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Hamada M, Nagasawa H, Taniguchi H, Sakai T, Ohsaka H, Omori K, Yanagawa Y. Effect of the Presence of Cardiac Tamponade on Jugular Vein Diameter in Cases of Cardiac Arrest Due to Thoracic Aortic Disease. Cureus 2023; 15:e50791. [PMID: 38239545 PMCID: PMC10796082 DOI: 10.7759/cureus.50791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2023] [Indexed: 01/22/2024] Open
Abstract
Background There have so far been no reports regarding whether or not the jugular veins remain distended even in cases of cardiac arrest, which is the worst form of shock. We focused on the diameter of the jugular vein in neck computed tomography (CT) in cases of thoracic aortic disease resulting in cardiac arrest to determine whether or not cardiac tamponade increased the diameter. Methodology From January 2014 to December 2021, patients were eligible for inclusion when they were transported to our hospital, judged to be in cardiac arrest at the emergency department, and then diagnosed with thoracic aortic disease as the cause of cardiac arrest according to CT. Patients were divided into two groups according to the presence (tamponade (+)) or absence (tamponade (-)) of cardiac tamponade. Comparisons between the two groups were also conducted after excluding cases in which relief of cardiac tamponade was obtained before CT or that had hemothorax. Results There were 52 cases in the cardiac tamponade (+) group and 16 in the cardiac tamponade (-) group. The diameters of both the right and left internal jugular veins were significantly larger in the cardiac tamponade (+) group than in the cardiac tamponade (-) group. After excluding cases with relief of cardiac tamponade before CT and hemothorax complications, the right and left internal and external jugular vein diameters in the cardiac tamponade (+) group were still significantly greater than those in the cardiac tamponade (-) group. Conclusions The present study showed that the cardiac tamponade induced by thoracic aortic cases tended to display larger internal jugular vein diameters compared to cases without cardiac tamponade, even in patients experiencing cardiac arrest. Additionally, cardiac tamponade consistently presented with larger diameters in the right-sided jugular vein.
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Affiliation(s)
- Michika Hamada
- Acute Critical Care Medicine, Juntendo University Shizuoka Hospital, Izunokuni, JPN
| | - Hiroki Nagasawa
- Acute Critical Care Medicine, Juntendo University Shizuoka Hospital, Izunokuni, JPN
| | - Hiroaki Taniguchi
- Acute Critical Care Medicine, Juntendo University Shizuoka Hospital, Izunokuni, JPN
| | - Tatsuro Sakai
- Acute Critical Care Medicine, Juntendo University Shizuoka Hospital, Izunokuni, JPN
| | - Hiromichi Ohsaka
- Acute Critical Care Medicine, Juntendo University Shizuoka Hospital, Izunokuni, JPN
| | - Kazuhiko Omori
- Acute Critical Care Medicine, Juntendo University Shizuoka Hospital, Izunokuni, JPN
| | - Youichi Yanagawa
- Acute Critical Care Medicine, Juntendo University Shizuoka Hospital, Izunokuni, JPN
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Ohsaka H, Yanagawa Y, Konagaya M, Onitsuka M, Nakamura S, Awata K, Okawa N. Transportation of Medical Staff by Helicopter to Manage a Concealed Delivery at Home. Air Med J 2023; 42:496-498. [PMID: 37996189 DOI: 10.1016/j.amj.2023.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 06/09/2023] [Accepted: 06/21/2023] [Indexed: 11/25/2023]
Abstract
An unmarried pregnant woman felt lower abdominal pain. She rested in bed in her room on the second floor in her home. The next day she performed a delivery by herself. After the neonate cried, her parents noticed the birth and called an ambulance. After receiving the first call, the fire department decided to request the dispatch of a physician-staffed helicopter emergency medical service in Eastern Shizuoka, in addition to dispatching an ambulance. After receiving the request, the helicopter emergency medical service transported 1 neonatal intensive care unit physician along with the original medical staff members of the fire department. Then, the 3 medical staff members were transported to the home by another ambulance. When emergency medical technicians climbed up a steep narrow ladder to enter the room, both the mother and female neonate were connected by the umbilical cord. Their vital signs were stable. At 30 minutes after delivery, the medical staff reached the mother and neonate and cut the umbilical cord. The mother and neonate were evacuated separately from the room but transported in the same ambulance. The ambulance transported them with the medical staff members to our hospital directly. Their postadmission courses were uneventful, and they were discharged. This is the first case report to send medical staff members to the patient's home by helicopter and ambulance to provide medical intervention for the neonate and her mother. Further prospective studies are needed in the future to determine whether this action could lead to favorable outcomes in both neonates and maternal bodies.
