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Journal of Medical Ultrasonics

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2016 - Vol.43

Vol.43 No.01

State of the Art(特集)

(0061 - 0074)

東日本大震災に対応した日本超音波医学会による超音波診断装置の緊急配備について: 岩手県の対応を振り返る

Deployment of portable ultrasound machines to Great East Japan Earthquake-Stricken Area by the Japan Society of Ultrasonics in Medicine: lessons learned from Iwate Prefecture

小山 耕太郎

Kotaro OYAMA


Department of Pediatrics, Iwate Medical University School of Medicine

キーワード : Great East Japan Earthquake, tsunami, portable ultrasound machine, telecommunication, logistics

この震災の特徴は,特に岩手県においては,従来から医療資源に乏しい沿岸地域における大津波による人的,物的被害とライフラインの喪失でした.岩手県の人的被害は,死者5,115人,行方不明者1,132人,負傷者211人で,injury-to-death ratioは0.04と,死者数に比べ傷病者数が著しく少なく,津波による人的被害の特徴を如実に示していますが,通信の途絶のため,当初,被災の実態は明らかでありませんでした.発災後1ヵ月間に心不全や心臓突然死,脳梗塞の発症が有意に増加し,医療機関と物流の障害から,ST上昇型心筋梗塞の患者に対する経皮的冠動脈インターベンションの施行率が有意に減少し,院内死亡率が上昇しました.

In response to the Great East Japan Earthquake, the Japan Society of Ultrasonics in Medicine (JSUM) deployed portable ultrasound machines to the three most seriously devastated prefectures in the northeastern region of Japan: Fukushima, Miyagi, and Iwate. Twenty-five portable ultrasound machines were loaned or donated to Iwate Prefecture.
In Iwate Prefecture, the medically underserved coast area was hit by a record-breaking tsunami; 5,115 people were confirmed dead, 1,132 remain missing, and 211 were injured, indicating a remarkably low injury-to-death ratio (0.04). At first, the impact of the tsunami on the healthcare system was underestimated as a result of the shutdown of the telecommunication networks. There were significant increases in the occurrence of acute decompensated heart failure, sudden cardiac and unexpected death, and cerebral infarction during the initial 30 days after the disaster. Due to disruptions at hospitals and in distribution systems, the rate of percutaneous coronary intervention decreased and in-hospital mortality increased in patients with ST-elevation myocardial infarction.
In the initial phase, deployed machines were used by local physicians at evacuation shelters and temporary hospitals or clinics, and by volunteer medical teams for DVT screening of the refugees. After 30 days, the machines were utilized to replace those damaged at hospitals and clinics in the coastal area.
In order to realize proper operation and consistent management of the machines, we directly communicated with members at JSUM headquarters, Iwate prefecture government officials, Iwate Disaster Medical Support Network officials, ultrasound machine companies and their agencies, and local physicians who requested the machines. E-mail and cellular phones were irreplaceable in these communications.
We need to develop resilient telecommunication and distribution networks to prepare against massive disasters in the near future. It is important that medical societies and industry work together to build logistics for supporting devastated regions.