Mobile intensive care unit "Ekmoka" is dispatched every day.

The number of severely ill patients with the new coronavirus continues to be at the highest level ever, and in Tokyo, it has become severe during hospitalization, and there are a number of cases in which treatment using an artificial heart-lung machine = ECMO is required and the patient is forced to transfer to another hospital. increase.

There have been a series of cases in which "Ekmoka", which can be treated using ECMO, is dispatched for transfer, and doctors in the field say, "If the number of seriously ill patients increases, it will be difficult to deal with it."

According to "Japan ECMO net," which summarizes the treatment of critically ill patients with the new coronavirus, the number of patients who are unable to breathe on their own and are receiving treatment using ECMO has reached 161 nationwide as of the 4th, in the past. The most updates continue.

At the "Tokyo Metropolitan Tama Medical Center" in Fuchu City, which is the base of this treatment, there are a number of cases in which patients who had been hospitalized for moderate illness at another hospital became severely ill and were requested to transfer to another hospital because they needed ECMO. I'm out.

The center is the only hospital in Tokyo where "Ekmoka" is deployed and is transferring to a hospital that can treat ECMO, and several times each in the third wave of infection spread from the end of the year to the beginning of the year and the fourth wave of spring Only was dispatched, but since the end of last month, it has been dispatched almost every day.

Doctors who deal with critically ill patients are dispatched from all over the country through "Japan ECMO net" to the hospital, and they board the Ekmo car and give guidance on the treatment of Ekmo at other hospitals, but the requests overlap. It means that it may be difficult to deal with.

Takaki Shimizu, director of the ECMO center at the hospital, said, "We have managed to deal with it with the help of doctors nationwide, but it is really a last-minute operation, and it will become difficult if the number of seriously ill people increases."

Strict operation site 6 hours to complete transfer

The Ekmocar is wider than a general ambulance and is equipped with medical equipment such as a respirator and oxygen cylinder, and it is possible to perform treatment using ECMO while on the move, which is a "mobile intensive care unit". Also called.

More staff than regular ambulances, such as doctors, nurses, and clinical engineers, can board and respond to sudden changes in the patient's condition.

At the Tokyo Metropolitan Tama Medical Center in Fuchu City, which is the only hospital in Tokyo, there have been a series of requests for dispatch since mid-August, when the number of critically ill patients increased sharply. In response to the request to let me do it, from around 8:30 am, doctors specializing in critical care, clinical engineers, and doctors dispatched from "Japan ECMOnet" proceeded with preparations, and a total of 7 people boarded the hospital. Departed from.

Ekmoka went to a hospital in Bunkyo Ward, Tokyo, which mainly accepts patients with moderate illness, and the respiratory condition of patients in their 50s who were being treated with a respirator worsened further, and at ECMO It means that treatment was needed.

In ECMO, by sending oxygen directly to the blood taken from the patient's body, the function of the lungs can be temporarily substituted, and after the blood is taken out from the body through a tube inserted from the neck or the base of the foot, Instead of the lungs, it dissolves oxygen and returns it to the body.

After arriving at the hospital, the medical team checked the patient's general condition, and then put on the ECMO for about 3 hours by passing a thick tube through the groin and neck of the patient to see if it worked properly. ..

After that, the medical team put the patient on the equimocar while wearing protective clothing, and carefully checked whether the tube was displaced while driving and whether there was a blood clot in the device or tube while looking at the monitor etc. was doing.

Then, when the patient arrives at Showa University Hospital in Shinagawa Ward, where the patient is transferred, about 10 people, including doctors and nurses from the university hospital, bring the patient to the hospital room and adjust equipment such as ECMO and respirator. I did.

It took about 6 hours from the departure of Ekmoka to the transfer of one patient from the Tokyo Metropolitan Tama Medical Center, and it may be difficult for the medical team to handle many patients. increase.

Takaki Shimizu, director of the ECMO Center of the Tokyo Metropolitan Tama Medical Center, said, "The patient who was transferred to another hospital this time was in a state where he could not save his life without wearing ECMO. The reality is that we have not been able to respond to all requests. We want many people to take action to reduce the number of infected people and reduce the number of more seriously ill patients. "