Monday, June 09, 2008

Re the Akihabara Massacre

For good and ill, Japanese emergency medical personnel have very little experience in treating weapons trauma victims.

Later - I stand corrected as to the incident in question. Two of the physicians responding to the emergency were specialists from the country's top emergency response medical corps. What time they arrived on the scene is unclear--and the NHK video did not show them treating victims--but they were there.

Even later - Well, that was instructive. I visited Japan Probe and found I was "blaming" EMS workers...for what, the link does not say.

In comments (and boy they are not fun to read!) Anonymous #1 says that the TBS broadcast claimed a full DMAT response.


Anonymous said...

So you're saying it's the paramedics's fault that the victims died? If only there were more violent crime in Japan, medical staff might amount to something. What are you talking about?

MTC said...

I am saying that there are trade-offs.

The lack of a familiarity with weapons trauma--due to Japan's low weapons-related crime rate and a 60+ year hiatus from warmaking--could lead to a high rate of mortality from wounds that would not necessarily be fatal in a country where emergency medical workers have daily experience with weapons-related trauma.

Go back to the still photos and videotapes of the emergency medical treatment being given Mayor Itō of Nagasaki following his shooting. Tell me if you believe the emergency medical personnel are properly stabilizing a patient with a single .22 caliber bullet wound in his back.

In the Akihabara incident an extraordinary number of adults were killed by a single man bearing a knife. Two, three deaths are understandable--but seven?

This is not to blame anyone. I am just suggesting the possibility that extended peace can result in certain unforeseen institutional weaknesses.

Anonymous said...

What trade-offs? Peace vs poor trauma treatment? High violent crime rate vs good trauma treatment? I have yet to see a coherent argument here.

Are you a qualified medic or doctor? I find it hard to accept that you can critique the quality of treatment by viewing a few images of a single incident. If you have medical qualifications, I'll be more inclined to believe you, but saying it's because Japanese medics lack experience is difficult to swallow without further explanation.

Since I am not a doctor, asking me to review the Nagasaki shooting is meaningless.

I am curious as to why you are incredulous at the deaths of 7 individuals? You forget several of the victims were run over. Maybe Kato hit major veins and arteries in all of his victims.

If you think the medics are so inexperienced, how do you explain the deaths in massacres such as Columbine and Virginia Tech? OK, it's guns versus knives, but the US is arguable the best and most experienced at treating trauma.

MTC said...

anonymous -

It is possible that the assailant managed to stab 20 individuals in short succession, managing a kill ratio of 35%, out of sheer luck.


Since the Akihabara victims received immediate assistance from both passersby and medical personnel, your comparison with the Columbine and Virginia Tech massacres--where hours passed between the start of the killings and the eventual securing of the buildings so that medical care could be provided--is not particularly relevant. It is also easier to kill at a distance with explosively propelled large pieces of metal than up close with a knife.

I am trying to be sympathetic toward the emergency workers--whose competence will be questioned, given the death toll. Inexperience with weapons injuries, coupled with a lack of equipment, materials and medications for treating such, are exogenous factors over which they had little control.

Anonymous said...

One way to remedy it is to regularly train Japan medical personnels in countries such as Philippines or Indonesia, where stabbing incidents happen on a daily basis. These experienced emergency workers can then be deployed all over the country.

Anonymous said...


You are being ridiculous. How can you criticize the paramedics when you don't know the condition the victims were in or the severity of their wounds?

You are painting with a very wide brush and getting paint all over the place.

MTC said...

anonymous -

No doubt you are right. But which anonymous are you?

Anonymous said...

Anonymous here, the one who first replied to your blog.

After watching the evening news on TBS, you're argument may be getting weaker. Apparently, Japan's first responders, DMAT, were there lickety split along with a ton of ambulances and the "super ambulance" that holds up to 8 beds. Maybe this was the news pumping up the hero aspect, but it's difficult to say there were problems with the response and the treatment.