Objective: The purpose of this study was to review research trends in the education of flight nurses in Japan and to identify potential issues.

Methods: We examined articles published up to January 2022 obtained from Ichushi-Web. Those articles that met the final eligibility criteria were included in the review.

Results: Twelve articles were included in the review. Articles related to both research and education subjects were few; single-center studies were more common in the included articles. The content of education mainly pertained to on the job training (OJT) and off job training (Off JT). Most articles were assessed by evaluation charts, and few attempted to examine the effects of education on flight nurse trainees.

Conclusion: There is a need to develop more effective educational methods by surveying flight nurses at base hospitals of helicopter medical services nationwide, and by conducting a quantitative multicenter study based on the results of this survey.

Background: The situation of air diffusion in ambulances has not been clarified for droplet nuclei smaller than the smoke particles verified by smoke machines, and it is necessary to understand the situation and take countermeasures.

Objective: To quantitatively evaluate the impact of air conditioning setting conditions in ambulances on the spread of droplet nuclei, and to take countermeasures against the spread of droplet nuclei.

Methods: We set the air conditioning and partitioning of the ambulance to inject CO₂ gas from near the head of the injured or sick person, and installed CO₂ concentration meters in the ambulance at eight locations to monitor and verify changes in the concentration of CO₂.

Results: As with the smoke machine, the rear cooler had a significant impact, and the installation of partitions was found to reduce exposure to the crew, but diffusion into the storage compartment under the crew’s seats, which was not considered an exposure area, was observed.

Conclusions: It was suggested that the spread of droplet nuclei could be controlled by setting air conditioning and installing partitions, but it is necessary to exhaust the droplet nuclei out of the ambulance by forced ventilation for a certain period of time after the patient is admitted during ambulances transport.

Objective: The purpose of this study was to examine the relationship and time-series trend between the number of times the ward nursing manual was viewed and the number of incidents.

Methods: The number of times the ward nursing manual was viewed per day, the total number of incidents, and the number of corrected incidents from January 28, 2016 to March 4, 2018. Correlation analysis was performed on the number of times the ward nursing manual was viewed per day and the total number of incidents and the number of corrected incidents. In addition, the number of times the ward nursing manual was viewed and the total number of incidents and the number of corrected incidents were analyzed by decomposing them into trend, seasonal, and irregular components of variation.

Results: The median of the number of times the ward nursing manual was viewed per day, the total number of incidents, and the number of corrected incidents were 2, 1, and 0, respectively, and there was no significant correlation. Only the number of times the ward nursing manual was viewed showed trend variation consistent with the first quarter.

Conclusions: There was no relationship between the number of times the ward nursing manual was viewed and the number of incidents, but there was a trend toward an increase in the number of times the ward nursing manual was viewed in the first quarter.

Mobile stroke units (MSUs) have not yet been installed in Japan. To investigate the usefulness of introduction and operation of MSUs in our country, we conducted a nationwide questionnaire survey. Respondents included representatives from stroke association branches, emergency hospitals, stroke centers, and fire departments. We found that several regions are underserved in offering treatment with tissue plasminogen activators and often experience delays in transporting patients to hospitals. Between 30-50% of respondents considered MSUs to be useful for resolving these issues in rural or depopulated regions. Additionally, more respondents anticipate the establishment of MSUs for all stroke subtypes and other brain diseases. Free-response comments cited issues with operating systems, staffing, and costs as potential problems. MSUs may be useful in some regions of Japan, and problems can be solved by organizing regional infrastructure, using telemedicine, and building low-cost MSUs.

As a will of patients have diversified, a case of patient doesn’t want to resuscitate who cardiac-arrested has increased. On the other hand, not a few patients were called an ambulance contrary to their will. We present a case to take over the management of a patient in home medical care, who made an emergency medical request, to family doctor without emergency transport. A patient who was 87-years old man with end stage of colorectal cancer, was called an ambulance for disturbance of consciousness. After medical staff contact, it became clear that a man didn’t request treatment of prolong his life and want to die at his home. Consulting with his family doctor, we decided that starting palliative care at his home without emergency transport. It is important that making living-will with their doctor correctly and building up share system with patient’s family, nursing  care staff, medical staff and rescue crew, for medical care that respects patients will.

As the number of exotic snakes kept as pets increases, snakebites are occurring frequently. We report a case of marked local symptoms caused by the bite of a Philodryas baroni. A 23-year-old woman was bitten on her right little finger for 5 min by a Philodryas baroni, which she kept as her pet. She visited the emergency department 2 h after the injury. Swelling extending to the upper arm and pain and hypoesthesia in the right little finger were noted. Although blisters appeared on the little finger and the swelling worsened on the second day of hospitalization, she was discharged on the fourth day without any complications.

Philodryas baroni is a venomous rear-fanged snake. When the bite is prolonged, massive local symptoms may manifest. Therefore, emergency physicians need to be familiar with the management of bites from venomous snakes kept as pets.

Our facility, which is a Type 2 infectious disease designated medical institution, has ever engaged in an infectious disease treatment in Nagoya City. Though we were involved in the treatment of patients with coronavirus disease 2019 from the initial stages of the pandemic, the intensive care unit had inadequate medical resources. This report indicates the environmental arrangement of our ICU, focusing on (i) renovation of facilities, (ii) securing of human resources, and (iii) thorough infection control by staffs, and the future tasks.