■原著
施策検討を可能とする首都直下地震を想定した災害医療シミュレーション・システムの開発
布施 理美1, 2, 鈴木 進吾1, 布施 明2, 林 春男3
1国立研究開発法人防災科学技術研究所災害過程研究部門主幹研究
2日本医科大学救急医学
3国立研究開発法人防災科学技術研究所
Development of A Novel Disaster Medical Simulation System for Validating the Flow of Medical Support Activities Following A Major Tokyo Inland Earthquake
Rimi Fuse1, 2, Shingo Suzuki1, Akira Fuse2 and Haruo Hayashi3
1)Disaster Resilience Research Division, National Research Institute for Earth Science and Disaster Resilience
2)Department of Emergency and Critical Care Medicine, Nippon Medical School
3)National Research Institute for Earth Science and Disaster Resilience
In the event of a major earthquake in the Tokyo metropolitan area, the number of people injured is predicted to be nearly 150,000 in Tokyo alone. Therefore, the Japanese government must be prepared to respond promptly by deploying medical teams and implementing appropriate medical systems in disaster-stricken areas with the support of base hospitals. Large-scale training of medical professionals is also required annually. Furthermore, all of these measures need to be validated. However, to date, no method has been established to validate measures for medical support activities after a disaster. In this study, we constructed a disaster medical simulation system using discrete-event simulation, reproduced the flow of medical support activities after a disaster, and quantified expected outcomes. The medical activity simulation was conducted in response to a hypothetical major earthquake in Tokyo. Results were assessed according to location by dividing Tokyo into the 12 districts specified as secondary medical districts by the Tokyo Metropolitan Government. The simulation time frame started from when an injury was first sustained due to the earthquake and concluded when all victims reached one of the following endpoints: admission to hospital, transport out of a staging care unit, or death. In this scenario, more than 3,000 yellow or red tag patients would be admitted to hospitals located in the Central Northeast and Central East districts of Tokyo, which is a very serious medical situation. In terms of load per hospital, affiliated hospitals in the Central East district can accept the largest number of yellow and red tag patients (more than 250) at one time, followed by affiliated hospitals in the Central South district, and disaster base hospitals and affiliated hospitals in the Central Northeast district. Under current assumptions for medical assistance, the disaster medical simulation system found that due to a lack of medical staff only 67.1% of yellow or red tag patients would survive a disaster through treatment, hospitalization, and wide-area medical transportation. In the future, it is hoped that this simulation system will be used to investigate and resolve bottlenecks for disaster medical care and to implement appropriate response measures.
日医大医会誌 2019; 15(4), 170-181
Key words
preventable disaster death, disaster response, medical relief team, wide area medical transportation, disaster base hospital
Correspondence to
Akira Fuse, Department of Emergency and Critical Care Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
E-mail：fuse@nms.ac.jp
受付：2019年8月8日 受理：2019年8月26日 |
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