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Affiliation(s)
- Hiromichi Ohsaka
- Doctor Helicopter at Eastern Shizuoka, Shizuoka Hospital, Juntendo University, Izunokuni City, Shizuoka, Japan
| | - Youichi Yanagawa
- Doctor Helicopter at Eastern Shizuoka, Shizuoka Hospital, Juntendo University, Izunokuni City, Shizuoka, Japan.
| | - Masaki Konagaya
- Doctor Helicopter at Eastern Shizuoka, Shizuoka Hospital, Juntendo University, Izunokuni City, Shizuoka, Japan
| | - Mika Onitsuka
- Doctor Helicopter at Eastern Shizuoka, Shizuoka Hospital, Juntendo University, Izunokuni City, Shizuoka, Japan
| | - Saori Nakamura
- Doctor Helicopter at Eastern Shizuoka, Shizuoka Hospital, Juntendo University, Izunokuni City, Shizuoka, Japan
| | - Kentaro Awata
- Department of Neonatology, Shizuoka Hospital, Juntendo University, Izunokuni City, Shizuoka, Japan
| | - Natsuki Okawa
- Department of Neonatology, Shizuoka Hospital, Juntendo University, Izunokuni City, Shizuoka, Japan
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Yanagawa Y, Takeuchi I, Nagasawa H, Muramatsu KI, Ohsaka H, Ishikawa K. Usefulness of Key Word Methods to Execute Early Requests for a Physician-Staffed Helicopter Emergency Medical Service Dispatch to Facilitate Early Medical Intervention by Physicians. Air Med J 2023; 42:365-368. [PMID: 37716809 DOI: 10.1016/j.amj.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 05/31/2023] [Accepted: 06/04/2023] [Indexed: 09/18/2023]
Abstract
OBJECTIVE A physician-staffed helicopter emergency medical service is called a doctor helicopter (DH) in Japan. We retrospectively investigated this service using a data bank provided by the Japan DH registry system. METHODS The following details of the dispatch activity were collected: patient age and sex, vital signs (Japan Coma Scale [JCS], systolic blood pressure, heart rate, and respiratory rate) at the scene measured by emergency medical technicians (EMTs), dispatch of the DH before the EMTs made contact with patients (key words group) or after (control group), and the survival outcome at 1 month. RESULTS During the investigation period, 28,357 patient records were analyzed (key words group, n = 13,861; control group, n = 14,496). The age, JCS, and respiratory rate were significantly smaller in the key words group than in the control group. The rates of male sex and survival in the key words group were significantly greater than those in the control group. In the multivariate analysis, dispatch of the DH after EMTs made contact with the patients (odds ratio [OR] = 0.72; 95% confidence interval [CI], 0.55-0.92), female sex (OR = 0.86; 95% CI, 0.75-0.98), older age (OR = 0.97; 95% CI, 0.96-0.97), elevated respiratory rate (OR = 0.97; 95% CI, 0.97-0.98), and high JCS (OR = 0.99; 95% CI, 0.99-0.99) were associated with a decreased 1-month survival (P > .0001). CONCLUSION This is the first report to describe the key words method as a potential factor influencing optimal outcomes/potential survival rates in patients evacuated by the DH using the JDRS. Our study results suggest that the firefighting central command room should consider adopting the key words method when the helicopter emergency medical service is used.
