Triage an ambulance with nowhere to go Osaka From the scene between life and death May 17, 21:24
Even if I call an ambulance, it's hard to get them to come.
Even if I get on an ambulance, I can't find a hospital to accept it.
It can take up to two days to find a hospital.
The medical system in Osaka has been pushed to that extent.
“If nothing is done, we cannot save lives,”
the hospital in Osaka has begun its own unusual initiative to triage “ambulances with nowhere to go”.
The current situation in Osaka, which is trying to save lives in the last minute situation, is now appealing to the whole country the true fear of being infected with the new corona.
(Osaka base broadcasting station reporter Daimu Shimizu)
A man who hasn't been found for 6 hours ...
April 24, 6:30 pm.
The patient was brought to the Kansai Medical University Medical Center in Moriguchi City, Osaka.
A man in his 50s who was receiving medical treatment at home in Sakai City.
My condition suddenly changed and I called an ambulance, but I couldn't find a place to accept it, and more than 6 hours had passed.
There is a consciousness of the man who was carried, but his facial expression is hollow and his arms are loose.
Doctors have determined that pneumonia may be progressing because the oxygen level in the blood is not stable.
I instructed to take a CT.
A CT of the chest shows a white frosted glass shadow on the lungs.
It is a characteristic symptom of patients with the new corona and is a serious condition requiring mechanical ventilation.
"I need to be admitted to a hospital with a seriously ill bed." The
man was taken to another hospital in Osaka.
Kansai Medical University Medical Center Doctor
"
People
who are receiving medical treatment at home or at a hotel do not know what kind of pneumonia is. I can't judge whether a moderate hospital or a severe hospital is good, so take a CT. I'm sorting out patients. "
Measures for bitterness “Triage ambulance”
Why does this hospital inspect and diagnose patients who are treated at other hospitals?
In fact, this is an initiative that the hospital started independently in mid-April to determine the urgency of treatment for patients waiting for emergency transport.
We named it "Ambulance Triage".
If you cannot find a hospital to accept for a long time and some patients have worsening symptoms, this hospital will accept the ambulance that has lost its place.
At the hospital, a doctor takes a CT image of the patient and examines the condition of the lungs to determine the severity.
As a result of the test, if there is a patient who is competing for the moment, he will manage to find a place where he can be hospitalized.
Patients who are relatively stable at one of the medical institutions will be transferred to another medical institution to secure a bed.
This hospital also accepts critically ill patients with high urgency, but since it is not possible to admit all critically ill patients to this hospital, it is necessary to find another medical institution that will accept them, and the adjustment is in Osaka. The prefecture is in charge.
"I can't save my life, I can't save it."
Mid-April when the hospital started "ambulance triage".
The medical system in Osaka was rapidly tightening.
The number of emergency transports for the new corona in the third week of April by the Osaka City Fire Department was 491, 21 times that of the first week of March.
In some cases, it took almost two days to transport.
The number of people who are undergoing medical treatment or waiting at home, where they can hardly receive medical treatment due to the tightness of their beds, is increasing day by day.
If we can grasp the exact medical condition of the patients
who are being
transported by emergency, we may be able to effectively utilize the limited beds.
It may be possible to transfer a patient who was hospitalized first and has a stable condition to a moderate hospital, or to a moderate or mild hospital from the beginning.
The hospital offered to cooperate with Osaka Prefecture and decided to undertake "ambulance triage".
Yasushi Nakamori, Deputy Director of Kansai Medical University Medical Center
"Originally, illness is evaluated and then hospitalized, but that is not possible for corona. Only PCR tests are performed, and no roentgen or CT is performed. There are a lot of people. Even if I suddenly feel sick, I don't know what the situation is, so the hospital that accepts it will be in trouble, but I think that CT examination will make it easier to accept. "
Ambulances one after another even at midnight
We will be in close contact with the "Ambulance Triage" site from April 24th to 25th.
Ambulances rushed in one after another in the middle of the night.
Around midnight on April 25th.
It was a man in his 60s who was brought in.
