臨牀透析 Vol.22 No.11(3-2)


特集名 透析医療における災害対策
題名 災害時の対応 -- 現在 [2] 検証された対策と今後の問題点
発刊年月 2006年 10月
著者 赤塚 東司雄 府中腎クリニック
著者 山川 智之 白鷺病院
【 要旨 】 透析医療における災害対策は,1978年宮城県沖地震に始まり,1995年阪神・淡路大震災を経て広域化がはかられた.その後,提唱されてきた対策が検証される機会をもたなかったが,2003年十勝沖地震,2004年新潟県中越地震,2005年福岡県西方沖地震を経験することで多くの検証がなされた.これらの地震の経験から,地域密着型災害は現在の対策で対応可能であることが示された.しかし,今後,首都圏直下型地震などの都市型災害に対する対策は万全ではない.これまでに地域密着型災害対応で有用だった対策 (患者監視装置やベッドのキャスター,ROや透析液供給装置の固定,患者のグループ化による情報伝達など) を十分に浸透させることで,減災は可能であると考えている.個々の被害が小さくなることで,総体としての被害量を小さくすることが重要である.それが,都市型災害の特徴である「対応しきれないほど多数の被災者」を,なんとか対応しきれる数に減じることにつながる.
Theme Contingency Plans for Dialysis Treatment
Title Present communication methods during disasters concrete measures to deal with natural disasters
Author Toshio Akatsuka Fuchu Renal Disease Clinic
Author Tomoyuki Yamakawa Shirasagi Hospital
[ Summary ] Measures to deal with natural disasters in relation to hemodialysis began after the Miyagi-oki earthquake (1978). After the Kobe earthquake (1995), the expansion of those measures continued. After that time, we did not have any opportunity to test those measures until we experienced the Tokachi-oki earthquake (2003), the Niigataken Cyuetsu earthquake (2004), and Fukuokaken seihou-oki earthquake (2005). In the process of dealing with those earthquakes, we were able to verify the usefulness of many measures to deal with natural disasters. From these many experiences, it was deemed that we could deal with natural disasters sufficiently. However, disasters only happened in small areas. We could not deal adequately with disasters happening in a major metropolitan area, such as the type of earthquake which might occur in or near the national capital. It is thought that we can do many things to decrease disaster damage. Hemodialysis, disaster measures already developed should be implimented at hemodialysis institutions. Those measures of dealing with disasters include the caster free method for beds and monitors, a fixing method for the RO and hemodialysis solution feeders, and information transmission for locating patients. It is important that the amount of overall damage be reduced by means of reducing individual damage cases. If we implement these measures fully, we can reduce cases where we say: “too many suffering patients we can not deal with” ; however this is the characteristic of disasters in a megalopolis, which we must somehow deal with.
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