Disaster Medicine against Chemical Hazard/Disasters: Revision mainly from Japanese Experience Presenters: Yoshikura Haraguchi, Tohru Tsubata, Yozo Tomoyasu, Tetsu Ishihara, Motohiro Sakai, Emiko Hoshino, Iyasu Nagata 1)Disaster Medicine Compendium Team, 2)Keiyo Hospital 3)Hikifune Hospital
Introduction Chemical attacks or disasters, caused by intention or terrorism are repeated.
Aim Even medical doctors in civilian hospitals may be requested to join the life-saving help. How to treat them are researched, mainly based on the Japanese experience.
Method The Tokyo Subway Sarin attack, 1995, which was caused by the Japanese Aum religeous group with more than 5,000 casualties with intoxication was analyzed, first. In this situation our medical experience of intoxicated patients treated exceeded 230, with more than 20 serious patients.
Other C hazards are Matsumoto sarin attack by the Aum, 1994, Osaka VX attack 1994 by Aum, Kuala Lumpur airport VX attack caused by suspicion of North Korea, 2017, etc.
Results Among patients involved in the 1995 sarin attack, we actually treated more than 100 policemen and necessitated medical care, in which PAM, Steroids, Atropine phosphate, etc. wereused. Five years after mental influence was researched. Nearly half of seriously contaminated patients(11 among 23, researched) had long-term mental damage, or diagnosed to be PTSD. Most medical doctors are not enough to treat or measure against such catastrophe. In addition to the basic disaster medicine capability, special knowledge, skill, idea regarding the safety/security are essential, considering the possibility of NBC hazards.
Discussion The status that most medical staff had been laypersons in the field, seems to be lasting at present, including the Japanese DMAT member. Insufficient medical measure increases victims as well as arouses anxiety of the society and ultimately the society. Basic disaster management are important without question: so-called, CSCATTT or Command Control, Safety, Communication, Assessment, Triage, Treatment and Transportation. However, it should be stressed that it should be promptly done to systematize the disaster medicine or make the compendium, considering the possibility of these special situations.