Disaster and Mass Casualty Incident Responses by Doctor Car

Introduction:Ambulances with physicians, known as Doctor Car, and Tokyo DMAT are the two prehospital care systems responsible for medical team dispatch in the Tokyo area. While there are 25 designated hospitals for DMAT, Doctor Car is only available at four hospitals. Our hospital incorporates both systems. While the prehospital care system must be utilized at the time of disaster, Doctor Car was dispatched 418 times in 2017, and the use of DMAT is less than ten times per year.Aim:To review the past disaster responses of our hospital.Methods:The study reviews three cases where our hospital responded to mass casualty incidents and disasters with either Doctor Car or DMAT. The first case was the treatment of crush syndrome caused by a collapsed parking slope. It took more than 24 hours for the rescue, in which the team treated patients during transport and at the hospital. The second case was our response to a mass stabbing incident committed at a facility for the disabled. In collaboration with the onsite rescue team, we conducted triage, hemostasis, transfusion, etc. The third case was caused by a fire in a building under construction. We provided treatments like triage and tracheal intubation on the spot.Results:Because paramedics are allowed to conduct only a limited amount of treatments, dispatch of the medical team to the site is effective.Discussion:For a medical team to be effective at the dispatched site, the team must be accustomed not only to the specific need of medical care during disasters but also prehospital medical care, which may include the abilities to ensure safety during transport and on-site and adapt to the prehospital environment. Doctor Car is a useful way to realize such abilities.