Although the number of people infected with the new coronavirus is still high, it is finally starting to decline.

On the other hand, the number of severely ill patients continues to be the highest level ever, and the number of cases where patients who cannot breathe on their own are treated with an artificial heart-lung machine = ECMO is also the highest level.



What is the actual situation in the medical field now?

When I was interviewed on an "Ekmocar" that transports patients while treating ECMO, I could see the harsh reality of treatment, which is said to be the "last fortune" that connects the lives of critically ill patients.

(Naoki Azuchi, Reporter, Faculty of Science and Culture)

"I want you to see the harsh scene and tell it," said the reporter ...

It was on the 2nd of this month that he was allowed to ride in the Ekmocar.


The number of infected people has decreased from the previous week, and there was an atmosphere that it might finally take a breather, but the doctor who deals with critically ill patients said, "I want you to see the harsh scene and tell me," and interviewed with him. I decided to do it.

We headed to the Tokyo Metropolitan Tama Medical Center in Fuchu City, the only ECMO treatment base in Tokyo where "Ekmoka" is operated.

What is Ekmoka?

Treatment using ECMO, a heart-lung machine, is performed for patients who have become severely ill and cannot breathe on their own and cannot take in oxygen.



ECMO draws blood out of the body, dissolves oxygen and returns it to the body.

By temporarily substituting the function of the lungs of a patient with severe pneumonia in the corona, the lungs are rested and the patient waits for recovery.



It has played a major role in the treatment of people who have become severely ill with the new corona.

It is the "Ekmoka" that can perform this treatment while the patient is being transported.

<8:30> A team of doctors The mission is to transfer critically ill patients

8:30 am.


At the Tokyo Metropolitan Tama Medical Center, a team of seven people, including doctors specializing in critical care centers, clinical engineers, and doctors from all over Japan who can treat severe cases, were dispatched from "Japan ECMO net". ..



The mission of Ekmokar on this day was to transfer a severely ill patient to a university hospital that can treat the severely ill at a hospital that accepts moderate illness.

<9:00> Departure from Ekmoka

Before departure, the medical team prepares a portable type of ECMO and checks each necessary item such as pipes, scissors, and power cable to be used for treatment.

I packed it in 5 or 6 big bags and boarded the Ekmo car around 9am.

What is the equipment of Ekmoka?

Ekmoka, also known as the "mobile intensive care unit".

It is equipped with a large-capacity battery and is equipped with a number of medical devices such as respirators, oxygen cylinders, and testing equipment.

It is wider than a general ambulance and can carry patients wearing ECMO.

Multiple staff, such as doctors, nurses, and clinical engineers who operate ECMO, can board and respond to sudden changes in the patient's condition.

Check treatment policy while on the move

Ekmoka headed to a hospital in Bunkyo-ku, Tokyo, which is 40 kilometers east of the Tokyo Metropolitan Tama Medical Center and accepts patients with moderate illness.



On the way to this hospital, the medical team will call the hospital to which they are transferred to check if they have the necessary equipment for treatment and discuss what kind of equipment to use for treatment.

<10:30> Arrive at the hospital “It is difficult to save lives without using ECMO”

At 10:30 am, one hour after departure, Ekmoka arrived at the hospital.



The person requested to be transported was a male patient in his 50s who was originally hospitalized for moderate illness.

I was being treated with a ventilator, but the medical team reconfirmed my general condition and decided that it would be difficult to save my life without ECMO.

Carefully check the operation of ECMO 3 hours to turn the patient into an exmocar

In ECMO treatment, blood is taken out of the body through a tube inserted from the neck or the base of the foot, and then oxygen is dissolved instead of the lungs and returned to the body.



Doctors wear it neatly, but ECMOs can be life-threatening for patients if they get stuck, so check again and again to see if they move stably.

The medical team, wearing protective clothing, was able to put the patient on the Ekmocar three hours after arriving at the hospital.

<13:30> Departure to the hospital to which you are transferred

At 1:30 pm, Ekmoka departs for the hospital to which he is transferred.

There was a separate driver's seat from the back room where the patient was treated, and I sat in the passenger seat.

While driving, I was watching the patient being treated from the passenger seat through the glass.

Doctors and clinical engineers constantly checked the monitors to see if there were blood clots in the equipment or tubes, or if the tubes had come off.

<14:00> Arrive at the hospital to which you are transferred

After 2:00 pm, I arrived at Showa University Hospital in Shinagawa Ward, where I was transferred.



Approximately 10 people, including doctors and nurses from a university hospital, brought the patient to the hospital room and adjusted equipment such as ECMO and respirator.

<15:00> Completion of work It takes about 6 hours to transfer one patient to another hospital

All the transfer work was completed around 3 pm.



It took about 6 hours from the time Ekmoka left the Tokyo Metropolitan Tama Medical Center to the completion of the transfer of one patient.

Transferring a critically ill patient required the operation of life-threatening equipment and perfect infection control, which was more difficult than I had imagined involving many staff members.

Severely ill patients continue to be the highest ever

As of the 5th of this month, the number of patients receiving treatment using ECMO was 165, which is the highest level ever since the middle of last month.

However, the number of hospitals that can treat ECMO is limited, and at the Tokyo Metropolitan Tama Medical Center, beds for critically ill patients are filled with patients wearing ECMO, making it difficult for hospital doctors to leave the ward.



Among them, the Tokyo Metropolitan Tama Medical Center has been receiving a series of hospital transfer requests since the end of last month, and now it is responding by dispatching a doctor from "Japan ECMO net".

Doctor "From the end of August, the operation of continuous sunrises is barely possible ..."

Dr. Takaki Shimizu, Director of ECMO Center, Tokyo Metropolitan Tama Medical Center


"We were dispatched only a few times in the 3rd wave of infection spread from the end of the year to the beginning of the year and the 4th wave of spring, but in the 5th wave of this summer, dispatch requests are almost every day. Since the end of August, we have been dispatching Ekmocar almost every day. ”



This time, while we were on board the Ekmocar and interviewed, Dr. Shimizu's mobile phone received multiple requests for new hospital transfer, and Japan ECMOnet The doctor dispatched from was dispatched to the request destination.

Dr. Shimizu says that it will be difficult to respond if there are more requests.



Dr. Takaki Shimizu, Director of ECMO Center, Tokyo Metropolitan Tama Medical Center


"This time, the patient who was transferred to another hospital could not save his life without wearing ECMO. The reality is that we are not able to meet all the requests at the last minute. We want many people to take action to reduce the number of infected people and reduce the number of more seriously ill patients. "

ECMO treatment to protect "in the last fortress"

I didn't know that it would take so much time and people to transfer to another hospital by Ekmocar.



Dr. Shimizu said, "The continuous sunrise movement of Ekmocar is clearly an abnormal situation," but it is expected that the situation where the operation will be carried out at the last minute will continue in the future.



Treatment with ECMO is also referred to as the "last fortune" of treatment for critically ill patients.

I strongly felt that it is important to reduce the number of infected people as soon as possible and return to the situation where the dispatch of Ekmoka is reduced, as we are one step closer to the situation where we can



not save lives that can be saved


.