Emergency Medical Teams' Responses during the West Japan Heavy Rain 2018: J-SPEED Data Analysis

Medical needs during the Kumamoto heavy rain 2020: analysis from emergency medical teams' responses

BACKGROUND

Rainfall-induced floods represented 70% of the disasters in Japan from 1985 to 2018 and caused various health problems. To improve preparedness and preventive measures, more information is needed on the health problems caused by heavy rain. However, it has proven challenging to collect health data surrounding disasters due to various inhibiting factors such as environmental hazards and logistical constraints. In response to the Kumamoto Heavy Rain 2020, Emergency Medical Teams (EMTs) used J-SPEED (Japan-Surveillance in Post Extreme Emergencies and Disasters) as a daily reporting tool, collecting patient data and sending it to an EMTCC (EMT Coordination Cell) during the response. We performed a descriptive epidemiological analysis using J-SPEED data to better understand the health problems arising from the Kumamoto Heavy Rain 2020 in Japan.

METHODS

During the Kumamoto Heavy Rain 2020 from July 5 to July 31, 2020, 79 EMTs used the J-SPEED form to submit daily reports to the EMTCC on the number and types of health problems they treated. We analyzed the 207 daily reports, categorizing the data by age, gender, and time period.

RESULTS

Among the 816 reported consultations, women accounted for 51% and men accounted for 49%. The majority of patients were elderly (62.1%), followed by adults (32.8%), and children (5%). The most common health issues included treatment interruption (12.4%), hypertension (12.0%), wounds (10.8%), minor trauma (9.6%), and disaster-related stress symptoms (7.4%). Consultations followed six phases during the disaster response, with the highest occurrence during the hyperacute and acute phases. Directly disaster-related events comprised 13.9% of consultations, indirectly related events comprised 52.0%, and unrelated events comprised 34.0%. As the response phases progressed, the proportions of directly and indirectly related events decreased while that of unrelated events increased.

CONCLUSION

By harnessing data captured by J-SPEED, this research demonstrates the feasibility of collecting, quantifying, and analyzing data using a uniform format. Comparison of the present findings with those of two previous analyses of J-SPEED data from other disaster scenarios that varied in time, location, and/or disaster type showcases the potential to use analysis of past experiences to advancing knowledge on disaster medicine and disaster public health.

Navigating into the unknown: exploring the experience of exposure to prehospital emergency stressors: a sequential explanatory mixed-methods

INTRODUCTION

The unpredictability of prehospital emergencies combined with constantly changing circumstances can lead to increased stress and mental health issues among Emergency Medical Technicians (EMTs). To accurately determine the stress-inducing factors in the prehospital environment, it is important to first identify the stressful events that occur in this environment. Therefore, this study strives to provide a thorough analysis of the stressors in the prehospital environment.

METHODS

Sequential explanatory mixed methods were conducted in Hamadan prehospital emergency centers in 2022. The study included 251 EMTs, who were selected through a method in the quantitative phase. The quantitative part used a questionnaire consisting of basic information and the Posttraumatic Stress Questionnaire (PCL-5). In the qualitative phase, 17 with extensive experience in dealing with prehospital stressors were selected based on their PCL-5 scores (above 33). The qualitative phase analysis was carried out using the contractual content method using the Graneheim and Ladman's approach. Statistical analyzes for the quantitative and qualitative phases were performed using SPSS 21 and maxqda 10, respectively.

RESULTS

The study revealed that the EMTs had an average PTSD score of 21. 60 ± 11. 45. Multivariate linear regression analysis showed that the number of shifts had a statistically significant relationship with PTSD scores (t = 26.38, P < 0.001). The qualitative phase of the study included 17 interviews, resulting in 14 subcategories, which consisted of four categories: "the overall impact of the stress crisis on technicians," "missing links in the communication network in incident management," "professional shortcomings in pre-hospital care," and "the complex and multifaceted context of stressful pre-hospital emergencies." Additionally, the study's theme was centered around "surveying the experiences of EMTs in stressful environments."

CONCLUSION

As the number of shifts increased, the primary cause of the high prevalence of PTSD in EMTs was revealed. Prehospital emergency stress can be reduced and managed more skillfully by adjusting various factors such as shortening workdays, offering continuous training, augmenting workforce, supplying ambulance equipment insurance, refraining from hiring personnel devoid of clinical training, hiring psychologists, hiring midwives in an emergency, updating prehospital protocols and guidelines, encouraging cooperation between EMTs and other relief groups, and utilizing cutting-edge technologies.

Use of a Helicopter Emergency Medical Service Hangar as a Staging Care Unit in a Disaster-Affected Area

OBJECTIVE

There are a few reports regarding the use of a hangar as a temporal medical facility (staging care unit [SCU]) during large-scale disasters. The aim of this study was to describe the activities performed by disaster medical assistance teams (DMATs) at the hangar of the eastern Shizuoka physician-staffed helicopter as an SCU in the 2022 Shizuoka Prefecture disaster drill.

METHODS

We selected the narrative method for this study.

RESULTS

Four DMATs helped manage the SCU at the hangar. During the training period, there were 3 instances of a mock doctor helicopter landing and takeoff and 1 actual eastern Shizuoka doctor helicopter landing and takeoff while transporting a mock burn patient. Four DMATs treated 3 mock patients in addition to receiving training regarding medical materials. Such an SCU was able to reduce the burden on the disaster base hospital because many severely ill or traumatized mock patients were transported to the hospital. However, an evaluation meeting held after the drill revealed problems with lifelines, safety management, stock, and quality management of materials in an actual disaster situation.

CONCLUSION

We reported our experience with a training exercise using a hangar of the eastern Shizuoka doctor helicopter as an SCU in the 2022 Shizuoka Prefecture disaster drill. There are advantages and disadvantages to using the hangar of a doctor helicopter in this way, so further investigation will be necessary.

Prevalence of Mental Health Problems among Patients Treated by Emergency Medical Teams: Findings from J-SPEED Data Regarding the West Japan Heavy Rain 2018

It is crucial to provide mental health care following a disaster because the victims tend to experience symptoms such as anxiety and insomnia during the acute phase. However, little research on mental health during the acute phase has been conducted, and reported only in terms of the temporal transition of the number of consultations and symptoms. Thus, the aim of the study was to examine how mental health care needs are accounted for in the overall picture of disaster relief and how they change over time. Using data from the Japanese version of Surveillance in Post-Extreme Emergencies and Disasters (J-SPEED), we assessed the mental health of injured and ill patients to whom Emergency Medical Teams (EMTs) were providing care during the acute period of a disaster. Approximately 10% of all medical consultations were for mental health issues, 83% of which took place within the first 2 weeks after the disaster. The findings showed that, from the start of the response period to the 19th response day, the daily proportion of mental health problems declined substantially, and then gradually increased. Such a V-shaped pattern might be helpful for identifying phase changes and supporting the development of EMT exit strategies.