standard and concept for aeromedical evacuation...
TRANSCRIPT
Standard and Concept for Aeromedical Evacuation in Japan Self-Defense Forces
(Abstract No.433)
Masanori. FUJITAMasanori. FUJITA11, Shoichi TACHIBANA1,
Sinsuke TAMURA 2 , Katsuhiko OGATA 3
11Division of Environmental MedicineDivision of Environmental Medicine,
National Defense Medical College Research InstituteNational Defense Medical College Research Institute,
3-2 Namiki , Tokorozawa ,Saitama 359-8513 Japan
Tel. +81-4-2995-1626 Fax. +81-4-2991-1612
e-mail. [email protected] or [email protected]
2Department of Pediatrics, National Defense Medical College,3 General Flight Surgeon, Japan Aerospace Exploration Agency ( JAXA),
May 15, 2013 ,Sheraton Chicago Hotel and Towers, The 84th Annual Scientific Meeting, Aerospace Medical AssociationPanel: Japan Session : Japan U.S. Mutual Interchange1
Disclosure Information
84th Annual AsMA Scientific MeetingMasanori FUJITA,M.D.,Ph.D.
I have no financial relationships to disclose.
I will not discuss off-label use and/or investigational use in my presentation.
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Medical and Health Care Personnel in Japan and USA
Japan United StatesRatio
United States/Japan
Populations 130,000,000 312,000,000 2.4
Area 380,000 km2 9,630,000 km2 25
Doctors 300,000 954,000 3.18
Physician Assistant No comparable license 83,500 -
Nurse Practitioner No comparable license 180,000 -
Nurses
Public health Nurse
45,000 Statistics not found -
Midwife 30,000 Statistics not found -
Registered Nurse
953,000 2,730,000 2.8
Assistant Nurse
368,000 Statistics not found -
Paramedic No comparable license Statistics not found -
Emergency Medical Technicians
42,000 270,0006.4
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Medical and Dental Doctors in Japan and Self-Defense
Forces(JSDFs)Ground
SDFMaritime
SDFAir SDF
Totalin JSDFs
All Japan
No. of Personnel 140,000 42,000 43,000 226,000130,000,00
0
No. of Medical Doctors
520 180 130 830 300,000
No. of Dental Doctors
140 40 40 220 10,000
No. of Nurses 1,100 180 170 1,450 1,396,000
No. of Emergency Medical
Technicians340 120 110 570 42,000
Reference: Heisei 22 Boei handbook, Asagumo-Shinbunsha (in Japanese) and
White Paper 2011, Ministry of Health, Labour and Welfair,Japan
rough number
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US Military Bases in Japan
Tokyo
Misawa Air Base
Yokota AB
Kadena Air Base
Futenma Air Base
Sasebo Naval Base
Iwakuni Base
Atsugi Air Base
Yokosuka Naval Base
Russia
North Korea
South Korea
China
Taiwan
5
Japanese Archipelago
Tokyo
508 islands
363
605
971
6852 islands (inhabited 400)
Data resource: Japan Maritime Public Relation Center http://www.kaijipr.or.jp/mamejiten/shizen/shizen_22.html 6
Doctorless Area
Tokyo
In the area around 4 km (2.5 mile) radius ,population of 50 or over and no medical facilities
anddifficult to receive health care service.
( Japan Ministry of Health, Labour and Welfare )7
800 area
Aeromedical Patient Transport System in Japan
• Doctor Helicopter ・・・ requested by fire dep. , or hospitals
• Fire and Disaster Management Agency
・・・ requested by fire dep., or hospitals
• Japan Coast Guard
・・・ requested by prefectural governor as disaster relief mission
• Japan Self-Defense Forces
・・・ requested by prefectural governor as disaster relief
mission, or by other ministry as collaboration
• Major Airline Company• Civil Patient Air Transport Service
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Search and Rescue Missions in Japan( Local Govt and Fire and Disaster Management Agency )
Tokyo
Osaka City Fire Dep..Shizuoka Pref. Govt,Shizuoka City Fire Dep.Hamamatsu City Fire Dep.
Fukuoka City Fire Dep.Kita-Kyushu City Fire Dep.
Hiroshima Pref GovtHiroshima City Fire Dep.
Okayama Pref GovtOkayama City Fire Dep.
Miyagi Pref GovtSendai City Fire Dep.
Yokohama City Fire Dep.Kawasaki City Fire Dep.
Hokkaido Govt Sapporo City Fire Dep.
