FUKUSHIMA Lives on the Line

129chap.IIIStruggle Against RadioactivityFUKUSHIMA: Lives on the LineFigure 4: Summary of Fukushima Medical University's Response Activitiespeople were helped to evacuate the Soso area (Hamadori in Fukushima Prefecture extending from Soma City to Hirono Town), and our hospital played a pivotal role because of our location as a relay point in the area. We set up beds for triage in the outpatient waiting area and the Nursing School training room while conducting 175 examinations to assess which patients were fit to continue traveling to their evacuation destinations and which needed to be temporarily hospitalized. A total of 125 patients were judged to require temporary admittance. These examinations were performed by physicians from all of the internal medicine departments and from the community/family medicine department, with assistance from the Nursing School faculty and others.Once the transportation of patients from the evacuation area had progressed to a degree, our activities gradually shifted toward medical care for the refugees themselves. We were grateful to have DMATs, physicians from local medical associations, physicians from the Japan Medical Assistance Team, and supporting physicians from central hospitals in the prefecture take responsibility for primary care at each evacuation center. In addition to these individuals, a number of physicians, nurses, and others gathered as volunteers from regions across Japan and assisted with the activities mentioned above. In this process, in order to enhance the organization of these activities and boost the overall medical care in response to the disaster, FMU worked to put in motion a university-wide framework in order to support the broad emergency medical response in the region. The following were our three main activities.1. Supporting Advanced Emergency Medical CareDrawing on experience from the 1995 Great Hanshin Earthquake, it was known that the need for advanced medical care was bound to arise at each evacuation center. Consequently, an Economy Class Syndrome Medical Team, that is, a specialist team able to address certain specific medical needs, prepared themselves to respond to deep vein thrombosis, embolism, and similar conditions. Using compact ultrasound devices, the team visited each evacuation center to conduct an early detection and treatment, along with providing preventative awareness information. By the time the rounds came to an end on May 11, 2,200 examinations had been performed and approximately 10% of them resulted in the detection of thrombosis. From April 25, a team of two doctors and two nurses/technicians from the Kingdom of Jordan joined this team. In addition, by June 2, when they finished taking rounds, the Pediatrics and Infectious Diseases Team visited a total of 31 evacuation centers, dispensing advice on caring for infants during the crisis and providing preventative awareness information for avoiding the spread of infectious diseases in the group living facilities. Medical teams from the Kingdom of Thailand joined this team as well, adding two doctors and two nurses from May 9 onward. The Mental Care Team received volunteers across Japan and worked to provide mental care in each prefecture, centering on the evacuation centers. Finally, the Nursing School Team primarily focused their efforts on supporting the activities of public health nurses, whose critical importance became evident in this disaster.2. Providing Medical Care within the 20–30 km Zone surrounding the Nuclear Power PlantFukushima Prefecture stood out in that a nuclear accident occurred in addition to the earthquake and tsunami aftermath. Consequently, there was a large gap Earthquake occursWeek 1 ~Week 2 ~Patient evacuation responseCritical phaseResident evacuation responsePost-critical phasePatients from five hospitals in the Iwaki Soso areaApproximately 1,300 patients transported outside the areaApproximately 175 patients admitted to triage midway through transportation (125 seriously injured patients given inpatient hospital care)Wide area emergency medical support1. Advanced Emergency Medical Care Support Team2. Regional and Family Medicine Team3. Specialized Medical ConsultationsOutpatient treatment and scheduled surgeries cancelledTotal resources put toward emergency medical responseApproximately 1,000 disaster patients admittedDisaster medical responseHypercritical phase12 patients given high-level radiation exposure decontamination; three hospitalizedApproximately 500 disaster victims surveyed for radiation exposureNuclear accident response