The life that can be saved cannot be saved The tightness of emergency medical care The worst ever, February 25, 19:49

"I thought I would be able to help as long as I got in the ambulance," says



a woman who recently lost her 76-year-old husband to an acute myocardial infarction.



Her husband once got on an ambulance but couldn't find a hospital to accept her and returned to her home to take her breath.



I can't save my life.



Such an unprecedented crisis is occurring in the emergency medical care of Corona.


(Social Department reporter Ayumi Kurokawa)

3 hours in an ambulance Still ...

In early February, my husband's blood pressure at his home in Tokyo dropped, and he fell into a state of consciousness.



The nurse she was visiting noticed something was wrong and called her ambulance.



Her paramedics determined that she might have a myocardial infarction and immediately put her husband in an ambulance.

In front of my wife who was on board, I searched for a place to accept, including hospitals other than Tokyo, but I could not find it even after about 3 hours.



The paramedics had no choice but to contact their home doctor and take her husband home.



A rushed doctor gave him oxygen, but the next morning her husband died.



Her cause of death was an acute myocardial infarction.

My wife , "The

rescuer


said,'This is no good, that's no good,' and he tried hard to find a hospital.



I never dreamed that this would happen, and I was stunned. If the corona infection had not spread, I would be treated at the hospital, live a little longer, and watch the growth of my grandchildren together. I hate Corona when I think I was able to do it. "

“Maybe I could have been saved if I was treated immediately”

Myocardial infarction is more likely to occur in winter, and in acute cases, catheter treatment within 2 hours of onset is said to increase the survival rate.



She suspected that the clinic, which was contacted by her paramedics to treat her husband, could have saved her life if she had been properly treated at the hospital immediately. I'm pointing out.

Hinata Zaitaku Clinic Director Kazuma Tashiro


"I heard that my condition was not bad for about 2 hours after calling the ambulance, but it got worse after 3 hours. Usually, patients with acute myocardial infarction When I heard that the destination was not decided because of the urgent need for treatment, I felt "no way". It is a critical situation that I cannot even receive treatment at the hospital even though I am in a situation where I am competing for the moment. "

"Difficult to transport by emergency" even in Japan

Emergency transportation is not possible immediately.



Such a situation is happening all over the country now.



The Fire and Disaster Management Agency of the Ministry of Internal Affairs and Communications has reported from 52 fire departments nationwide that the cases where the ambulance crew inquired to the hospital four times or more before the transportation destination was decided and the ambulance crew stayed at the site for 30 minutes or more were regarded as "difficult to transport cases". I have received and summarized it.



6064 cases in the week until February 20th.



We updated the record high for 6 consecutive weeks.

Until now, even medical institutions that have managed to accept patients are approaching their limits.



Sakakibara Memorial Hospital, which specializes in the treatment of the heart and aorta in Fuchu City, Tokyo, has been brought in one after another by emergency patients who could not find a place to accept it since January when the infection of the new corona began to spread. It came to be.

A patient who had an acute myocardial infarction and was transported from Machida City, Tokyo, about 20 km away, for more than an hour and a half.



It took about 2 hours from Yamanashi prefecture, which is about 70 km away, because the artery of the thigh was occluded and there was a risk of dying in a few hours, but it was said that it could not be accepted from 7 hospitals. The patient who was brought in.



Patients with heart failure who could not find a place to receive after 77 calls by the ambulance crew, who could not find a destination immediately even if they needed urgent treatment, had a medical record record. There are more than 20 people alone.

Due to the placement of medical staff, the maximum number of beds that can accept inpatients is 260, but in early February, 99% was temporarily filled.



Since then, the sickbed has continued to be tight, and there is a risk that we will have to decline acceptance as it is.

Sakakibara Heart Institute Director Mitsuaki Isobe


"I feel that emergency medical care is an order of magnitude tighter than in the 5th wave so far. We have accepted a wide range of patients to protect emergency medical care, but we have reached the limit. As

we get closer, we feel a great sense of crisis.



In some cases, we may miss the timing of treatment, and we may have already done so. "

In the shadow of the increased corona beds

Why is emergency medical care so tight?



When I interviewed the network created by 73 hospitals in Tokyo that deal with emergency patients with heart disease, the reason became clear.



The number of emergency patients that can be accepted is lower than usual in some of the affiliated hospitals.

Tokyo CCU Network Chairman Morimasa Takayama (Specially Appointed Deputy Director of Sakakibara Heart Institute)


"Some hospitals specializing in heart have secured corona beds at the request of the government. Specialized hospitals accept more patients than before. I've been there, but now I feel like I'm walking a rope. "

The Ministry of Health, Labor and Welfare has requested prefectures to increase the number of beds for corona patients in response to a series of patients who could not be hospitalized in the fifth wave of last year.



As a result, approximately 20 hospitals affiliated with the network have converted some of the beds normally used for intensive care of the heart to beds for critically ill patients in Corona, making them less able to accept patients with heart disease than before. It means that it is.



In response to the pressure of emergency medical care, the Ministry of Health, Labor and Welfare reminded prefectures in January that it would be possible to accept general emergency patients if the corona bed was vacant.



Regarding this, Mr. Takayama, Chairman of the Network, said, "It is not impossible, but it is not easy from the viewpoint of infection prevention because it is necessary to separate the whereabouts of patients who are infected with corona and those who are not."



A person in charge of the Ministry of Health, Labor and Welfare also said, "Many people say that it is difficult to accept general emergency patients in the corona bed, and I feel it is difficult. There is no silver bullet to relieve the tension, and I have to take every approach. ".

Medical staff who cannot go to work

Another reason why emergency medical care is so tight has become clear.



As with myocardial infarction, the academic society investigated the acceptance status of stroke patients, whose number of emergency patients increases in winter, at hospitals around the world as of January.



Among the hospitals that have been certified as advanced treatment facilities, more than 20% of the hospitals that answered "There are days when acceptance was restricted" were able to be investigated so far.



There were a number of cases where medical staff were infected or became close contacts and could not go to work.

Teruyuki Hirano, Director, Japan Stroke Society


"Omicron strain has spread the infection closer to medical staff than ever before. As a result, the way of emergency transportation up to now is fundamentally unsustainable



. We do our best to the patients who came within our reach, but they happened to be the patients who happened to have a vacant bed and were transported smoothly. Looking at the situation, there may be cases where some people have not reached the hospital and the patients who could normally be saved cannot be saved. "

Mr. Hirano says that the strain on emergency medical care cannot be expected to be resolved immediately.



At the end of the interview, patients and others requested that they protect themselves.

Teruyuki Hirano, Director, Japan Stroke Society


"There is a part that can be tackled for prevention of stroke. I would like people with chronic illnesses to continue to work on prevention without stopping treatment. It is not the situation that we can receive emergency treatment smoothly now, including traffic accidents. Please be careful on a daily basis without thinking that it is a person. "


Ayumi Kurokawa , a

reporter from the Social Affairs Department , worked


in the Kumamoto Bureau and Fukuoka Bureau, and


then covered the social security and medical fields.


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