Experience of flood disaster drills at a disaster base hospital

Abstract

Recently, the risk of flood disasters due to concentrated heavy rains has been increasing in Japan. While some cases of hospital evacuation have been reported, to date, no standards for hospital evacuation have been established. Moreover, no medical facilities are included in regional administrative evacuation plans. Our hospital is located below sea level in an area close to major rivers, so in addition to large earthquakes, flood disasters represent a serious threat. Therefore, as a criterion of our hospital’s emergency response based on the Arakawa River Downstream Timeline, which is a timeline for the Arakawa River, a large river located near our facility, we have established a timeline for evacuation during a flood disaster. We have also considered the time required to make the decision to evacuate by calculating backwards from 0 hr at the point when the river reaches flood level, and conducted a drill to verify the timeline, which was based on the water level of the Arakawa River as objective evidence for the risky transfer of critical patients. The decision to evacuate was made when the water reached a dangerous level (−3 h). However, this timeline did not provide sufficient time and caused a shortage of human resources for evacuating both patients and medical resources. Earlier and improved evacuation preparation is needed to reduce the time needed to discharge patients able to leave the hospital when a flood disaster is expected. However, more than 10,000 patients would need to be evacuated in our region in the event that the Arakawa River were to flood, and this remains problematic. A more comprehensive regional plan is therefore indispensable for large-scale, simultaneous hospital evacuations.