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Affiliation(s)
- Youichi Yanagawa
- Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Shizuoka, Japan.
| | - Ikuto Takeuchi
- Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Shizuoka, Japan
| | - Hiroki Nagasawa
- Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Shizuoka, Japan
| | - Ken-Ichi Muramatsu
- Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Shizuoka, Japan
| | - Hiromichi Ohsaka
- Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Shizuoka, Japan
| | - Kouhei Ishikawa
- Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Shizuoka, Japan
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Yanagawa Y, Jitsuiki K, Iwasa F, Miyake A, Tosaka N, Okawa M, Nishino T, Nakagawa Y. Importance of a Collaboration Agreement in the Management of Physician-Staffed Helicopters. Air Med J 2022; 41:52-56. [PMID: 35248343 DOI: 10.1016/j.amj.2021.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 08/25/2021] [Accepted: 09/21/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The purpose of this study was to present the management of 3 physician-staffed helicopters (helicopter emergency medical service [HEMS]) in 3 different requests in eastern Shizuoka based on a collaboration agreement and to investigate the current state of dispatches based on the agreement. METHODS We investigated 3 incidents managed simultaneously by HEMS based on the collaboration agreement by inquiry to the bases, which were located in eastern Shizuoka, Yamanashi, and Kanagawa. We also investigated all records on the management of HEMS based on the collaboration agreement since the contract was made in 2014 by inquiry to the Shizuoka prefectural government. RESULTS Three simultaneous flight requests were successfully completed. The total number of dispatches based on the collaboration agreement was 112 flights for 7 years from 2014 to 2020. The most frequent reason for request was overlapping request (n = 71). The prefecture with the highest number of requests was Shizuoka (n = 79), where medical resources were limited and the most frequent disease was trauma (n = 93). CONCLUSION The present study reports how 3 HEMS were operated simultaneously for 3 different requests. To use medical resources effectively, including HEMS, the collaboration agreement among neighboring prefectures was very important, especially for areas in which medical resources are limited.
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Affiliation(s)
- Youichi Yanagawa
- Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Shizuoka, Japan.
| | - Kei Jitsuiki
- Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Shizuoka, Japan
| | - Fumiaki Iwasa
- Yamanashi Prefectural Central Hospital, Yamanashi, Japan
| | | | | | - Mayo Okawa
- Tokai University School of Medicine, Tokai, Japan
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Yanagawa Y, Jitsuiki K, Ota S, Muramatsu KI, Kushida Y, Nagasawa H, Takeuchi I, Ohsaka H, Omori K, Ishikawa K. Significance of medical intervention for non-traumatic hemorrhagic cardiac tamponade. Am J Emerg Med 2021; 50:636-639. [PMID: 34879479 DOI: 10.1016/j.ajem.2021.09.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 09/07/2021] [Accepted: 09/09/2021] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND The outcomes of patients with cardiac arrest induced by non-traumatic hemorrhagic cardiac tamponade are poor. PURPOSE We retrospectively investigated the significance of medical intervention with pericardiocentesis and/or pericardiotomy for non-traumatic hemorrhagic cardiac tamponade. METHODS From January 2013 to April 2021, we retrospectively reviewed the medical charts of all patients with cardiac arrest in a prehospital setting or emergency room due to cardiac tamponade confirmed by an ultrasound examination with or without an invasive procedure (pericardiocentesis and/or pericardiotomy) and computed tomography findings, including those obtained at autopsy imaging. The subjects were divided into two groups: the Intervention (+) group, which included subjects who underwent pericardiocentesis or pericardiotomy, and the Intervention (-) group, which included subjects who did not undergo pericardiocentesis or pericardiotomy. Variables were then compared between the two groups. RESULTS There were 68 patients with non-traumatic cardiac tamponade. All three survival cases had witnessed collapse, and the initial rhythm was pulseless electrical activity (PEA).There were no statistically significant differences in the sex, age, means of transportation, bystander chest compression, electric shock, or adrenalineor FDP levels between the two groups.However, the number with witnessed collapse, PEA, rupture of the heart;the ratio of obtaining return of spontaneous circulation; and the survival ratio were significantly greater in the Intervention (+) group than in the Intervention (-) group. CONCLUSION Based on the results of preliminary study, we hypothesized that invasive medical intervention for patients with cardiac arrest induced by non-traumatic hemorrhagic cardiac tamponade might be useful for obtaining return of spontaneous circulation and a survival outcome, especially for patients with witnessed collapse with PEA as the initial rhythm.