Already in a serious condition, I will be admitted to this hospital as it is.
It was a situation that required management with a respirator.
Two ambulances arrive at the same time after 1:30 am.
A man in his 70s was brought by an ambulance in Sakai City.
It seems that he walked into the ambulance, but when he took a CT image of his lungs, it was pure white.
If you need to be hospitalized immediately, you will be admitted to this hospital.
On the other hand, a woman in her 80s was carried by an ambulance in Osaka City.
It had been five hours since I called the ambulance before I was taken to this hospital.
The oxygen level in the blood when the ambulance crew arrived was 75%.
The normal value is 96% or more, and according to the Ministry of Health, Labor and Welfare's "Medical Examination Guide", oxygen inhalation is required for 93% or less.
While I couldn't carry it, the ambulance crew was giving 5 liters of oxygen, but when I took a CT of the lungs at the hospital, it was still white.
I'm seriously ill.
Dr. Nakamori speaks to the woman with a gentle expression to relieve her anxiety.
"Grandma, it's been a big deal. Can you give me the contact information for my family?"
The woman operates her mobile phone with her trembling hands while lying on the CT examination table.
I gave Dr. Nakamori the contact information of his family in a screaming voice.
The woman was hospitalized as it was.
Yasushi Nakamori, Deputy Director, Kansai Medical University Medical Center
"The characteristic of Corona is that even if the person is unexpectedly sick, the oxygen in the blood can finally be maintained when examined. That ’s the scary thing about Corona. ”
"If we say the limit, Osaka will collapse medical care."
During the eight hours we witnessed, five people were taken to this hospital by ambulance triage.
Four of them were determined to be seriously ill.
The medical situation in Osaka is that even patients who are diagnosed as seriously ill after undergoing an examination and need to be hospitalized immediately are waiting in an ambulance for a long time.
I was afraid that I would not be taken to the hospital just by singing the symptoms, and I also felt the importance of inspecting and knowing the exact symptoms.
Both men and women who were transported after 1:30 am were hospitalized and treated for more than a week, but died afterwards.
I feel that Corona is afraid that even if she can finally be hospitalized, there are lives that will not be saved.
Kansai Medical University Medical Center Deputy Director Yasushi Nakamori
"Honestly, the medical field is really confused because it clearly exceeds our capacity. I think it is the limit. But if we say the limit, medical collapse there. So I want to do it without thinking that it is the limit. "
Things in Osaka can happen anywhere
Ten years ago, when the Great East Japan Earthquake struck, Dr. Nakamori went to Tohoku as a member of DMAT.
However, with the spread of the new corona infection this time, no matter how critical the medical care in Osaka is, "it is difficult to call for support in the situation where disasters are occurring all over the country."
In May, the death toll of the new corona in Osaka Prefecture was announced one after another on the day when more than 50 people were announced.
As of May 17, there are 13,218 people in Osaka prefecture who are undergoing medical treatment or waiting at home.
The fourth wave is now spreading all over the place.
Emergency declarations have also been issued in Hokkaido, Hiroshima, and Okayama, and the situation in Osaka can occur anywhere.
Dr. Nakamori, who has been at the forefront of "ambulance triage," is calling for the recognition that the new corona countermeasures so far will not work in the fourth wave, where the mutant virus is rampant.
Yasushi Nakamori, Deputy Director of Kansai Medical University Medical Center,
"The infectivity of mutant strains is amazing, and in many cases, if one person is infected, the whole family is positive. Even younger people are more likely to die. I have a feeling. Osaka wasn't doing it indiscriminately, and it happened in a month with just a little regaining of everyday life. This is not a problem only in Osaka. The situation is beyond the line. With that in mind, I want each and every one of us to take action to curb the flow of people, taking Osaka as our own thing. That's the only thing. "
Osaka-based broadcasting station reporter
Daimu Shimizu
Joined the
station in
2019
After working in charge of the Osaka Prefectural Police Department, he is now interviewing the Osaka municipal administration.
We are continuing to cover the medical field of the new corona.