Abstract
In April 2005, a derailment on the JR Fukuchiyama line led to a serious accident when, as a consequence, the train crashed into a nearby apartment block. The purpose of this paper is to show how the medical services worked at the site of this accident, using time-history analysis from our Research Center's investigation, and to suggest how the findings could be used in the management of future mass causality incidents. Conclusions: 1) The hospitals to which causalities were transported were within 20 km of the site of the accident. The Fire and Police Authorities issued statements on the accident to hospitals within this distance, whereas the media and the HYOGO Emergency Medical Information System (HYOGO-EMIS) gave out news to hospitals, irrespective of their distance from the accident, and therefore contacted more. It is important that both the emergency services and the EMIS system are used effectively to ensure that news of any accident spreads to as many hospitals as possible, but particularly to those based in the disaster zone. 2) Good outcomes were achieved when the minor casualties were transported quickly to the hospitals in the immediate aftermath. The reason for this is that, as the accident site is very crowded, the presence of a lot of minor casualties will interfere with the management of the accident. The analysis showed that hospitals to which the minor casualties were transported, as well as the means used to get them there, differed from those used for the serious casualties. 3) Ten serious and moderate casualties were transported by helicopter to hospitals within 25 km of the site of the accident, and it appeared that this form of transportation contributed greatly to reducing the burden which would otherwise have been placed on the nearby hospitals. 4) The time-history analysis of the accident showed that the medical and emergency organizations located near the site of the accident, for example the hospitals, the medical assistant teams, Firefighters and Police, generally worked for 70 (or 90) minutes after the accident had occurred before additional assistance arrived. It is extremely important to shorten this time interval, in order to provide support to the medical services as soon as possible. To achieve this, we need to establish training for disaster scenarios, which take into account the individual characteristics of any region.
