JRCS First Meeting of Radiation Emergency Medical Care Advisors (FY2015)

2015/08/21

The Japanese Red Cross Society (JRCS) organized the JRCS First Meeting of Radiation Emergency Medical Care Advisors and held it on July 22 and 23, 2015. The attendees were physicians, radiological technologists, etc. who work at the relevant Japanese Red Cross hospitals and are appointed as radiation emergency medical care advisors by the JRCS. They discussed development of a JRCS relief structure during a nuclear disaster.

1. Background to the meeting



Meeting of Radiation Emergency Medical
Care Advisors.

Meeting of Radiation Emergency Medical Care Advisors.

Based on the lessons learned from the activities conducted soon after the TEPCO’s Fukushima Daiichi Nuclear Power Plant accident (Fukushima Daiichi accident) occurred, the JRCS developed and issued “Nuclear Disaster Guidelines for Preparedness, Response and Recovery” (Guidelines) in March 2015. The JRCS has also deployed radiation protection equipment and materials such as personal dosimeters to JRCS chapters and facilities across Japan and provided “JRCS Nuclear Disaster Response Basic Training Session” for its relief teams to prepare for possible future nuclear disasters.
 In addition to these efforts, the JRCS held a “Meeting for Medical Personnel of Japanese Red Cross Radiation Emergency Hospitals*” on August 26, 2014. This meeting was developed into the “JRCS Meeting of Radiation Emergency Medical Care Advisors” held in July this year, at which the JRCS radiation emergency medical care advisors gathered for the first time. The advisors consist of relevant physicians and radiological technologists working at Japanese Red Cross hospitals which are located in prefectures with nuclear power plants and designated as radiation emergency hospitals by local governments; Hiroshima Red Cross Hospital & Atomic-bomb Survivors Hospital; Japanese Red Cross Nagasaki Genbaku Hospital; and Fukushima Red Cross Hospital.
 If a nuclear disaster occurs, the JRCS radiation emergency medical care advisors will be dispatched to the headquarters of disaster control (HDC) both at the JRCS HQ and a chapter in an affected area and will give advice there. For example, they give advice to the chapter HDC in the affected area when the HDC decides on how the JRCS should develop its relief activities in that area. The advisors also provide radiation dose management for JRCS relief team members.

* Japanese Red Cross hospitals which are designated as radiation emergency hospitals by local governments

Related:
Nuclear Disaster Guidelines for Preparedness, Response and Recovery
Meeting for Medical Personnel of Japanese Red Cross Radiation Emergency Hospitals

2. Program of JRCS First Meeting of Radiation Emergency Medical Care Advisors


For the program, please click here. [PDF]

3. Overview of the meeting


Session 1: “Nuclear Disaster Guidelines for Preparedness, Response and Recovery”
Masahito Yamazawa, Director General of JRCS Disaster Preparedness Planning Task Force, gave a presentation about the Nuclear Disaster Guidelines for Preparedness, Response and Recovery (Guidelines).

Presentation summary:

  • The Guidelines were developed based on the experience and reflection of the JRCS relief activities conducted soon after the Fukushima Daiichi accident.
  • Following the development and issuance of the Guidelines, the Red Cross Nuclear Disaster Resource Center (NDRC) began disseminating the Guidelines, educating/training JRCS relief team members and working on the challenges that emerged during the discussions made at the “Guidelines for Red Cross Activities during Nuclear Disasters Committee” meetings.
  • The above committee was comprised of experts in various fields. In the process of developing the Guidelines, the committee presented the 11 challenges which should be considered in anticipation of the revision of the Guidelines in the future. The JRCS hopes to discuss and consider these challenges at the Meeting of Radiation Emergency Medical Care Advisors. Among the challenges, the JRCS will focus on “efforts for securing the safety of JRCS responders” and “evacuation, etc. of JRCS facilities”.

Related:
Challenges to be Considered Based on the Discussions at the “Guidelines for Red Cross Activities during Nuclear Disasters Committee” [PDF]

Session 2: “Safety management after the Fukushima Daiichi accident for JRCS staff living in the affected area -Response and current situation in Fukushima-“
Dr. Yoichi Watanabe, President of the Fukushima Red Cross Hospital, gave a presentation about the session title.


Dr. Watanabe, President of the Fukushima
Red Cross Hospital, during a Q&A session.

Dr. Watanabe, President of the Fukushima Red Cross Hospital, during a Q&A session.

Presentation summary:

  • Due to the long-time belief in safety of nuclear power plants, the Fukushima Red Cross Hospital had not expected that it would respond to a nuclear disaster until the Great East Japan Earthquake and Tsunami occurred.
  • Soon after the nuclear accident, the hospital responded to its staff mainly in terms of information sharing. Specifically, the hospital measured the air dose rates in Fukushima City, around the hospital and in each department inside the hospital and shared the values. Furthermore, knowledge about radiation was provided to the staff. They were also given instructions for daily life (e.g. minimizing time to stay outdoors). For some of the Fukushima Red Cross Hospital staff who hoped to be evacuated outside of Fukushima City, the hospital dealt with them on the assumption that they would return to the hospital sometime in the future.
  • Shortly after the Fukushima Daiichi accident occurred, the hospital began considering a possibility of sheltering all patients and hospital staff members indoors just in case. Preparedness would be essential including how to secure supplies.

Session 3: “Current situation of radiation emergency medicine in Japan”
Dr. Makoto Akashi, Executive Director of the National Institute of Radiological Sciences, gave a keynote speech.


Dr. Akashi, Executive Director of the National
Institute of Radiological Sciences, giving
a keynote lecture.

Dr. Akashi, Executive Director of the National Institute of Radiological Sciences, giving a keynote lecture.

