Tatsuya Kinugasa
Takayuki Matsumae
1.The Early Medical Management of the Critical Accident cases in Tokai-mura
Tatsuya Kinugasa
Mitsubishi Kobe Hospital
Abstract
People who needed medical attention after radiation exposure were grouped as follows:
1. Three highly-irradiated workers who required treatment for acute radiation syndrome.
2. About 100 people, mostly workers, with documented low-dose exposure who needed medical follow-up. This group was comprised of those who were within the facility at the time of the accident and those who were engaged in the concerted efforts to terminate the continuing disater.
3. Residents who lived near the uranium conversion facility. No significant radiation exposure was documented among those people, but medical explanation of health hazards and psychological attention were needed.
The medical scenes after the accident were presented.
1. The accident scene at the uranium conversion facility
2. Transportation of three patients
3. The initial treatment and triage at the local national hospital
4. The National Institute of Radiological Sciences (NIRS)
5. The University Hospitals where acute and long-term treatment was carried out for acute radiation syndrome.
NIRS has its advisory committee called ﾒthe radiation emergency network councilﾓ, made up mainly of out-side experts in critical care, trauma surgery, general surgery, hematology, radiology, and radiation health physics. This network council played a very important role in evaluating the intial assessment of patients, deciding the treatment policy, and triaging three patients according to the estimated dose.
Some new clinical observations about three patients were made in their clinical courses :
1. Hypoxia was seen soon after the exposure in these three patients.
2. A prolonged, massive wound exudate from the injured skin was seen in the most highly-exposed patient.
3. Massive watery diarrhea after 4 weeks and the GI bleeding after 7 weeks were observed in this patient.
Key words：critical accident, acute radiation syndrome, blood stem cell transplantation
2.Transportation of the Nuclear Accident Victims in Tokai Village, Japan
Takayuki Matsumae
National Mito Hospital, Department of Anesthesiology
Abstract
Three victims of the nuclear irradiation accident which took place in Tokai Village, Japan on September 30, 1999 were initially treated at National Mito Hospital in Mito, Japan. Reviewing the means of communication and of transport of the victims, several problems were brought to attention. One example was circulation of an incorrect report to deny the contamination of the victims by radioactive materials. Because of this misinformation, emergency technicians and hospital personnel involved in the care of the victims took no precautions to protect themselves from secondary irradiation. From the neutron beam irradiation, the victims' body fluids such as vomitus, urine, and stool were all contaminated and secondary irradiation occurred. Fortunately, the extent of damage was very limited. In this type of unexpected accident, initial information can be inaccurate, and care and precaution must be taken among involved personnel. As this was a very unexpected and unusual accident, difficulties arose early in handling and managing the circumstances. Overall, appropriate actions were taken and victims were successfully transported by air to the National Institute of Radiological Sciences in Chiba, Japan.
Key words：Nuclear accident, radiated pollutant, transportation, information