Survey on improving the efficacy of the patient care system for crush syndrome in disaster-based hospitals in Japan

A multifaceted approach to implementing blood purification therapy in large-scale earthquakes

Abstract

Based on experiences from large-scale disasters such as the Great Hanshin-Awaji Earthquake, the establishment of a system for providing rapid medical care to seriously ill patients in disasters, especially those with crush syndrome (CS), is recognized as an urgent issue. This study aimed to evaluate the current status of and identify challenges regarding the acceptance of patients with CS and the availability of blood purification therapy at disaster-based hospitals in Japan. A questionnaire survey was conducted in 770 disaster-based hospitals nationwide (as of April 2023), and valid responses were received from 170 facilities (response rate: 22.0%). The results indicated that while 148 of the 170 facilities (87.1%) reported the capacity to accept patients with CS, only 66 facilities (44.6%) had actual experience in accepting patients with CS. Blood purification equipment was available in 155 facilities (91.2%). Regarding blood purification therapy for pediatric patients (under 15 years old), 61 facilities (35.9%) reported the capability to provide treatment, but only 28 facilities (18.9%) provided such treatment during normal operations. Although the basic infrastructure for accepting patients with CS is in place, this study revealed operational challenges. Our study revealed the need to strengthen regional medical systems, including the establishment of efficient patient transport systems between facilities and enhanced interfacility cooperation.