Hostname: page-component-cd9895bd7-lnqnp Total loading time: 0 Render date: 2024-12-27T07:06:26.687Z Has data issue: false hasContentIssue false

Hypothermia in Victims of the Great East Japan Earthquake: A Survey in Miyagi Prefecture

Published online by Cambridge University Press:  12 September 2014

Hajime Furukawa*
Affiliation:
Department of Emergency and Critical Care Medicine/Emergency Center, Tohoku University Hospital, Tohoku, Japan
Daisuke Kudo
Affiliation:
Department of Emergency and Critical Care Medicine/Emergency Center, Tohoku University Hospital, Tohoku, Japan Division of Emergency Medicine, Tohoku University Graduate School of Medicine; Tohoku, Japan
Atsuhiro Nakagawa
Affiliation:
Department of Emergency and Critical Care Medicine/Emergency Center, Tohoku University Hospital, Tohoku, Japan Department of Neurosurgery, Tohoku University Graduate School of Medicine; Tohoku, Japan
Takashi Matsumura
Affiliation:
Department of Emergency and Critical Care Medicine/Emergency Center, Tohoku University Hospital, Tohoku, Japan
Yoshiko Abe
Affiliation:
Department of Emergency and Critical Care Medicine/Emergency Center, Tohoku University Hospital, Tohoku, Japan
Ryota Konishi
Affiliation:
Department of General Internal Medicine, Kanto Rosai Hospital, Kawasaki City, Ishinomaki, Japan
Satoshi Yamanouchi
Affiliation:
Department of Emergency and Critical Care Medicine/Emergency Center, Tohoku University Hospital, Tohoku, Japan Division of Emergency Medicine, Tohoku University Graduate School of Medicine; Tohoku, Japan
Satoru Ishibashi
Affiliation:
Emergency Center, Japanese Red Cross Ishinomaki Hospital, Ishinomaki, Japan
Masakazu Kobayashi
Affiliation:
Emergency Center, Japanese Red Cross Ishinomaki Hospital, Ishinomaki, Japan
Norio Narita
Affiliation:
Department of Neurosurgery, Kesennuma City Hospital, Kesennuma, Japan
Toshikatsu Washio
Affiliation:
National Institute of Advanced Industrial Science and Technology, Tokyo, Japan
Tatsuhiko Arafune
Affiliation:
School of Science and Engineering, Tokyo Denki University, Tokyo, Japan.
Teiji Tominaga
Affiliation:
Department of Neurosurgery, Tohoku University Graduate School of Medicine; Tohoku, Japan
Shigeki Kushimoto
Affiliation:
Department of Emergency and Critical Care Medicine/Emergency Center, Tohoku University Hospital, Tohoku, Japan Department of Neurosurgery, Tohoku University Graduate School of Medicine; Tohoku, Japan
*
Correspondence and reprint requests to Hajime Furukawa, MD, Department of Emergency and Critical Care Medicine/Emergency Center, Tohoku University Hospital, 1-1 Seiryo-cho, Aoba-ku, Sendai, Miyagi 980-8574, JAPAN (e-mail: fhajime@ac.auone-net.jp).

Abstract

Objective

A survey was conducted to describe the characteristics of patients treated for hypothermia after the Great East Japan Earthquake.

Methods

Written questionnaires were distributed to 72 emergency medical hospitals in Miyagi Prefecture. Data were requested regarding inpatients with a temperature less than 36ºC admitted within 72 hours after the earthquake. The availability of functional heating systems and the time required to restore heating after the earthquake were also documented.

Results

A total of 91 inpatients from 13 hospitals were identified. Tsunami victims comprised 73% of the patients with hypothermia. Within 24 hours of the earthquake, 66 patients were admitted. Most patients with a temperature of 32ºC or higher were treated with passive external rewarming with blankets. Discharge without sequelae was reported for 83.3% of patients admitted within 24 hours of the earthquake and 44.0% of those admitted from 24 to 72 hours after the earthquake. Heating systems were restored within 3 days of the earthquake at 43% of the hospitals.

Conclusions

Hypothermia in patients hospitalized within 72 hours of the earthquake was primarily due to cold-water exposure during the tsunami. Many patients were successfully treated in spite of the post-earthquake disruption of regional social infrastructure.(Disaster Med Public Health Preparedness. 2014;0:1-11)

Type
Original Research
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERNCES

