The newborn infant was alarmingly tiny, weighing under 600 grams (about 21 ounces), and small enough to fit into an adult’s hand. With underdeveloped lungs, the infant had difficulty controlling its breathing, so it was hooked up to an array of special respiratory equipment and devices.
“Even so, this baby will live.” Dr. Masataka Honda, director of the Tokyo Metropolitan Children’s Medical Center, calmly offered his positive assessment. He explained, “We have a track record of taking in about 38,000 emergency pediatric patients a year. Few places in the world can match the staff, equipment, and know-how we have for pediatric critical care.”
With an aging population, the metropolis had been experiencing an ongoing increase in the number of ambulance patients, but the number and capacity of hospitals handling emergency admissions at night or on holidays was limited, and it was not uncommon for an ambulance to be sent from hospital to hospital in search of a facility willing to accept the patient it was carrying.
To address this issue, from 2001 the metropolitan government established Tokyo ER (emergency room) facilities at four metropolitan hospitals: Hiroo Hospital, Bokutoh Hospital, Tama Medical Center, and Children’s Medical Center. At these facilities, all arriving emergency patients are admitted regardless of the severity of their cases. Expert nurses conduct “triage,” classifying each incoming patient according to the urgency of the treatment he or she requires. And they decide whether the patient needs to receive emergency surgery or resuscitation treatment from specialists at the emergency and intensive care center or can be sent to an appropriate department in the hospital for treatment by one of the doctors on duty there. This arrangement enables prompt, efficient assignment and treatment of the incoming patients.
Dr. Taiji Kondo, director of the Tama Medical Center, one of the Tokyo ER locations, declares, “This setup greatly reduces the work of finding a hospital and the risk that an ambulance patient will be turned away from one hospital after another.”
By establishing close links between the ER facilities and other area hospitals, the Tokyo ER setup has provided for the smooth transfer of patients following the completion of emergency treatment. In this way, the ER facilities can concentrate their resources on the emergency stage. The Children’s Medical Center, which adjoins the Tama Medical Center, has also benefited from this setup. It has its own ER facilities and is equipped to provide advanced perinatal treatment.
“We can confidently admit and treat emergency patients ranging from the newborn to the aged,” declares Dr. Kondo, adding, “We hope to boost our foreign-language capabilities and make our ER even more open.”
Twenty-four hours a day, 365 days a year, the Tokyo ER facilities are accepting all who need their care and are saving numerous lives—linking people to their tomorrows.
The Tama Medical Center and Children’s Medical Center are physically connected at the third floor; mothers and children can both be treated promptly.
In addition to its ER facilities, the center has 8 divisions and 37 departments, handling such fields as cancer treatment and psychiatric care for children. It is considered a rare facility globally, and many come from Japan and abroad to visit or receive training here.
Large “doctor cars” are always standing by. Customized for neonatal and pediatric use, they carry doctors and nurses to provide treatment en route. Last fiscal year they were dispatched 566 times.