1. Neurosurgical Services For Disaster
Prof Yoko Kato
Dept. Of Neurosurgery
Fujita Health University
Japan.

2. Natural Disaster
Tsunami India
Landslide Indonesia

3. Man Made Disaster Bombing –World Trade Centre. 1993 & 9/11
Rail Accident 2005-Japan
Bombing –World Trade Centre & 9/11

4. Example: Wenchuan Earthquake (China)
How to manage disaster?
Example: Wenchuan Earthquake (China)

5. Earth quakes 500,000 earthquakes /year.
Significant morbidity and mortality.
More frequent than before .
Eg: Wenchuan , Haiti , Chile…
Head trauma : 2nd most common type of injury.
Head injury : major cause of mortality.

6. 8.0 on the Richter scale . Sichuan Province on May 12, 2008.

7. Caused Grave loss and deaths

8. More than 80,000 killed and over 3,00,000 injured.

9. GCS in 1281 cases

10. Waiting for rescue and transfer

11. Field hospital in Mianzhu

12. Temporary wards in Mianyang hospital

13. Temporary wards in Deyang hospital

14. After the earthquake, many patients escaped from the buildings in hospital.

15. Many victims were transferred to hospitals in Chengdu.

16. How to manage disaster? Pre disaster planning Disaster Mitigation
Disaster preparedness
No role for a Neurosurgeon in this.
Post disaster management

17. How to Rescue? Domestic and International aid
for the relief. (WHO, Red Cross, NGOs..)

18. Rescue Organization- Team work
GOVERNMENT
VOLUNTEERS
RESCUERS
TROOPS
MEDICAL TEAMS

19. How to manage Patients? Triage
To find patients who require most attention
To refer to appropriate medical facility.
Classification:
Lightly Injured
Seriously Injured
Critically injured

20. Role of a Neurosurgeon
First line of management :

21. Categorize the patients
Non Operative
Critical –shift to CCU
Operative
Operation Room

22. Head of the Department supervises
How to use man power?
Neurosurgical ward
Operation room
Critical care unit
Head of the Department supervises
3 units

23. Experiences from Wenchuan earthquake
1 frontline medical stations: first aid
2 medical team or local hospital: basic treatment triage, observation, patient transfer, tackle emergency.
3 tertiary hospitals : comprehensive therapy…
( antibiotics, fluid therapy, surgical therapy and
physiological interventions )

24. Education Pre disaster MOCK DRILLS WFNS , FIENS and other courses.
Online symposiums - skype
Post Disaster
Telemedicine / telesurgery
Young Neurosurgeons –a big role.
Volunteer for working.

25. Conclusion Team work- Network- Domestic & International
Efficient use of manpower.
Every hospital should have a disaster management plan.
PREVENTION IS ALWAYS BETTER.