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Affiliation(s)
- Youichi Yanagawa
- Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Japan.
| | - Kei Jitsuiki
- Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Japan
| | - Soichiro Ota
- Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Japan
| | - Ken-Ichi Muramatsu
- Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Japan
| | - Yoshihiro Kushida
- Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Japan
| | - Hiroki Nagasawa
- Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Japan
| | - Ikuto Takeuchi
- Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Japan
| | - Hiromichi Ohsaka
- Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Japan
| | - Kazuhio Omori
- Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Japan
| | - Kouhei Ishikawa
- Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Japan
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Muramatsu KI, Omori K, Kushida Y, Nagasawa H, Takeuchi I, Jitsuiki K, Shitara J, Ohsaka H, Oode Y, Yanagawa Y. Clinical significance of the level of fibrin degradation products in drowning patients without cardiac arrest. J Rural Med 2020; 15:201-203. [PMID: 33033542 PMCID: PMC7530585 DOI: 10.2185/jrm.2020-012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 07/10/2020] [Indexed: 11/27/2022] Open
Abstract
Objective: This study aimed to retrospectively investigate the clinical
significance of the level of fibrin degradation products in drowning patients without
cardiac arrest. Patients and Methods: All drowning patients who were transported to our
department from January 2011 to December 2019 were retrospectively investigated through a
medical chart review and included as subjects in the present study. The exclusion criteria
were the occurrence of cardiac arrest before patient arrival to our department and lack of
measurement of the fibrin degradation product level on arrival. The subjects were divided
into two groups: early discharge group, which included patients who were discharged within
3 days, and late discharge group, which included patients who were discharged after 3
days. Results: The early discharge group included 10 subjects and the late
discharge group included 39 subjects. No significant differences were observed in age,
sex, proportion of freshwater drowning cases, proportion of alcohol drinkers, vital signs,
blood gas analysis findings, proportion of lung lesions, or survival rate between the two
groups. The levels of glucose and fibrin degradation products on arrival were
significantly greater in the early discharge group than in the late discharge group. A
multivariate analysis showed that the only significant predictor of early discharge was
the fibrin degradation product level among variables identified in a univariate
analysis. Conclusion: This is the first study to show that the level of fibrin
degradation products on arrival can predict early or late discharge in drowning patients
without cardiac arrest before arriving to the hospital.
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Affiliation(s)
- Ken-Ichi Muramatsu
- Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Japan
| | - Kazuhiko Omori
- Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Japan
| | - Yoshihiro Kushida
- Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Japan
| | - Hiroki Nagasawa
- Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Japan
| | - Ikuto Takeuchi
- Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Japan
| | - Kei Jitsuiki
- Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Japan
| | - Jun Shitara
- Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Japan
| | - Hiromichi Ohsaka
- Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Japan
| | - Yasumasa Oode
- Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Japan
| | - Youichi Yanagawa
- Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Japan
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Muramatsu KI, Omori K, Kushida Y, Nagasawa H, Takeuchi I, Jitsuiki K, Shitara J, Ohsaka H, Oode Y, Yanagawa Y. An analysis of patients with acute aortic dissection who were transported by physician-staffed helicopter. Am J Emerg Med 2020; 44:330-332. [PMID: 32331956 DOI: 10.1016/j.ajem.2020.04.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 04/10/2020] [Accepted: 04/11/2020] [Indexed: 10/24/2022] Open
Abstract
PURPOSE The present study aimed to determine whether or not patients with acute aortic dissection (AAD) treated by the staff of a doctor helicopter (DH) service while being transported from the scene or for interhospital transportation obtained a favorable outcome. METHODS We retrospectively investigated all patients with AAD who were transported by DH between January 2015 and December 2019 using the registry data of the DH control room of our hospital. RESULTS One hundred five cases were enrolled in the present study. All patients were transported within 24 h from the onset. Male patients accounted for 55.2% of the study population, the average age was 71 years and the rate of Stanford A AAD was 51.4%. Regarding transportation, 61.6% of the patients underwent interhospital transportation, and 42.8% were transported to our hospital. All patients underwent drip infusion during transportation and 81.9% of the patients received drugs (e.g., depressors, pain killers and/or antiemetics). Two patients underwent tracheal intubation due to unconsciousness and profound shock with restless state, respectively. The systolic blood pressure after transportation to hospital was significantly higher in comparison to before transportation. No patients suffered cardiac arrest or showed a deterioration of vital signs. All patients were safely transported to the destination. CONCLUSION The present study suggests the safety of using a Dr. Heli to transport AAD patients from the scene and for interhospital transportation, even after the onset.
