【Purpose】Department of Pharmacy, Ogaki Municipal Hospital has prepared an emergency communication network and action cards for disaster event, and has conducted disaster trainings with the aim of ensuring smooth operations. However, despite three times training, because each member was so focused on individual action during disaster, we were unable to achieve an appropriate response in disaster training. Therefore, we evaluated the usefulness of debriefings in improving knowledge and understanding of disaster operations. 【Method】Debriefing was defined as a lecture of the medical management on disaster and inspection of the hospital section to be used in case of disaster. During the disaster training before and after the debriefing, the level of understanding of disaster operations was rated on a 5-point scale using a questionnaire method. 【Results】Debriefing significantly improved business understanding. The number of staff who understood disaster operations increased. 【Conclusion】Debriefing is expected to improve the disaster response skills of pharmacy department staff in disaster training.

When urgently dispatched to a disaster scene, information of the scene are often ambiguous. Therefore, it is critical to accurately grasp the disaster situation and take action. In this case, we experienced medical management at a fire scene, in which limited information was provided beforehand. One Sunday in March, at midnight, there was a request to dispatch a doctor car due to a residential fire accident. We were told that one person had been rescued, however, some might still be left behind. We held a short briefing in four minutes before arriving at the fire scene. After arrival, the on-site command post requested treatment and transportation of two rescued casualties with suspected airway injury. After initial examination and confirmation that their respiratory condition was stable, we had to decide whether to transport them into the emergency room or to stay at the scene for expedient treatment of left-behind casualties. We decided to continue medical management at the site for a maximum of 15 minutes while arranging to convene additional emergency physicians into the hospital. 10 minutes later, we succeeded in gathering additional staff and was able to focus on the medical activity. We confirmed two deaths and treated 19 additional casualties rescued from the scene, returning to the hospital one hour later. In this case, we experienced many difficulties, including the limited time of briefing before arrival, gathering information on the scene after arrival, deciding whether to stay or to leave the scene for optimal management, communicating with the other stuff and the commander, and providing medical treatment. We present this case to increase awareness of the difficulties in the rapid decision-making at the fire scene.

【Background】 The elderly and people with disabilities require extra considerations during disasters, and efforts to reduce mortality and prevent secondary health damage after a disaster are also required. The Japan Disaster Rehabilitation Assistance Team was organized in the wake of the Great East Japan Earthquake 2011, and has since been working as a support group that combines both medical and welfare functions in the events of a domestic disaster. On the other hand, the rehabilitation profession as a whole is not well informed about the roles and functions of rehabilitation in times of disaster, and raising awareness and developing response capacity are urgent issues. This study aims to evaluate the Disaster Rehabilitation Assistance Game and the Disaster Rehabilitation assistance team Honbu Start Up Game based on the gaming simulation theory and the draft manual for public health activities by rehabilitation professionals and the draft public health textbook for rehabilitation professionals during disasters. 【Method】 Descriptive statistics of self-administered questionnaires after the training. 【Results】 62 DREAG participants and 98 REHSUG participants completed the questionnaires (response rate: 98.4% and 95.1%, respectively). The median and interquartile range of participants’ ratings of whether each game was meaningful were 9 (8, 9) and 8 (7, 9), DREAG and REHSUG respectively. The main learning focus of each game was also generally highly evaluated. 【Conclusion】 The results suggest that both games are useful in increasing rehabilitation professionals’ interest in disasters, and obtaining basic knowledge about the roles of rehabilitation professionals as well as responding to various situations under disasters.

For disasters in which medical resources are scarce, the means to secure and utilize medical resources become a challenge. The students have been assisting with disaster recovery in addition to receiving training for disasters under the instruction of respective schools and hospitals. If students are able to carry out activities on their own, then the human resources in health care that were allocated to support students can be allocated to provide restoration assistance. In order to verify whether students are capable of independently providing disaster recovery assistance, a student volunteer office was set up for disaster training at a university hospital in order to provide a training in which the students themselves lead and direct volunteer activities. As a result, under the instruction of the student volunteer office, the student volunteers transported and guided the patients, carried medical materials, and searched the hospital for the families of the patients. It was found that medical students who are engaged in clinical practice at the hospital can carry out adequate support activities in disaster training without advance preparation. It is believed that the implementation of medical students engaged in clinical practice who are independently carrying out volunteer activities in the hospital will lead to the effective use of limited medical resources.

Since December 2019, the coronavirus disease 2019 (COVID-19) has been spreading worldwide. The first wave in Japan caused confusion from the lack of testing resources and insufficient facilities to accommodate patients. The National Center for Global Health and Medicine began providing medical services for COVID-19 in January 2020, but the rapid rise in the number of consultations and referrals, as well as the need to prioritize treating severely ill patients, led to a disproportionately heavy workload on certain departments. This situation increased the number of hours worked overtime in the Department of Infectious Diseases by 3.5 times compared to the previous year. Reasons considered were that dealing with critically ill patients requires resources, including human and material, and as the situation was unclear to other departments, providing support, was difficult for them. A task force including the director and other hospital executives was formed with the aim of providing efficient and safe medical care. A unique phasing system was created within the hospital that was determined by the number of critically ill patients. This could act as a bottleneck for hospital administration systems. By obtaining cooperation from the entire hospital staff, the overtime hours were improved. It will be necessary to change the phases and medical care burden according to increases and decreases in the number of COVID-19 patients. In addition, when the situation worsens, it is advisable to consider changing the health-care system and reduce low-priority medical care such as health-checkup.