Keynote speech summary:

  • Japan’s radiation emergency medicine system was reviewed based on the experience of the Fukushima Daiichi accident.
  • The government’s new Nuclear Emergency Response Guidelines specify that a new radiation emergency medicine system should be established with a focus on cooperation among hospitals and role sharing. The guidelines also require prefectures with nuclear power plants to designate nuclear disaster relief core hospitals and register nuclear emergency medical cooperation hospitals. For the designation, the guidelines urge the prefectural governments to refer to the designation of primary and secondary radiation emergency hospitals. It is expected that the hospitals that have been already designated as radiation emergency hospitals will continue to prepare for possible nuclear disasters.

Session 4: “Plan for evacuation of hospital”
Dr. Kiyoshi Endo, Director of Department of Neurosurgery of the Mito Red Cross Hospital, and Dr. Takeshi Tanabe, Director of First Anesthesia Department and Director of First Emergency Department of the Fukui Red Cross Hospital, made presentations regarding a plan for evacuation of hospital.

Presentation summaries:

- Presentation by Dr. Kiyoshi Endo, Mito Red Cross Hospital

  • Mito City where the hospital is located has a large population and there are many other hospitals. Surrounding the city, there are many facilities which handle radioactive materials. Therefore, the city needs to prepare for nuclear disasters.
  • In December 2014, the Mito Red Cross Hospital carried out an exercise on the assumption of accepting people exposed to radiation. The assumption of the exercise was not about a large-scale evacuation such as during the nuclear disaster in Fukushima but acceptance of a small number of patients.
  • In Ibaraki Prefecture, the Prefectural Government and the Ibaraki Medical Association are preparing plans for hospital evacuation. The prefectural government’s plan assumes temporary evacuations with transportation within the prefecture. The plan sets an upper limit for the number of patients to be accepted by hospitals. The limit was calculated by multiplying the quota of patients of hospitals located in the prefecture by a coefficient of up to 1.5 and then the acceptance of patients was simulated. The acceptance feasibility between hospitals was not examined, because the prefectural government regards the plan only as a draft. Moreover, it has not yet been considered how the transportation means for evacuation should be secured or whether the patients can be referred to other hospitals in case that they cannot be accepted by the planned hospitals. In addition, large hospitals including Japanese Red Cross hospitals within the prefecture are required to consider responding to hospital evacuation independently.

- Presentation by Dr. Takeshi Tanabe, Fukui Red Cross Hospital


Dr. Tanabe of the Fukui Red Cross Hospital,
giving a presentation.

Dr. Tanabe of the Fukui Red Cross Hospital, giving a presentation.
  • In Fukui Prefecture, the preparedness for nuclear disasters is steadily progressing. Dr. Tanabe shared the status.
  • The Fukui Prefectural Government’s plan assumes the Fukui Red Cross Hospital to accept patients from more than one hospital in the event of a nuclear disaster. To accept many patients, the hospital needs preparations such as gathering relevant information, securing related equipment and materials and ensuring human resources. The hospital hopes to start working on it and will also need to consider providing psychosocial care to its staff and their family members as well as patients.
  • In the plan prepared by the Fukui Prefectural Government, acceptance of patients within the prefecture is assumed. However, given the evacuation routes, this plan may need to be considered in anticipation of cooperation with other prefectures. There are also many other matters that should be specifically considered.

Session 5: Reporting about “CBRN International Summer School at Italian Red Cross”
Dr. Kiyoshi Endo, Director of Department of Neurosurgery, Mito Red Cross Hospital, reported about a summer school program organized by the Italian Red Cross (RC).


Dr. Endo of the Mito Red Cross Hospital,
reporting on a training program received
at the Italian Red Cross.

Dr. Endo of the Mito Red Cross Hospital, reporting on a training program received at the Italian Red Cross.

Reporting summary:

  • The Italian RC invited other Red Cross and Red Crescent (RCRC) Societies to join the summer school program. In response to the invitation, disaster coordinators of many RCRC Societies took part in the program.
  • The history of Europe includes many conflicts and wars. Therefore, the RC Societies in Europe are expected to take on a role of responding to emergencies instead of disasters. Since the Italian RC has a close relationship with the military, its facilities are large and they are well equipped.
  • During the summer school program, planning for CBRN disasters and importance of continuing preparedness with radiological specialty were emphasized. The summer school program confirmed that it is important to respond to CBRN disasters in cooperation among the RCRC Societies.

Related:
Dispatching of a Japanese Red Cross hospital physician to a training program for nuclear and radiological preparedness organized by the Italian Red Cross

Session 6: “JRCS Nuclear Disaster Response Basic Training Session”
The schedule for the JRCS Nuclear Disaster Response Basic Training Session for FY2015 was explained and discussed.


Dr. Maruyama of the Japanese Red Cross
Medical Center, during a Q&A session.

Dr. Maruyama of the Japanese Red Cross Medical Center, during a Q&A session.

Session summary:

  • The training will be held twice (in September and November) for FY2015 as was in FY2014.
  • A draft of the program was proposed by the secretariat and was agreed upon at the meeting.
  • Most of the instructors for the training sessions were agreed on.

Related:
JRCS First Nuclear Disaster Response Basic Training Session (FY 2014)

Session 7: “Revision of Manual for Relief Activities under Nuclear Disasters”
The revision of the Manual for Relief Activities under Nuclear Disasters was discussed.

Session summary:

  • The instructors for the Nuclear Disaster Response Basic Training Session agreed to attach the materials for the basic training session to the manual.
  • The revision of the materials for the basic training session for FY2016 and onwards will be coordinated after the September training session is finished.

Related:
Manual for Relief Activities under Nuclear Disasters [PDF]

4. List of the attendees


For the list, please click here. [PDF]