Abstract
At 09:18 on April 25, 2005, a train derailment occurred on the JR-Fukuchiyama Line in Western Japan. In this incident, 107 people died and 549 people were injured. At 10:01, we arrived at the scene of the accident by the doctor car as a first medical team and carried out triage and treatment at the casualty cleaning station. After the successive arrival of more medical teams, the role of “medical commander” of other medical teams was established. Because the doctor car system was available and well known at daily emergency system, a medical team could be dispatched in an early stage immediately after the incident's occurrence. In general, all medical teams were well organized and well managed at the incident site. So, it is supposed that “preventable deaths” were avoided. However, some problems, especially communication and intelligence, came to light, so in the future, we hope that information sharing and coordination with the fire and police departments through the incident control units will improve, and that an uninterrupted chain of triage, treatment and transfer will be available to casualties. By examining the issues of this incident and improving the problems we accoutered, we hope that a better and more effective disaster medical system in Japan will be established.
