＜JSAS News＞
Results of
Doctor-Helicopter Operation in Japan
The following is translated into English by Mr. Y. Yamano, from "Japanese Society for Aeromedical Services News", dated July 25, 2006, written by W. Nishikawa originally in Japanese.
A scientific study report entitled "Current Status of the Doctor-Helicopter Performance and Its Assessment" was released in March 2006. The study was carried out by a group headed by Kunihiro Mashiko, Ph.D. under the fiscal 2005 scientific study program supported by the Ministry of Health, Labour and Welfare.
Total number of missions that the Doctor-Helicopters in 10 bases carried out in the fiscal year 2005 was 4,098 times - approximately 400 missions per each base. Two-third of the missions (67.0%) were primary mission to ambulance scene, and one-quarter (25.6%) were inter-hospital transport. The rest of 7.4% was a cancellation on the way.
It is not unusual at all that a helicopter once took off for a mission is cancelled on the way, since immediate response is always top priority over everything, including a time-wasting patient's condition inspection in an emergency medical mission. A call for urgent response of a Doctor-Helicopter happens eventually based on an urgent determination to save time. Therefore, there is a case that a patient's state is found better than a presumptive diagnosis by further inspection made after the Doctor-Helicopter is called. However, it would be a cause of belated effort if a dispatcher stick to a careful judgment too much for the above-mentioned reason.
An average of 15% cancellation of mission flights on the way is considered to be within a permissible limit in Europe and the U.S. From a point of the view in Europe, it may be considered that useless mission in our operation was lesser than the permissible limit. However, higher mission frequency for more substantial lifesaving results must be carried out even if the cancellation goes up. Even if a detailed situation does not turn out, an ambulance helicopter should be called immediately especially in a traffic accident like a multiple pileup as indicated in the above-referred report.
Any dispatcher or on-site rescue personnel who is in position to receive a request for Doctor-Helicopter or telephone operator at 119 emergency call desk in a fire station are advisable to be positive for dispatching a Doctor-Helicopter.
Table 1: Number of Missions Performed by Operation Units in Fiscal 2005
|
Prefecture |
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Hokkaido |
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|
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Chiba |
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|
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Kanagawa |
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|
|
|
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Shizuoka/East |
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|
|
|
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Shizuoka/West |
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|
|
|
|
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Nagano |
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|
|
|
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Aichi |
|
|
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|
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Wakayama |
|
|
|
|
|
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Okayama |
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|
|
|
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Fukuoka |
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|
|
|
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Total |
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Ratio |
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There is one more remarkable fact that is worthy of attention. As shown in the Table 1, the number of persons who received medical treatment was a little more than 3,900. The report says that "it has been proved that the Doctor-Helicopter is a indispensable tool having a lifesaving emergency medical service function for brain hemorrhage, brain infarct, apoplexia cerebri including subarachnoid hemorrhage, cardiovascular diseases including acute coronary syndromes, acute aortic dissection, and others, and serious traumatic injuries" and the report further describes details that the successful results by use of a Doctor-Helicopter is far greater than use of a conventional Doctor-Car and it also plays important role in inter-hospital transports, although neither the content of the diagnosis and treatment nor statistics of the gross result have come out. However, ratio of the inter-hospital transport mission to the primary mission is only 25 percent, which is extremely low compared with the ratio about 70 percent in the U.S. More use of the Doctor-Helicopter for inter-hospital transport mission is expected.
The table 2 includes results achieved in a period of trial operation between 1999 nd 2000. Full-fledged official operation started in fiscal 2001. The aggregated number of missions achieved by all of operation units in the seven years, including the trial period, totaled almost 15,000.
Table 2: Number of Missions by Fiscal Years by Operation Units
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Prefecture |
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Okayama |
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Kanagawa |
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Shizuoka/West |
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|
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|
|
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Chiba |
|
|
|
|
|
|
|
|
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Aichi |
|
|
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|
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|
|
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Fukuoka |
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Wakayama |
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|
|
|
|
|
|
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Shizuoka/East |
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|
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|
|
|
|
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Hokkaido |
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|
|
|
|
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Nagano |
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Total |
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Number of operation bases has totaled 10, but it is not of course enough. In Germany, the helicopter emergency medical service (HEMS) started in 1970. It is four years later since then West Germany started the HEMS operation that the number of the HEMS operation bases reached 10, the same number current Japan has. Seven years later, which is in 1976, the HEMS operation bases in Germany totaled 22, and German EHEMS diffusion rate was already is more than 2 times higher than the current state of Japan.
Judging from the emergency flight frequency performed currently, number of the emergency missions carried out at one base in Germany in 1976 would have been probably about 2 times higher than the number of missions carried out in current Japan although the exact actual data logged in that year is not available. On the basis of a value obtained by multiplying 22 bases by number of missions that one base performed, it is estimated that the number of patients cared or HEMS system diffusion rate during the seven years since the HEMS system was established in Germany in 1970 may be 4 times higher than those of current Japan.
Considering these facts, it cannot be said simply that the Japan's start of Doctor-Helicopter operation falls behind Germany for 30 years, but it must be said that even the progress of the HEMS content since its start merely one fourth. If Japan leaves the things concerning the HEMS as it is now, the difference of HEMS quality or achievement between HEMS advanced countries including Germany and Japan will develop more and more.
(Wataru NISHIKAWA, "Japanese Society for Aeromedical Services News", July 25,2006)
