Adequate emergency care could have saved 40 percent of patients' lives
Eric Takabayashi
http://tinyurl.com/qqlm
Adequate emergency care could have saved 40 percent of
patients' lives
Sunday, October 12, 2003
About 40 percent of the people who died at emergency
medical centers across Japan could have been saved if
they had received adequate emergency care, according to
a recent study by the Ministry of Health, Labor and
Welfare.
[snip]
[Kyorin University professor Shuji Shimazaki] says it
is necessary to improve the overall quality of
emergency care and the state should eventually
establish a central hospital that specializes in
external injuries with which to evaluate the level of
emergency care provided across the country.
Experts say Japan is about 30 years behind the United
States in emergency medical care.
[end]
Which is precisely what I guessed from my experience in
Japanese emergency medicine, the damned place looks
like the local hospital* I remember from my childhood
in a rural Hawaii community. It's a bad sign when the
flagship hospital of the city (it was either the
kokumin byouin or the shimin byouin) has ONE rookie
doctor on duty in their so called "emergency room" at
night and ONE nurse roaming around with her cell phone
around her neck, and they must TELEPHONE a radiologist
to come in and open the X-ray room (as in ONE) to take
an X-ray, and must TELEPHONE a pharmacist to come in
and open the pharmacy (it looked like a storeroom) just
to get some medicated pads to put on a swollen ankle.
I also live a few blocks away from the offices of the
physicians' association, with a fair sized nursing
school next to it. They have a night children's
hospital, with service to maybe 11 p.m. It is an
appreciated service which we have used at least twice
for fevers. But neither they nor any other hospitals I
have had experience with, have any modern medical
equipment available at night. It is mostly literally
roaming through darkened halls, searching for personnel
on duty, just to be told to go to a doctor the next
day.
* My hometown hospital was overhauled about 20 years
ago, and despite being in a town of less than 10,000,
looks more like "E.R." than anything I have ever seen
in Japan outside of fiction.
Whoa. 12:09 a.m.: Kyou no Dekigoto just reported that a
nurse at Fukuyama National Hospital was stabbed Monday
afternoon with a fruit knife by an elderly man, who was
arrested for attempted murder.
I hope she had better care.
Bryce
"Eric Takabayashi" <eta...@yahoo.co.jp> wrote in message
news:3F8AC120...@yahoo.co.jp...
>
> http://tinyurl.com/qqlm
>
> Adequate emergency care could have saved 40 percent of
> patients' lives
>
Japanese hospitals have always appeared "kinda dirty" and straight out of
the 50's. The care is the same as well.
Ryan Ginstrom
"Eric Takabayashi" <eta...@yahoo.co.jp> wrote in message
news:3F8AC120...@yahoo.co.jp...
>
> http://tinyurl.com/qqlm
> About 40 percent of the people who died at emergency
> medical centers across Japan could have been saved if
> they had received adequate emergency care, according to
> a recent study by the Ministry of Health, Labor and
> Welfare.
The problem is, shouldn't that emergency care include paramedics? If
paramedics can't even administer CPR, you're gonna get a lot more "mamonaku
shibou shimashita" on presentation.
But yes, the emergency rooms are a joke, too. Usually they get some scrub
doctor in there fresh out of medical school, who doesn't know what the hell
is going on, to basically say "ok, come back tomorrow."
> * My hometown hospital was overhauled about 20 years
> ago, and despite being in a town of less than 10,000,
> looks more like "E.R." than anything I have ever seen
> in Japan outside of fiction.
Japanese hospitals are some of the most depressing places I have ever seen.
--
Regards,
Ryan Ginstrom
Eric Takabayashi
> "Eric Takabayashi" <eta...@yahoo.co.jp> wrote in message
> news:3F8AC120...@yahoo.co.jp...
> >
> > http://tinyurl.com/qqlm
>
> > About 40 percent of the people who died at emergency
> > medical centers across Japan could have been saved if
> > they had received adequate emergency care, according to
> > a recent study by the Ministry of Health, Labor and
> > Welfare.
>
> The problem is, shouldn't that emergency care include paramedics? If
> paramedics can't even administer CPR, you're gonna get a lot more "mamonaku
> shibou shimashita" on presentation.
That too, but the study covered people who arrived alive, whom the study deems
had "better than" 50 percent chance of survival:
The Shimazaki team studied the quality of emergency care by computing the
estimated chances of survival of 1,432 people who had been admitted to
emergency rooms but later died.
To make the computation, the team used information obtained through the
survey, including the seriousness of the injury, level of consciousness, the
state of breathing and blood pressure. The team excluded patients whose heart
and lungs had already stopped by the time they were admitted to emergency
centers.
The Shimazaki team found that 719 of the 1,432 people had a better than 50
percent chance of survival when they were admitted.
In addition, the team determined that 546 of the 719 people, excluding those
who were older than 80 and those who had suffered acute subdural hematoma,
could have been saved, indicating that 38.1 percent of the total number of
people who died in emergency rooms could have survived.
The team also found that people who had a more than 80 percent chance of
survival accounted for nearly a quarter of the deaths, while those who had
more than 90 percent of survival chance accounted for more than 10 percent of
the total. These results suggest that inadequate emergency care may have
allowed many patients to die unnecessarily.
The study also revealed marked difference in the quality of medical care in
various emergency centers.
The team found that all the patients who died at three of the emergency
centers had had more than 50 percent chance of survival, while 12 centers kept
the death rate of patients with more than a 50 percent chance of survival
under 20 percent.