Journal of Nippon Medical School = Nippon Ika Daigaku zasshi
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Comparative Study
An analysis of Japan Disaster Medical Assistance Team (J-DMAT) deployments in comparison with those of J-DMAT's counterpart in the United States (US-DMAT).
Lessons learned from the Great Hanshin-Awaji earthquake of 1995 underscored the necessity of establishing Disaster Medical Assistance Teams (DMATs) in Japan, and in 2005, the Japanese government's Central Disaster Prevention Council revised its Basic Disaster Management Plan to include full deployment of DMATs in disaster areas. Defining a DMAT as a trained, mobile, self-contained medical team that can act in the acute phase of a disaster (48 to 72 hours after its occurrence) to provide medical treatment in the devastated area, the revised plan called for the training of DMAT personnel for rapid deployment to any area of the country hit by a disaster. This paper presents descriptive data on the number and types of missions carried out by Japan DMAT (J-DMAT) in its first 5 years, and clarifies how J-DMAT differs from its counterpart in the United States (US-DMAT). ⋯ In response the kind of man-made disasters that occur in Japan-mainly transportation accidents, and occasional cases of random street violence-J-DMATs need to be deployed as soon as possible to provide medical services at the scene at the critical stage of the disaster. This means that J-DMATs have to be compact. The fact that J-DMATs are smaller and more agile than US-DMATs is a result of the types of disaster that hit Japan and the relatively small size of the country.
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Titration of oral or intravenous medication is the preferred method of pain management for most patients with cancer pain. However, some patients experience insufficient pain relief or considerable adverse effects from systemic opioids. For these reasons, the control of severe cancer pain continues to present a variety of challenges to clinicians. ⋯ This therapy reduced the patient's nausea, vomiting, and somnolence, led to early hospital discharge, and increased her level of daily activity. There were no signs of motor paralysis, psychomimetic alteration, neurological dysfunction, or infection related to the intrathecal route during treatment. Intrathecal therapy is an effective treatment in terminally ill patients.