ネットワークセントリックな災害医療システムの研究 : 高信頼性組織理論の観点から

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  • 神藤 猛
    (独)防災科学技術研究所地震防災フロンティア研究センター

書誌事項

タイトル別名
  • Network-centric Disaster Medical Systems Research Based on High Reliability Organization Theory
  • ネットワーク セントリックナ サイガイ イリョウ システム ノ ケンキュウ コウシンライセイ ソシキ リロン ノ カンテン カラ

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抄録

When major incidents, such as terrorism attacks or large-scale earthquakes, occur in metropolitan areas, the success of a wide-area disaster medical relief effort delivered under emergency conditions is largely dependent on the prompt operation of many complicated medical systems, which are very different from the systems usually required during ordinary times. The environment requiring a wide-area disaster medical relief effort consists of many casualties, with an uncertain outcome, and the number of injured people markedly exceeds the capacity of the medical systems designed to deal with regular conditions. Therefore, in the event of a major incident, it is important to go through the entire process of CSCATTT, which covers accurate assessment of situation, safety, command, communication and the three T's, i.e., triage, transport, and treatment. First of all, it is necessary to provide triage within a very short period of time to clearly differentiate severely injured victims from mildly injured victims. Secondly, it is necessary to mobilize and organize various medical resources, relay accurate information regarding multiple medical modules (triage, transport, and treatment). and organize the activities. Thirdly, it is necessary to establish a highly intensive medical system to provide intensive care to severely injured victims and a medical system that can efficiently provide an optimal standard care to a large number of mildly injured victims. In the present paper, wide-area emergency disaster medical organizations were considered from the perspective of high reliability organizations that are capable of operating continuously under severe environments and of preventing injury. They were analyzed as network-centric, high reliability organizations that can identify early signs of death and danger to avert preventable trauma deaths. This analysis clarified the practical characteristics of disaster medical organizations that are necessary for developing wide-area emergency disaster medical systems.

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