Multi-Victim Assault with a Penetrating Weapon and an Alkaline Agent: Disaster Report

At a factory in eastern Shizuoka Prefecture, Japan, a man clad in protective gear and wielding a spear-like knife attached to a pole attacked employees at a plant with a blade while spraying alkaline chlorine bleach from a backpack. This resulted in eight cases of torso stab wounds and seven cases of alkaline damage to the cornea, skin, and pharynx. Eight patients were transported to one hospital, the nearest emergency center equipped to handle critical cases, while the other seven were transported to another hospital. Of the eight patients transported to the first hospital, six received blood transfusions for hemorrhagic shock. Four patients required endotracheal intubation, two underwent emergency surgery, two underwent emergency interventional radiology (IVR) procedures, and two had chest drains placed. All patients survived and were discharged.This paper introduces the basic concept for managing mass casualties in eastern Shizuoka Prefecture with limited medical resources during localized disasters. It outlines the overall situation of a mass-casualty incident involving puncture wounds and alkaline corneal and skin injuries, and it discusses evaluation and issues.