【Objective】 We conduct a survey to assess the number of staff who will be able to come to the hospital in the event of a Nankai Trough earthquake. 【Method】 We surveyed 2,052 hospital faculty and staff using the ANPIC^®, a safety confirmation system’s questionnaire function to assess the number of staff who could come to the hospital 24 hours after a tsunami disaster. 【Results】 Responses were obtained from 1,155 individuals (56.3%). Out of these, 801 respondents (69.4%) indicated that they could come to the hospital, while 224 individuals (19.4%) reported that they could not come to the hospital due to lack of transportation. As for the time necessary to get to the hospital, 602 individuals (52.1%) responded within one hour. 【Discussion】 The results of this study suggests that securing transportation to the hospital was an issue. Furthermore, the co-occurrence network analysis of free-text responses revealed the strongest relationship with the presence of children, emphasizing the importance of support for family members. The results of this study are considered to contribute as a partial aid in ensuring personnel availability immediately after a disaster.

【Purpose and Method】This study aimed to determine the current status and issues related to the acceptance of patients with crush syndrome and the ability to respond to blood purification therapy in the event of a major disaster at base hospitals for disaster management in Japan. 【Results】A questionnaire survey was conducted at 755 base hospitals for disasters in Japan. 256 institutions (34.0%) consented to the study, and 214 institutions (83.6%) provided valid responses. 【Discussion】It was clarified that 3,000 patients with crush syndrome, which is expected to occur in the northern Tokyo Bay earthquake, cannot be accepted.

【Purpose】 Among disaster base hospitals, there are some facilities that face problems such as securing sufficient space when setting up medical aid stations that accept casualties. For this reason, it is desirable to secure sufficient space while considering the layout of the medical aid station beginning at the design stage of the facilities. 【Method】 In this study, we conducted a questionnaire survey that was completed by a total of 72 doctors and nurses with training experience in how to accept casualties during a disaster. We examined the data obtained using a two-factor analysis of variance that identified differences based on area and occupation. 【Results and Conclusions】 From this analysis, we confirmed that disaster-response hospitals require set dimensions in certain areas in order to accommodate disaster-aid-related areas and their positions in preparation for times of disaster. In addition, since the number of medical personnel required differs depending on area and occupation, we confirmed that it is important to scrutinize the details of setting up a medical aid station taking into consideration the opinions of individuals from multiple occupations.

【Purpose】We conducted a cross-sectional study on business continuity plan (BCP) issues for disaster base hospitals based on estimates of surge capacity. 【Methods】The study included hospital BCP assessments, the results of staff questionnaire survey at disaster base hospitals, and damage assumptions in Wakayama Prefecture, assuming triple interlocked great earthquakes (so-called “Sanrendo Jishin”). We estimated the medical supply and demand balance after the earthquakes and discussed the BCP issues. 【Results】The results of the medical supply and demand balance estimation revealed a clear division between medical areas that could and could not meet the medical demand. Although their training plans were generally fulfilled in the BCP, there were weaknesses in the supply systems for food and other staff supplies and in the plan for receiving medical support. 【Discussion】When medical supply is inadequate, it is particularly desirable to enhance the plans for receiving medical support. However, almost all hospitals were inadequate in this area.In areas where many doctors had difficulties commuting to their hospital after a disaster, the content of personnel structures was found to be inadequate. This was considered an issue for the BCP that was developed. 【Conclusion】The balance between medical supply and demand was potentially inadequate in many areas as were the BCP plans for receiving medical support and the efforts to raise disaster awareness among staff.

【Purpose】 In Mie Prefecture, it is assumed that there is a 70–80% probability of tsunami damage occurring within the next 30 years. As a secondary pediatric emergency medical facility and disaster base hospital, it is important for more hospital workers to be able to continue working after a tsunami. Approximately 20% of hospital workers leave their infants at nursery schools. Therefore, in order to determine whether hospital workers can continue working, we surveyed the actual tsunami evacuation plans and disaster countermeasures of nursery schools. 【Methods】 A total of 33 nursery schools in A city, Mie Prefecture, were surveyed using a self-administered, anonymous questionnaire. 【Results】 29 facilities responded, resulting in a response rate of 87.9% (valid response rate: 100%). Of the 18 nursery schools (with a total of 691 children) in the tsunami inundation zone, five did not have a tsunami evacuation plan. Additionally, although they had stockpiles of items necessary for childcare, they lacked supplies related to crisis management, such as communication equipment. Furthermore, 18 facilities (60.7%) did not plan to continue or resume childcare services. 【Conclusion】 It was confirmed that the nursery schools’ tsunami evacuation and business continuity plans were insufficient. Tsunami damage and disruption of childcare operations for infants and toddlers may hinder the increase in medical needs for pediatric emergencies and the staffing of hospital workers.

【Purpose】Focusing on the Disaster Medical Assistance Team (DMAT) activities during Typhoon No. 19 in 2019 in Fukushima Prefecture, we conducted an objective evaluation of this topic and its changes during the disaster by analyzing chronological records. 【Results】The analysis reveals a notable progression in both number of words and sentences, transitioning from the hyperacute phase to the acute period, followed by a marked decline during the subacute phase. Furthermore, the frequency of words in the chronological records changed with period. 【Discussion】During the hyperacute phase, there was an active engagement by both hospitals and DMAT in collecting information from medical institutions. In the acute phase, frequent mentions of evacuation centers and district names suggested a transition in DMAT activities toward local community support. As the situation moved into the subacute phase, an increase in the usage of words related to logistics operations indicated a shift in other work. 【Conclusion】 In conclusion, text mining on chronological records offers a promising and objective approach to evaluate topics and their changes during disasters.