1. Largest Earthquakes in the World Since 1900. US Geological Survey website. http://earthquake.usgs.gov/earthquakes/world/10_largest_world.php. Accessed February 23, 2014.Google Scholar
2. Nagamatsu, S, Maekawa, T, Ujike, Y, Hashimoto, S, Fuke, N. Japanese Society of Intensive Care Medicine. The earthquake and tsunami--observations by Japanese physicians since the 11 March catastrophe. Crit Care. 2011;15:167.CrossRefGoogle ScholarPubMed
3. Satomi, S. The Great East Japan Earthquake: Tohoku University Hospital's efforts and lessons learned. Surgery Today. 2011;41:1171-1181.Google Scholar
4. Damage situation and police countermeasures associated with 2011 Tohoku district - off the Pacific Ocean Earthquake [in Japanese]. National Police Agency of Japan; 2014. http://www.npa.go.jp/index.html. Accessed February 24, 2014.Google Scholar
5. Weather information [in Japanese]. Japan Meteorological Agency website. http://www.jma.go.jp/jma/menu/report.html. Accessed March 25, 2013.Google Scholar
6. Health and Medical Services. Annual Health, Labour and Welfare Report 2012-2013. Ministry of Health, Labour and Welfare website. http://www.mhlw.go.jp/english/wp/wp-hw7/dl/02e.pdf. Accessed June16, 2014.Google Scholar
7. Ishida, T, Ohta, M, Katsurada, K, Sugimoto, T. The emergency medical system in Japan. J Emerg Med. 1984;2:45-55.Google Scholar
8. Tanigawa, K, Tanaka, K. Emergency medical service systems in Japan: past, present, and future. Resuscitation. 2006;69:365-370.CrossRefGoogle Scholar
9. Kudo, D, Furukawa, H, Nakagawa, A, et al. Reliability of telecommunications systems following a major disaster: survey of secondary and tertiary emergency institutions in Miyagi Prefecture during the acute phase of the 2011 Great East Japan Earthquake. Prehosp Disaster Med. 2014;29(2):204-208.Google Scholar
10. Brown, DJ, Brugger, H, Boyd, J, Paal, P. Accidental hypothermia. N Engl J Med. 2012;367:1930-1938.Google Scholar
11. Howard, A, Bessen, BN Hypothermia. In: Tintinalli J, ed. Tintinalli's Emergency Medicine, 7th ed. New York: McGraw-Hill Professional; 2010: 1335-1339.Google Scholar
12. Lloyd, EL. Accidental hypothermia. Resuscitation. 1996;32:111-124.Google Scholar
13. Kempainen, RR, Brunette, DD. The evaluation and management of accidental hypothermia. Respir Care. 2004;49:192-205.Google Scholar
14. Danzl, DF, Pozos, RS. Accidental hypothermia. N Engl J Med. 1994;331:1756-1760.Google Scholar
15. Epstein, E, Anna, K. Accidental hypothermia. BMJ. 2006;332:706-709.Google Scholar
16. Molnar, GW. Survival of hypothermia by men immersed in the ocean. JAMA. 1946;131:1046-1050.Google Scholar
17. Nakagawa, A. 72 hours after the Great East Japan Earthquake at Tohoku University Hospital: what we learned from the chronological analysis. J Japan Congress Neurol Emergencies. 2012;24:24-31 (Japanese).Google Scholar
18. Nakagawa, A, Furukawa, H, Konishi, R, et al. The great East Japan earthquake: lessons learned at Tohoku University Hospital during the first 72 hours. IEEE Pulse. 2013;4:20-27.Google Scholar
19. UMIN Clinical Trials Registry (UMIN-CTR). University Hospital Medical Information Network (UMIN) website. http://www.umin.ac.jp/ctr/. Accessed May 19, 2013.Google Scholar
20. Forbes, SS, Eskicioglu, C, Nathens, AB, et al. Evidence-based guidelines for prevention of perioperative hypothermia. J Am College Surg. 2009;209:492-503.Google Scholar
21. Rajagopalan, S, Mascha, E, Na, J, Sessler, DI. The effects of mild perioperative hypothermia on blood loss and transfusion requirement. Anesthesiology. 2008;108:71-77.Google Scholar
22. Sessler, DI. Mild perioperative hypothermia. N Engl J Med. 1997;336:1730-1737.Google Scholar
23. Kanda, Y. Investigation of the freely available easy-to-use software 'EZR' for medical statistics. Bone Marrow Transplant. 2013;48(3):452-458.Google Scholar
24. Ali, NA, O'Brien, JM Jr, Hoffmann, SP, et al. Acquired weakness, handgrip strength, and mortality in critically ill patients. Am J Respir Crit Care Med. 2008;178:261-268.Google Scholar
25. Ishii, M, Nagata, T. The Japan Medical Association's disaster preparedness: lessons from the Great East Japan Earthquake and Tsunami. Disaster Med Public Health Prep. 2013;7:507-512.Google Scholar
26. Walpoth, BH, Walpoth-Aslan, BN, Mattle, HP, et al. Outcome of survivors of accidental deep hypothermia and circulatory arrest treated with extracorporeal blood warming. N Engl J Med. 1997;337:1500-1505.Google Scholar
27. van der Ploeg, GJ, Goslings, JC, Walpoth, BH, Bierens, JJ. Accidental hypothermia: rewarming treatments, complications and outcomes from one university medical centre. Resuscitation. 2010;81:1550-1555.Google Scholar
28. Steele, MT, Nelson, MJ, Sessler, DI, et al. Forced air speeds rewarming in accidental hypothermia. Ann Emerg Med. 1996;27:479-484.CrossRefGoogle ScholarPubMed
29. Vassal, T, Benoit-Gonin, B, Carrat, F, Guidet, B, Maury, E, Offenstadt, G. Severe accidental hypothermia treated in an ICU: prognosis and outcome. Chest. 2001;120:1998-2003.Google Scholar
30. Danzl, DF, Pozos, RS, Auerbach, PS, et al. Multicenter hypothermia survey. Ann Emerg Med. 1987;16:1042-1055.Google Scholar
31. Farstad, M, Andersen, KS, Koller, ME, Grong, K, Segadal, L, Husby, P. Rewarming from accidental hypothermia by extracorporeal circulation: a retrospective study. Eur J Cardiothorac Surg. 2001;20:58-64.Google Scholar
32. Kornberger, E, Mair, P. Important aspects in the treatment of severe accidental hypothermia: the Innsbruck experience. J Neurosurg Anesthesiol. 1996;8:83-87.Google Scholar