Hyogo Pref GovtKobe City Fire Dep.
Fire and Disaster Management Agency, Ministry of Internal Affairs and CommunicationsFire and Disaster Management Agency, Tokyo Metropolitan Govt
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Chiba Pref Govt
Aichi Pref Govt,Nagoya City Fire Dep.
Kyoto City Fire Dep.
Japan white paper on fire and disaster,2012
Search and Rescue Missions in Japan(Japan Self-Defense Forces, Coast Guards and other)
Tokyo
15th Aviation Unit (JGSDF)Naha Helicopter Airlift Squadron and Naha Air Rescue Squadron (JASDF)Japan Coast GuardCivil Medical Evacuation Service
1st Squadron(JMSDF)72th Helicopter Rescue Squadron , Kanoya Sub Squadron (JMSDF)
72th Helicopter Rescue Squadron (JMSDF)22nd Flight Squadron (JMSDF)
Ashiya Air Rescue Squadron (JASDF)
3rd Tactical Airlift Group (JASDF)
73th Helicopter Rescue Squadron (JMSDF) 21th Flight Squadron (JMSDF)
71th Rescue Squadron (JMSDF)
Northern Army Aviation Group(JGSDF)Chitose Air Rescue Squadron(JASDF)
1st Tactical Airlift Wing ( JASDF)
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Necessary for Call Out Japan Self-Defense Force Air Transport Team
• Three requirement have to be cleared
to call out Japan Self-Defense Force.
Publicness ・・・ absolute necessity to protect for public benefit
Urgency ・・・・・・ burning necessity to assist
Nonsubstitutability ・・・ no other appropriate measure
To fulfill above three is required
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Who Can Ask Japan Self-Defense Forces for Aeromedical Evacuation?
• Prefectural Governor• Commandant of Japan Coast Guard• Chief of Regional Coast Guard Headquarters• Director of Airport Administrative Office
http://www.clearing.mod.go.jp/hakusho_data/2011/2011/html/n3126000.html
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Who Can Make Decision for Aeromedical Evacuation ?
• Prime Minister• Minister of Defense• Commander of each level,
(Division Commander, Base Commander, etc )
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By the courtesy of Public Information Division, Minister’s Secretariat, Japan Ministry of Defense
Japan Air Self-Defense Force, Aero Medical Evacuation Squadron
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Japan Air Self-Defense Force, Aero Medical Evacuation Unit
Interior Interior
5.1m
Exterior Exterior
Tie-down Ring
ventilation fan
Emergency Light
2.4 m
2.5 m
Weight 2.5 t
Door
Oxygen cylinders
There is not necessary to consider EMI issue inside the unit.
15 By the courtesy of Aero Medical Evacuation Squadron, Japan Air Self-Defense Force
Standard of Electromagnetic Interference for Onboard Electronic Equipment
・ MIL-STD-461
( United States Military)
・ RTCA/DO-160
( US Radio Technical Commission for Aeronautics/Document-160)
・・・ sequentially matched
in US and Europe
・ IEC60601-1-2(JIS T 0601-1-2)
( International Electrotechnical Commission ) (Japanese Industrial Standards)
・・・ Japan National Defense Standard for evaluate electromagnetic compatibilities (NDS C0011 C) was compliant with MIL-STD-461.
・・・ All equipment certified with RTCA/DO-160 is allowed to be onboard other than Japan Self-Defense Force.
・・・ All Japanese medical equipment have to be matched after 2006.
Strict
Lax16
According to the Press ( December,2012 )
• FCC said FAA to allow broader use of electronic device in flight.
• Some easing of regulations may be performed in the near future.
• There is no proof that a electronic devices are danger. From the technical aspect, reasonability of restriction are doubtful.
• Does this discussion enlarge allowance of onboard medical equipment ?
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Some Efforts to Reduce Electromagnetic Emission
• Electromagnetic Interference Shielding• Electromagnetic Shielding Sheet (aluminum foil)
• ・・・・ It is effective to reduce
electromagnetic emission.
• We do not know this effort is absolute necessary from technical aspect.
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To Develop Our Aeromedical Evacuation System
・ Retrospectively , we have some cases with electromagnetically uncertified medical equipment. No EMI-related hazardous event were reported.
・ Which standard is suitable for efficient aeromedical evacuation ?
MIL-STD-461,RTCA/DO-160, IEC60601-1-2,
other international standard ?
・ Is it possible to ease the standard
and “waive “ the standard with flight safety ?
It is just started to discuss in Japan.
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