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The Tsukui (Japan) Yamayuri-en Facility Stabbing Mass-Casualty Incident

Published online by Cambridge University Press:  08 April 2019

Takaaki Maruhashi ,
Ichiro Takeuchi ,
Jun Hattori ,
Yuichi Kataoka  and
Yasushi Asari
Takaaki Maruhashi*
Affiliation:
Department of Emergency and Critical Care Medicine, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
Ichiro Takeuchi
Affiliation:
Department of Emergency Medicine, Yokohama City University School of Medicine, Yokohama, Kanagawa, Japan
Jun Hattori
Affiliation:
Department of Emergency and Critical Care Medicine, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
Yuichi Kataoka
Affiliation:
Department of Emergency and Critical Care Medicine, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
Yasushi Asari
Affiliation:
Department of Emergency and Critical Care Medicine, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan
*
Correspondence: Takaaki Maruhashi, MD, Department of Emergency and Critical Care Medicine, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0375, Japan E-mail: [email protected]
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Abstract

Introduction:

In July 2016, a mass-casualty stabbing attack took place at a facility for disabled persons located in Sagamihara City (Kanagawa Prefecture, Japan). The attack resulted in 45 casualties, including 19 deaths. The study hospital dispatched physicians to the field and admitted multiple casualties. This report aimed to review the physicians’ experiences and to provide insights for the formulation of response measures for similar incidents in the future.

Report:

This incident involved 30 emergency teams and 12 fire department teams, including those from neighboring fire departments. Five physicians from three medical institutions, including the study hospital, entered the field. The Simple Triage and Rapid Treatment (START) method was used on the field. The final field triage category count was: 20 red, four yellow, two green, and 19 black tags. All the casualties (n = 26) except for the 19 black tag casualties were transported to one of six neighboring medical institutions.

The median age of the transported casualties was 41 years (interquartile range [IQR] = 35.5 – 42.0). Three casualties (21.4%) were in hemorrhagic shock on arrival at the hospital. Twelve patients had multiple cervical stab wounds (median four wounds; IQR = 3.75 – 6.0). A total of 91.7% of these stab wounds were in mid-neck Zone II region. Of the 12 patients with cervical stab wounds, four (33.3%) required emergency surgery, and the rest were sutured on an out-patient basis. One patient had already been sutured on the field. All patients requiring emergency surgery had deep wounds, including those of the carotid vein, thyroid gland, nerves, and the trachea. Eight of the casualties were hospitalized at the study institution. Five of them were admitted to the intensive care unit. There were no deaths among the casualties transported to the hospitals.

Conclusion:

Regional core disaster medical hospitals must take on a central role, particularly in the case of local disasters. Horizontal communication and interactions should be reinforced by devising protocols and conducting joint training for effective inter-department collaborations on the field.

Maruhashi, T, Takeuchi, I, Hattori, J, Kataoka, Y, Asari, Y. The Tsukui (Japan) Yamayuri-en facility stabbing mass-casualty incident. Prehosp Disaster Med. 2019;34(2):203–208

Keywords

disasterfirst aidmass-casualty incident
Type
Special Report
Information
Prehospital and Disaster Medicine , Volume 34 , Issue 2 , April 2019 , pp. 203 - 208
Copyright
© World Association for Disaster and Emergency Medicine 2019 

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Footnotes

Conflicts of interest: none

References

Giri, S, Risnes, K, Uleberg, O, et al. Impact of 2015 earthquakes on a local hospital in Nepal: a prospective hospital-based study. PLoS One. 2018;13(2):e0192076.CrossRefGoogle ScholarPubMed
Kellermann, AL, Peleg, K. Lessons from Boston. N Engl J Med. 2013;368(21):1956–1957.CrossRefGoogle ScholarPubMed
Okumura, T, Hisaoka, T, Yamada, A, et al. The Tokyo subway sarin attack--lessons learned. Toxicol Appl Pharmacol. 2005;207(2 Suppl):471–476.CrossRefGoogle ScholarPubMed
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(3):167.CrossRefGoogle ScholarPubMed
Tsuda, T, Lindahl, L, Tokinobu, A. Ethical issues related to the promotion of a “100 mSv Threshold Assumption” in Japan after the Fukushima Nuclear Accident in 2011: background and consequences. Curr Environ Health Rep. 2017;4(2):119–129.CrossRefGoogle ScholarPubMed
Gonzalez, RP, Falimirski, M, Holevar, MR, Turk, B. Penetrating Zone II neck injury: does dynamic computed tomographic scan contribute to the diagnostic sensitivity of physical examination for surgically significant injury? A prospective blinded study. J Trauma. 2003;54(1):61–65.CrossRefGoogle ScholarPubMed
Garner, A, Lee, A, Harrison, K, Schultz, CH. Comparative analysis of multiple-casualty incident triage algorithms. Ann Emerg Med. 2001;38(5):541–548.CrossRefGoogle ScholarPubMed
Sapp, RF, Brice, JH, Myers, JB, Hinchey, P. Triage performance of first-year medical students using a multiple-casualty scenario, paper exercise. Prehosp Disaster Med. 2010;25(3):239–245.CrossRefGoogle ScholarPubMed
Christopher, AK, Brooke, L, David, CC. “Chapter 12 Triage.” In: Koenig, KL, Schultz, CH, (eds). Koenig and Schultz’s Disaster Medicine. New York, NY USA: Cambridge University Press; 2009:174–183.Google Scholar
Leow, JJ, Lingam, P, Lim, VW, Go, KT, Chiu, MT, Teo, LT. A review of stab wound injuries at a tertiary trauma centre in Singapore: are self-inflicted ones less severe? Singapore Med J. 2016;57(1):13–17.CrossRefGoogle Scholar
Nasr, A, de Oliveira, JT, Mazepa, MM, et al. Evaluation of the use of tomography in penetrating neck trauma. Rev Col Bras Cir. 2015;42(4):215–219.CrossRefGoogle ScholarPubMed
Thoma, M, Navsaria, PH, Edu, S, Nicol, AJ. Analysis of 203 patients with penetrating neck injuries. World J Surg. 2008;32(12):2716–2723.CrossRefGoogle ScholarPubMed