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Affiliation(s)
- Ken-Ichi Muramatsu
- Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Japan
| | - Kazuhiko Omori
- Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Japan
| | - Yoshihiro Kushida
- Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Japan
| | - Hiroki Nagasawa
- Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Japan
| | - Ikuto Takeuchi
- Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Japan
| | - Kei Jitsuiki
- Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Japan
| | - Jun Shitara
- Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Japan
| | - Hiromichi Ohsaka
- Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Japan
| | - Yasumasa Oode
- Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Japan
| | - Youichi Yanagawa
- Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Japan.
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Kushida Y, Omori K, Muramatsu KI, Nagasawa H, Takeuchi I, Jitsuiki K, Ohsaka H, Oode Y, Ito H, Yanagawa Y. Epidemiology of a Femur Shaft Fracture in an Acute Critical Care Center in a Rural Area of Japan. Open Orthop J 2019. [DOI: 10.2174/1874325001913010295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
Purpose:
Japan has the most rapidly aging population in the world. As of 2017, the number of people ≥65 years of age in Japan was 35.1 million, constituting 27.7% of the total population. The purpose of the study was to investigate the epidemiology in patients with a femur shaft fracture in a rural area with a super-aging population.
Methods:
Electronic medical charts from January 2011 to March 2019 were retrospectively reviewed for all patients with the main disease of ‘femur shaft fracture’ who had been transported to Numazu City Hospital. Subjects were divided into two groups based on the mechanism of injury: a Low-Energy (LE) group, which included patients who had been injured by falling down or suffered a fracture while walking; and a High-Energy (HE) group, which included patients who had been injured by traffic accidents or free fall from a high place (over 3 m). The variables were compared between the two groups.
Results:
During the investigation period, there were 58 patients with the femur shaft fracture, including 28 patients in the HE group and 30 in the LE group. The male ratio, injury severity score and ratio of open fracture in the HE group were significantly greater than in the LE group. The age and systolic blood pressure in the HE group were significantly lower than in the LE group.
Conclusion:
Among patients with femur shaft fracture in the acute critical care center in a rural area of Japan, where the population is super-aging, the frequency of HE and LE femur shaft fracture was almost the same. The fragility of the femur shaft in elderly people may explain this tendency.
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Yanagawa Y, Nagasawa H, Takuchi I, Madokoro S, Jitsuiki K, Ohsaka H, Ishikawa K, Omori K. An analysis of patients evacuated by a civilian physician-staffed helicopter from a military base. J Rural Med 2019; 14:231-235. [PMID: 31788148 PMCID: PMC6877930 DOI: 10.2185/jrm.3012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 05/13/2019] [Indexed: 11/27/2022] Open
Abstract
Objective: We herein report our analysis of patients evacuated by a
physician-staffed helicopter (doctor helicopter; DH) from a Japan Self Defense Force
(JSDF) base. Methods: From March 2004 to November 2018, a medical chart review was
retrospectively performed for all patients who were transported by a DH from the temporary
heliport at the JSDF Fuji base. The subjects were divided into two groups: the Before-2013
group (n=6) and the After-2013 group (n=7). Results: The rate of military-patient involvement and the heart rate of the
After-2013 group were greater than those of the-Before 2013 group, and the percutaneous
oxygen saturation in the After-2013 group was lower than the Before-2013 group.
