FUKUSHIMA Lives on the Line

105chap.IIFukushima Medical University Record of Activities [Notes and Messages]FUKUSHIMA: Lives on the Linewas cause by the earthquake, but we nevertheless prepared ourselves to promptly perform emergency surgery. Thus, in nine rooms, we placed equipment for general anesthesia, open chest surgery, abdominal surgery, craniotomy, transforation, osteosynthesis, and for other procedures we expected might be needed. We also placed emergency carts, antiseptics, rinse water, medication, gauzes, and syringes in the middle of the supply room. A large part of the city lost water supply in the earthquake, as did the hospital. We were unable to wash equipment or other machines after they had been used. Because we could no longer use high-pressure steam sterilization or ethylene oxide gas, we could only sterilize using Sterrad machines. The Sterrad machines of the surgery department had small capacity. Hence, we moved the higher capacity ones of the supplies department to the surgery department so that we could use them on a regular basis. For the time being, we had to wipe down the machines after use with more protein-dissolving cleaners than usual and covered them with plastic bags to prevent them drying out. The hospital set up an emergency response team, and because the extent of the damage was unclear, all staff were instructed to stay, except for contract employees and those who were pregnant or had small children. We also quickly rearranged staffing to increase staff at night and during the weekend. Although we stayed on duty in the hospital until 10 pm the day of the earthquake, there were no patients transferred to us for surgery.(2) The Operating Room Thereafter The following week, all surgeries in the hospital were cancelled; however, as certain hospitals in the city were unable to perform surgery due to the lack of water, we performed a few emergency caesarian sections and osteosyntheses on a daily basis. Some of our operating room staff helped at other wards to take in patients transferred from hospitals and facilities in the disaster area. On the 18th, one week after the earthquake, water supply finally resumed. We could re-operate on patients who had been in surgery at the time of the earthquake and perform a few other scheduled surgeries. But the provision of supplies had still not completely returned to normal. Hence, we were not in a situation to perform as many surgeries as we could prior to the earthquake. Thus, a few surgery department nurses visited various disaster areas to perform examinations.*Because there was no direct damage to the hospital buildings from the earthquake, we applied all that we learned from evacuation drills held by the surgery department at the end of the previous year; the staff were able to calmly address the situation. At the time of the evacuation drills, we noted an insufficient supply of back valve masks and flashlights appropriate for the number of operating rooms. So we had purchased and restocked these and were able to tackle the disaster without a lack of supplies. But from the supply management viewpoint, we had not thought about where to store the stretchers, which is a regrettable. Thus, when the hospital asked to borrow them, no staff member knew of the stretchers’ whereabouts. Moreover, because we had kept them in the back of the instrument room, it took a long time to get them out. Although the physicians’ and operating room staff’s efforts to ensure everyone’s safety are commendable, the need for each division to quickly create a staff manual, keep staff informed, and rethink on supply management remains.Two months have passed since the great earthquake. Our lifelines have resumed, we can now easily buy what we want from supermarkets and convenience stores, and life has mostly returned to what it used to be before the disaster. But there are certain scenes that make the earthquake impossible to forget. We are still experiencing aftershocks, the news covers the disaster day in and day out, and blue tarp covers the roofs of houses whose roof tiles are yet to be repaired. It is true that even now, two months after the earthquake, some people still have no choice but to live as evacuees.(1) Rushing to the Hospital after the EarthquakeI was at home the day of the earthquake. With the sudden, vigorous quakes, I went outside oblivious to what was going on, only to find my neighbors standing motionless together and looking worried, each pair of eyes fixed on their shaking homes and cars. Looking at the people around me and everything that shook, I realized that this was a massive earthquake. I was very anxious at seeing a reality I had never experienced before.Our hospital’s emergency medicine response manual Engaging with Affected Infants and Families in the Pediatric WardKayoko WatanabeWest Ward, 4th FloorActivity Records of the Fukushima Medical University Hospital