In FY 2017, 28.69 million foreign tourists visited Japan. We have to establish a medical system for foreign travelers because the Tokyo Olympics will be held soon in Japan. Tokyo Medical University Hospital is a facility where only critically ill patients are transported, among which many foreign patients are transported. Therefore, we aimed to determine medical problems and trends in 87 patients with severe foreign patients, including foreign tourists in Japan. The gender ratio was 2:1. By nationality Asians were 74%. Chinese were the largest at 33%. The patients to need an interpretation was 54%. The patients to need a hospitalization was 51%. As an admission diagnosis, cardiopulmonary arrest was the most frequent, 25%. The unpaid patients for medical expenses reached 14.9%. As difficulties in medical practice, it was often difficult to cooperate with other organizations such as the embassy and international transportation service, but there were few cases that had difficulties in language and cultural issues. It was found that there were few specialists among the interpreters, and that severe foreign patients were being treated at high medical safety risks.
Purpose: In Japan, the Simple Triage and Rapid Treatment (START) method is widely used during disasters. However, patients in the “green” category are often neglected, as their conditions are less urgent and less serious than others. Moreover, due to the large number of “green” category patients, the treatment and observation they receive are often insufficient. We examined the experiences of individuals affected by the 2016 Kumamoto earthquake; identified how many “green” category patients were hospitalized; and investigated problems associated with in-hospital “green” category, as well as solutions to these problems. Subjects and Methods: The subjects were earthquake-affected patients admitted to the Kumamoto Red Cross Hospital between April 14 and 18, 2016 who underwent triage under medical supervision, and who were identified as “green” category patients. Patients’ outcomes and reasons for admission (endogenous versus exogenous complaints) were abstracted using triage tags, disaster medical records used by the hospital, and electronic medical records. Results: 921 patients were categorized “green” triage. Eleven “green” category patients (1.2%) were hospitalized. Most of these patients had endogenous complaints (8/11, 72.7%). Some patients were scheduled to leave the “green” category area and return home, but instead were hospitalized based on re-examination in the “Exiting Patient Waiting Area” established by the hospital. Conclusion: Disaster-affected individuals classified by START method as “green” category include patients who require inpatient treatment. To avoid overlooking these patients, it is effective to establish an “Exiting Patient Waiting Area” where final treatment checks can be conducted, overseen by a department devoted to managing patient exits.
People encounter fierce animals in other regions of the world, such as Africa, India, etc., but seldom do in Japan. We present a rare case of trauma due to a lion attack. In Japan, the most frequently reported trauma caused by large wild animals is bear-induced trauma, in which the majority of damage is to the upper body, especially the head, neck, and chest. Similarly, this case showed a large amount of damage to the head and neck, and other areas were scratched. While bear attacks often result in trauma from claws, lion victims are often bitten by fangs and the form of the injury resembles that of a bite by a dog or cat. Based on similarities between bear- and lion-caused injuries, and between dog-, cat-, and lion-induced trauma, we studied imaging methods for contrast CT examination in preparation for similar cases in the future.