Furthermore, the Glasgow Coma Scale in the After-2013 group was significantly lower than
in the Before-2013 group. The survival rate was not significantly different between the
two groups. Conclusion: Patients transported by DHs in the After-2013 group tended to be
in more severe conditions than those transported in the Before-2013 group. This might be
due to the fact that over time, the fire department, or JSDF, began to appreciate the
useful role played by the DH in life-saving management.
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Affiliation(s)
- Youichi Yanagawa
- Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Japan
| | - Hiroki Nagasawa
- Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Japan
| | - Ikuto Takuchi
- Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Japan
| | - Shunsuke Madokoro
- Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Japan
| | - Kei Jitsuiki
- Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Japan
| | - Hiromichi Ohsaka
- Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Japan
| | - Kouhei Ishikawa
- Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Japan
| | - Kazuhiko Omori
- Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Japan
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10
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Management of Multiple Burned Patients with Inhalation Injuries. Air Med J 2019; 37:174-177. [PMID: 29735230 DOI: 10.1016/j.amj.2018.02.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2017] [Accepted: 02/01/2018] [Indexed: 11/20/2022]
Abstract
The fire department in Atami received an emergency call at 6:17 am, with notification of 4 or 5 casualties because of a fire. Because there was only 1 ambulance (O) at the station, an additional ambulance (P) was also requested. Ambulance O transported 2 patients (A and B), and ambulance P transported 2 patients (C and D). These 4 patients were judged to have severe inhalation injuries at the scene and were transported to 2 local hospitals (X and Y). After patients C and D arrived at hospital Y, the medical staff decided to transfer them to the emergency medical service center. Patient C was transported by an emergency medical helicopter (doctor helicopter), and patient D was transported to our hospital by ambulance P. After tracheal intubation, both patients (C and D) required intensive care and mechanical ventilation. Patient A at hospital X was also intubated and transported to another hospital by the doctor helicopter. Fortunately, all patients survived. After a review among the parties involved in the incident, initiating an early request for additional human resources, vehicles, and medical support was recognized as contributing a key role in achieving a successful outcome.
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Yanagawa Y, Onitsuka M, Nozawa Y, Nagasawa H, Ikuto T, Jitsuiki K, Madokoro S, Ohsaka H, Ishikawa K, Omori K. The Significance of a Cooperative Medical System for Treating Decompression Illness on the Izu Peninsula in Japan. Wilderness Environ Med 2019; 30:268-273. [PMID: 31345722 DOI: 10.1016/j.wem.2019.05.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 05/15/2019] [Accepted: 05/20/2019] [Indexed: 11/28/2022]
Abstract
INTRODUCTION In 2011, our hospital on the Izu peninsula began to hold meetings to discuss how to manage patients with decompression illness (DCI) to establish a cooperative medical system. We retrospectively investigated the influence of these meetings and the changes subsequently effected. METHODS A medical chart review was retrospectively performed to investigate all cases between January 2005 and December 2017 in which the transport of patients with DCI via a physician-staffed helicopter emergency medical service (HEMS) was attempted. The patients were divided into 2 groups: the preprogram group and the postprogram group. RESULTS There were 63 patients in the preprogram group and 65 in the postprogram group. There were no cases in which a patient's symptoms deteriorated during transportation by the HEMS. The frequency of dispatch to the scene for direct evacuation in the postprogram group (86%) was greater than that in the preprogram group (74%), but the difference was not statistically significant (P=0.09). In the postprogram group, the duration of activities at the scene or the first aid hospital was significantly shorter in comparison to the preprogram group (P=0.01). CONCLUSIONS This retrospective study revealed simultaneity between the introduction of the yearly meetings and a reduced duration of the HEMS staff's activity at either the scene or the first aid hospital.
