICU 和 HCU 床位都可用于严重患者，仍需要额外的 15053 张床位。如果非灾害时期使用 80%的床位，那么可用的 ICU 和 HCU 床位将只有 2361 张。日本内阁府（东京都千代田区）假设在 JSIS 六级以上地区，60%的医院床位将无法使用。因此，在灾害期间可用的 ICU 和 HCU 床位将进一步减少。因此，南海海槽地震发生时，严重患者所需的床位将严重短缺。有必要开始治疗那些“更有可能获救”的严重患者。
