Thread by @abul_h_johari

@zrnthecat Okay, sorry it took some time. Inside his lecture notes he detailed some of the things he had experience on that day. So, the Derailment accident of JR Fukuchiyama line happen on 25th April 2005

@zrnthecat A commuting train with 7 carriages containing 850 passengers derailed and collided with mansion-type building i.e in Japan it is an apartment type building. 107 were killed, 139 heavily injured and 410 lightly injured.

@zrnthecat What made this disaster case interesting is that, the train derailed then slammed into 1st floor multi-storey parking lot, with the first coach stuck inside. So, they literally had one coach disappear in the middle of the city.

@zrnthecat The Dr also state that this was quite a large disaster since the Great Hanshin- Awaji Earthquake. During that earthquake, 80% of the death was due to Crush Syndrome and basically since rescue was done by local residence where despite rescue done,

@zrnthecat disaster victim would die in the waiting room. So, for them, Lesson Learnt was how to intervene and prevent death due to Crush syndrome.

@zrnthecat When the derailment happen, the early estimate was made based on train and truck collision leading to underestimation. The bigger the disaster, the bigger the problem of underestimation.

@zrnthecat During early phase of the rescue, nearby factory workers and train passengers helped to transport victim to safety. But due to their inexperienced, they priorities those that shout or seek help.

@zrnthecat so, that was some of the early mistakes done despite their good intentions leading to those who participated in the rescue to developed trauma as those they set aside hoping to comeback later to help would die.

@zrnthecat Now regarding the first coach that was hidden, they found survivor inside of it. They were partly saved due to other passengers ends up being human cushion. They had 3 routes to approach the carriage; upper, side and lower route.

@zrnthecat They pulled the window glass for the driver’s floor to enter the coach. Took them a lot of time to get to the survivors as they are unable to determined victims obstructing their route were dead or not.

@zrnthecat So they had to proceed carefully. The Dr then details how medical personnel was sent into the first coach to give death confirmation to speed up the rescue operation. Those who survived had to be turn upside down and given infusion due to dehydration.

@zrnthecat The rescue team are able to reach other survivors through the other routes. One route was quite dangerous, and the Dr remarked how it was a miscalculation as they had sent a doctor into place filled with vaporized gasoline.

@zrnthecat There is also incident where corpse drop out from the train window.

@zrnthecat They managed to reach victim and provide IV drips through the back of his hand since it was only his hand that they could reach.

@zrnthecat But since the rescue process was taking a lot of time, he began to lose hope and started saying “Thank you, everyone. I have no resent for you guys. You guys given your best. Please send my regards to my father and mother." Then his blood pressure dropped sharply.

@zrnthecat The Dr said that affected him greatly and made him felt powerless and helpless as medical practitioner. But not wanting to give in the Dr kept giving his word of encouragement as much as he can until the disaster victim starts to reply “I'll try do my best a little bit more”

@zrnthecat So the Dr then relates how later, he would ask this survivor, why he felt depressed and began to lose hope. The survivor said “He said when the medical team first arrived they said “We’ll quickly save you, just give us 1 hour, another 40 mins, so you do your best”,

@zrnthecat however as time went on with the rescue not going anywhere he felt slightly angry, and at the same time, when one member of the rescue team said “this is as far as we can go huh”, He seriously thought “I’m going to die right here”, that thought made him lose hope.

@zrnthecat So, guys remember during disaster, mental care is really important. That was the reason why the Dr relate this story.

@zrnthecat The same survivor told him that at the beginning of the disaster there were more than 10 voices that can be heard, by the time the rescue team found them, the number of voices available are only 4 left.

@zrnthecat One voice died out when they were saving him, as a result only 3 people with severe crush syndrome was safely transported to the hospital

@zrnthecat The Dr also tells of the story of victim, a pregnant woman who thrown off from the second coach. She was found 5 hours after the disaster, in between the apartment and the second coach. There were many people passing by that area, yet no one noticed

@zrnthecat Once found, he prescribed analgesic drug for severe pain and use a portable ultrasound machine, which was rare at the time, to confirm response from the fetus. Once confirm the lady begins to calm down. He was also lucky to be able to see the baby born safely.

@zrnthecat The Dr wrote a lot of things in his lecture notes. Hope you will find it interesting.