Introduction
Large-scale natural disasters occur often all over the world. Japan participates in international disaster relief (IDR) operations regularly. Effective IDR medical recording procedures are very important in confusing disaster situations. IDR medical records must be succinct, only containing what is necessary. However, they must have enough information for patients' analysis and evaluation later.
The authors investigated what contents are important for effective IDR medical records, and offer a proposal for a standardized record format.
Methods
In 2005 and 2006, the authors mailed a self-administered questionnaire to survey 51 doctors and nurses who had participated in IDR in the past about what is important for IDR medical records. The IDR Medical Record 2008 format was produced using the results. To evaluate its usefulness, the authors later interviewed 10 specialists of disaster medicine regarding their assessment of the previously proposed IDR Medical Record 2008 format.
Results
In the first investigation, focused on people who responded to the survey, more than half valued the following features of IDR medical records: "Well organized," "Simple and easy," "Entry language," "Easy to read," "Meets international standards," "Body diagram," "Easy symptom entry," "Durability" and "Combined with prescription." On the other hand, less than half of the participants indicated that they valued: "Compatibility with other organizations," "Electronic file," and "Combined with examination records."
For the second investigation, the authors prepared the IDR Medical Record 2008 format by using the result of the first investigation. Then, the authors made the IDR Medical Record 2012 format based on the results of the interviews.
Conclusions
The authors proposed the IDR Medical Record 2012 format, which is a practical and effective medical record format for IDR operations.

When participating in international disaster relief operations (IDR), medical staff must work under limited human resources and medical equipment. The actual role of a nurse in IDR has not yet been clarified, while the role of a doctor is relatively clear.
In this study, we have examined the actual role of nurses in IDR through a survey by questionnaire to 61 medical staff who have worked in past IDR. Full usable responses were received from 50 (82%) of them. These 50 were consisted of 24 doctors, 17 nurses, and 9 medical coordinators. The questionnaire was distributed from September 1 to December 31 in 2005. We investigated 17 activities reported variously in the literature;-setting up temporary medical facilities, inside arrangements, health care of the medical staff, coordination within the team, keeping medical records, performing triage, wound irrigation, debridement, performing incisions, removing stitches, suturing, reception of patients, medical interview of patients, assisting a doctor performing medical examination and treatment, management of commodities, management of medical waste, management of medical records, and conventional nursing care. The questionnaire asked the respondent to indicate a level of appropriate for a nurse to perform each of the activities in IDR.
Provided that the nurse had a basic national licence in nursing and IDR education and training, then triage and wound irrigation were each considered appropriate during IDR with a doctor supervising, beyond the conventional nursing role. But suturing, performing incisions, removing stitches, and debridement were each considered to be problematic for nurses.