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Affiliation(s)
- Youichi Yanagawa
- Department of Acute Critical Care Medicine, Juntendo Shizuoka Hospital, Izunokuni City, Japan.
| | - Mika Onitsuka
- Department of Acute Critical Care Medicine, Juntendo Shizuoka Hospital, Izunokuni City, Japan
| | - Yoko Nozawa
- Department of Acute Critical Care Medicine, Juntendo Shizuoka Hospital, Izunokuni City, Japan
| | - Hiroki Nagasawa
- Department of Acute Critical Care Medicine, Juntendo Shizuoka Hospital, Izunokuni City, Japan
| | - Takeuchi Ikuto
- Department of Acute Critical Care Medicine, Juntendo Shizuoka Hospital, Izunokuni City, Japan
| | - Kei Jitsuiki
- Department of Acute Critical Care Medicine, Juntendo Shizuoka Hospital, Izunokuni City, Japan
| | - Shunsuke Madokoro
- Department of Acute Critical Care Medicine, Juntendo Shizuoka Hospital, Izunokuni City, Japan
| | - Hiromichi Ohsaka
- Department of Acute Critical Care Medicine, Juntendo Shizuoka Hospital, Izunokuni City, Japan
| | - Kouhei Ishikawa
- Department of Acute Critical Care Medicine, Juntendo Shizuoka Hospital, Izunokuni City, Japan
| | - Kazuhiko Omori
- Department of Acute Critical Care Medicine, Juntendo Shizuoka Hospital, Izunokuni City, Japan
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12
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Yanagawa Y, Oode Y, Adegawa Y, Muramatsu KI, Kushida Y, Nagasawa H, Takeuchi I, Jitsuiki K, Ohsaka H, Omori K. Japanese civilian and US military interaction in the evacuation of casualties from Camp Fuji. BMJ Mil Health 2019; 166:e73-e74. [PMID: 31256003 DOI: 10.1136/jramc-2019-001247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 06/14/2019] [Accepted: 06/18/2019] [Indexed: 11/04/2022]
Abstract
Historically, if US soldiers at Camp Fuji become severely ill or suffer trauma, they are transported by the ground ambulance, as the doctor-led air ambulance in eastern Shizuoka has never been permitted to land at Camp Fuji. However, it is widely recognised that severely ill or traumatised patients require time-dependent medical management. It was therefore agreed to undertake a joint exercise between the US medical assets of Camp Fuji and the doctor helicopters in eastern Shizuoka prefecture in evacuating a simulated severely ill or traumatised US soldier. The aim of this article is to describe the background and rationale between this collaboration between the civilian Japanese air ambulance and the US medical assets in Camp Fuji.
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Affiliation(s)
- Youichi Yanagawa
- Acute Critical Care Medicine, Juntendo Daigaku Igakubu Fuzoku Shizuoka Byoin, Izunokuni, Japan
| | - Y Oode
- Acute Critical Care Medicine, Juntendo Daigaku Igakubu Fuzoku Shizuoka Byoin, Izunokuni, Japan
| | - Y Adegawa
- Acute Critical Care Medicine, Juntendo Daigaku Igakubu Fuzoku Shizuoka Byoin, Izunokuni, Japan
| | - K-I Muramatsu
- Acute Critical Care Medicine, Juntendo Daigaku Igakubu Fuzoku Shizuoka Byoin, Izunokuni, Japan
| | - Y Kushida
- Acute Critical Care Medicine, Juntendo Daigaku Igakubu Fuzoku Shizuoka Byoin, Izunokuni, Japan
| | - H Nagasawa
- Acute Critical Care Medicine, Juntendo Daigaku Igakubu Fuzoku Shizuoka Byoin, Izunokuni, Japan
| | - I Takeuchi
- Acute Critical Care Medicine, Juntendo Daigaku Igakubu Fuzoku Shizuoka Byoin, Izunokuni, Japan
| | - K Jitsuiki
- Acute Critical Care Medicine, Juntendo Daigaku Igakubu Fuzoku Shizuoka Byoin, Izunokuni, Japan
| | - H Ohsaka
- Acute Critical Care Medicine, Juntendo Daigaku Igakubu Fuzoku Shizuoka Byoin, Izunokuni, Japan
| | - K Omori
- Acute Critical Care Medicine, Juntendo Daigaku Igakubu Fuzoku Shizuoka Byoin, Izunokuni, Japan
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13
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A Smartphone Video Transmission System for Verification of Transfusion. Air Med J 2019; 38:125-128. [PMID: 30898283 DOI: 10.1016/j.amj.2018.11.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 11/10/2018] [Accepted: 11/21/2018] [Indexed: 11/20/2022]