【Purpose】 As a fundamental survey aimed at fostering collaboration between local communities and universities with the goal of creating a disaster-resistant town, this study sought to clarify the current awareness and behavior of local residents during disaster prevention activities. 【Method】 Heads of households within neighborhood associations adjacent to Yasuda Women’s University were asked to complete a questionnaire regarding their current awareness and practice of disaster prevention activities, as well as their needs for the involvement of university nursing faculties during these activities. 【Results】 First, residents who require evacuation support expressed their need for “assistance with walking,” “communication and guidance,” and “taking out medication.” Second, it was observed that 40% of those who require evacuation support could not receive assistance from their own family members, even if they lived in the same household. Third, at least 50% of residents had never visited an evacuation site, and 80% lacked experience with evacuation drills. Finally, there was a need for university nursing faculties to use nursing students and faculty to provide support during disasters and utilize their facilities. 【Discussion】 The findings indicate that universities should consider their organizational role in disaster response protocols and establish continuous exchanges between students, faculty, and local residents during non-emergency periods to foster collaborative disaster prevention activities with the community.

【Purpose】To prepare for major disasters, we should seek a solution to reduce the under strain of the medical system by strengthening the medical cooperation between the community and medical institutions. Additionally, we considered the possibility of utilizing private Emergency Medical Technicians (EMTs). 【Target】Individuals in the Kita-Oe district of Chuo-ku, Osaka City, who participated in evacuation drills at the Osaka Municipal Chuo High School. 【Methods】We provided triage training to local residents in an online evacuation drill assumed to use Osaka Municipal Chuo High School as an evacuation center. We exchanged opinions and conducted questionnaire surveys on the role of medical experts and emergency medical care. 【Results】Triage by private EMTs and others at evacuation centers is expected to reduce the number of injured and sick people transported to hospitals at an early stage, and residents may provide first aid to non-acute injured and sick people. Discussion was held on cooperation with residents. 【Conclusion】There are limits what the local residents could perform at an evacuation center if disasters occur. It was thought that paramedics with expertise in disaster medicine could work with the community to reduce the pressure on medical facilities.

Humanitarian crises are on the rise in abroad, and the opportunities for international relief are increasing. Nurses involved in international medical relief are expected to have the knowledge and skills to treat a wide range of target populations and a variety of illnesses and injuries. Therefore, Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital has implemented a training program to strengthen the practical nursing capabilities required for international relief work. The program combines On-the-Job Training (OJT), in which participants rotate through a selected clinical department based on their background and training goals, with Off-the-Job Training in the International Medical Relief Department. The OJT content covers 19 of the 27 medical services listed in the Classification and Minimum Standard for Emergency Medical Teams. Twenty-three participants who have completed the training have been deployed a total of 58 times for in disaster relief, humanitarian assistance in conflict areas and long-term development cooperation projects, and three have also worked in management positions. The training is organized as a self-development program for nurses working internationally, in medical facilities rather than educational institutions. To make the program more effective, Infection Control, Community Engagement and Accountability, and Protection, Gender and Inclusion are required to be included by international standards.

Japan’s Doctor Heli (DH) project was introduced in 2001, and disaster medical assistance teams (DMAT) were introduced in 2005. Both initiatives were inspired by the lessons learned from the Great Hanshin-Awaji Earthquake in 1995. Since then, the use of DH and Self-Defense Force aircraft for air medical transport in response to disasters such as the Great East Japan Earthquake in 2011 and the Kumamoto Earthquake in 2016 has been shown to be effective but many problems have become apparent. Given the expected Nankai Trough and Tokyo inland earthquakes, it would be beneficial for society to review and share the progress of air medical transport, including DH, during previous disasters. When the number of DH deployments in Japan was still small, plans were formulated to transport patients outside of disaster areas using Self-Defense Force aircraft. However, by April 2022, DH had expanded to include 56 aircraft deployed across all 47 prefectures. Furthermore, the strategy for disaster medical care in Japan has been shifting from “transporting patients from the disaster area to outside” to “injecting resources into the disaster area to respond within the disaster area.” The findings indicate that air medical transport is changing to focus more on DH.

Since the start of the novel coronavirus infection (COVID-19) pandemic, simulation training with large numbers of participants is no longer easy to conduct due to concerns about the spread of infection. On the other hand, simulation training is essential for education to provide appropriate medical care. In particular, disasters are critical and unique challenges, and regular training is essential to facilitate appropriate medical care. Here we report our experience and some challenges we faced while conducting a large-scale disaster training session for all employees of our hospital during the COVID-19 pandemic. The session was held on a weekday at the end of the 7th wave. This was a blinded exercise, and all employees participated by ceasing their normal work duties. All patients were considered with COVID-19 and were required to be handled using personal protective equipment. Patients who were determined to require hospitalization were to be evaluated for COVID-19 using antigen testing. In principle, COVID-19 patients were to be treated in private, negative pressure units, but assessment of COVID-19 and thorough infection protection proved extremely difficult in practice due to the requirements of managing many trauma patients. One important takeaway for the staff was that protecting themselves against infection should be especially prioritized before assessment patients during a disaster.