Analysis of Countermeasures and Demands for Hospital Facilities Accepting Casualties

Abstract

In this study, we examined countermeasures and facility demands when taking in casualties at disaster base hospitals during a disaster. 1. Many institutions had all disaster areas on the access floor and raised many concerns about the flow were raised. 2. The emergency department was designated for the critical care area in many institutions. This factor is effectively increased satisfaction in the ability to appropriately deal with serious illnesses and injuries. And it is shorter distances to scan rooms and ward elevators during emergency use. 3. Close proximity between the triage area and the critical care area was most strongly desired.

Studies of first‐aid medical stations by flow simulation of damaged patients by the earthquake part 2: Investigation based on the area scale of disaster base hospitals by predicting the number of patients affected by a northern Tokyo Bay earthquake

“…Many facilities assume that in the green and yellow area(s), the spaces for treatment, recovery, and observation will not be particularly divided between treatment and recovery/observation. They also often assume that the green area will be in front of the outpatient entrance, in the outpatient department and the entrance hall, that the yellow area will be in the outpatient department and the entrance hall, that the red area will be in the emergency department, and that the black area will be near the morgue, the outpatient department, and the radiation department 8 . With reference to the above and considering that certain areas can be indicated in the architectural plans of the target hospital, we assumed that the treatment and recovery spaces for the green area correspond to the outpatient waiting area on the 2nd floor, the treatment space for the yellow area corresponds to the entrance hall (payment waiting area) on the 1st floor, the recovery space for the yellow area corresponds with the outpatient waiting area on the 2nd floor, the treatment and recovery spaces for the red area correspond to the emergency department, and the treatment space, when possible, and morgue space for the black area correspond to the radiation waiting area (Figure 2).…”

“…In addition, even if the number of casualties presenting to a hospital can be treated by the corresponding medical staff, including situations such as being unable to return home due to a disaster there and difficulty in moving from place to place due to road damage, etc., the cumulative number of casualties will eventually become a very large number. In other words, although areas corresponding to each color tag are assigned at the time of hospital design and based on the results of training, 8 it is necessary to consider that the number of people may be too large for the current facility to accommodate, depending on the time elapsed after a disaster. In this study, the green area was assigned to an outpatient waiting room on the 2nd floor assuming ambulatory casualties; however, this area will be flooded with casualties immediately after the disaster. Therefore, it is necessary to consider allowing green‐tag casualties to leave the hospital as soon as possible after treatment and recovery.…”

“…Or a green area should be set up deeper inside the hospital, because green‐tag casualties are able to move relatively easily. For the yellow area, in this study, the treatment space was assumed to be the entrance hall on the 1st floor, and the recovery space was assumed to be the outpatient waiting area on the 2nd floor. For casualties whose conditions suddenly change to red, there remains a problem in securing a flow line to the emergency department, which is often assumed to be a red area, 8 but it was found that a relatively large area could be secured even after a long lapse of time after the disaster. For the red area, most hospitals chose the emergency department, 8 but in our research, 12 the area of the emergency department does not provide a high correlation between the average number of outpatients per day and the number of available beds, and it is an almost constant area scale. Therefore, the fact that the number of red‐tag casualties exceeds capacity immediately after a disaster cannot be changed within the current system even in a relatively large hospital.…”

“…In addition, if we do not take measures, such as transporting hospitalized but stable patients to other facilities, there will be no bed vacancies. Thus, even if problems with medical equipment and the number of staff remain, there is a need for a sufficiently large red area in order to respond to the disaster and adequate building construction should be secured accordingly. When devising a method for accepting casualties in the hospital, the basic plan is to allocate areas corresponding to each triage color tag and to consider the distribution of each area 8,13,14 . However, since the red‐area space is insufficient for accommodating all red‐tag casualties, it may be possible to initially place lower priority red‐tag casualties in the yellow area.…”

“…They also often assume that the green area will be in front of the outpatient entrance, in the outpatient department and the entrance hall, that the yellow area will be in the outpatient department and the entrance hall, that the red area will be in the emergency department, and that the black area will be near the morgue, the outpatient department, and the radiation department. 8 With reference to the above and considering that certain areas can be indicated in the architectural plans of the target hospital, we assumed that the treatment and recovery spaces for the green area correspond to the outpatient waiting area on the 2nd floor, the treatment space for the yellow area corresponds to the entrance hall (payment waiting area) on the 1st floor, the recovery space for the yellow area corresponds with the outpatient waiting area on the 2nd floor, the treatment and recovery spaces for the red area correspond to the emergency department, and the treatment space, when possible, and morgue space for the black area correspond to the radiation waiting area (Figure 2). 1 In the case of green-tag spaces, when the target hospital's useable outpatient waiting area of 543 m 2 , is multiplied by 70% (rental ratio) and the result is divided by 2 m 2 (minimum space necessary per person), it is revealed that 190 casualties can be accommodated in that space (note: in the outpatient waiting room 9 , the area per seat is 1.9 m 2 , so the figures quoted are rounded to the nearest whole number).…”