Abstract
A physician-staffed helicopter emergency medical service called a doctor helicopter (DH) in Eastern Shizuoka was equipped with a smartphone video transmission system in April 2018. We herein report on the introduction of this system for the verification of transfusion in the DH. A 51-year-old man visited a local hospital after cutting his left neck himself. He was diagnosed with jugular vein injury and underwent compressive hemostasis. As he entered profound hemorrhagic shock, he underwent tracheal intubation, massive fluid resuscitation, and administration of 3 vasopressor agents to maintain circulation. The Eastern Shizuoka DH was requested to transport this patient. After making contact with the patient, the staff of the DH started prehospital transfusion. Because this was the first case of transfusion in a prehospital setting for our hospital, we held a meeting in which we used a smartphone video transmission system to verify the condition surrounding the transfusion in the DH. By reviewing the video record, we confirmed that the transfusion was performed safely and correctly in the prehospital setting. This smartphone video transmission system was useful for verifying the activity of the staff in the DH.
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14
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Jitsuiki K, Omori K, Takeuchi I, Kondo A, Ohsaka H, Ishikawa K, Nakagawa Y, Inokuchi S, Yanagawa Y. Multiple Patients With Heatstroke Air Evacuated by Agreement Concerning Collaboration. Air Med J 2018; 37:388-391. [PMID: 30424859 DOI: 10.1016/j.amj.2018.07.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 05/27/2018] [Accepted: 07/22/2018] [Indexed: 12/01/2022]
Abstract
On August 30, 2017, the wet-bulb globe temperature was 30°C. Three female military personnel fell unconscious almost simultaneously around noon after a long-distance march that had started at 6 am. The fire department in Gotenba received a 119 call [at 1:16 PM] and requested dispatch of the eastern Shizuoka doctor helicopter (DH) because it would take about 1 hour from the scene to arrive at our hospital by ground ambulance. At that time, the DH of eastern Shizuoka was transporting an injured patient to Kanagawa Prefecture, so the flight dispatcher of the DH of eastern Shizuoka decided to request support DHs from Kanagawa Prefectures based on an agreement concerning collaboration using the DH. The DH of Kanagawa Prefecture met 1 of the patients and transported her to its base hospital. The remaining 2 patients were then transported by the DH of eastern Shizuoka to its base hospital after completing the previous mission. All patients obtained a survival discharge without major complications after receiving proper treatment and rehabilitation. The agreement concerning collaboration using multiple DHs was important in this case, and dispersion transportation was successfully achieved.
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Affiliation(s)
- Kei Jitsuiki
- Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Shizouka, Japan
| | - Kazuhiko Omori
- Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Shizouka, Japan
| | - Ikuto Takeuchi
- Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Shizouka, Japan
| | - Akihiko Kondo
- Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Shizouka, Japan
| | - Hiromichi Ohsaka
- Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Shizouka, Japan
| | - Kouhei Ishikawa
- Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Shizouka, Japan
| | - Yoshihide Nakagawa
- Department of Emergency and Critical Care Medicine, Tokai University School of Medicine, Isehara-shi, Kanagawa, Japan
| | - Sadaki Inokuchi
- Department of Emergency and Critical Care Medicine, Tokai University School of Medicine, Isehara-shi, Kanagawa, Japan
| | - Youichi Yanagawa
- Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Shizouka, Japan.
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