著者

Tomokazu Motomura Hisashi Matsumoto Kunihiro Mashiko Hirotoshi Ishikawa Tetsuya Nishimoto Yoshihiro Takeyama

出版者

The Medical Association of Nippon Medical School

雑誌

Journal of Nippon Medical School (ISSN:13454676)

巻号頁・発行日

pp.JNMS.2020_87-406, (Released:2020-03-31)

被引用文献数

5

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IntroductionTo increase survival rates among patients with severe trauma from road traffic accidents, Japan launched the D-Call Net (DCN) system for dispatching doctors by helicopter utilizing Advanced Automatic Collision Notification technology in November 2015. As of October 2019, DCN has dispatched doctors 4 times.CasesCase 1: Canceled because trauma was mild. Case 2: Doctor made contact with 2 patients with moderate trauma 29 min earlier than would have occurred conventionally. This was the first case of doctor dispatch and patient treatment based on automotive engineering information worldwide. Case 3: An accident involving 3 severely injured patients activated DCN, enabling doctor-patient contact 20 min earlier than would have been possible conventionally. Case 4: DCN was utilized ineffectively.DiscussionAccording to 2008 data from Chiba Prefecture, in accidents where victims sustained severe trauma, the time from accidence occurrence to hospital arrival was 67 min, even with doctor dispatch by air ambulance ("Doctor-Heli" [DH]). Accident information for faster doctor dispatch effectively improved survival rates. An algorithm was developed to assess trauma severity (severity probability) based on accident information. DCN dispatches doctors based on information, including accident site and severity probability, that is sent to smartphones of doctors, reducing the time from accident to DH request by approximately 17 min.DCN is the world's first system for faster doctor dispatch to traffic accident sites based on automotive engineering information. It is crucial for improving survival rates and mitigating aftereffects.

著者

Tomokazu Motomura Atsushi Hirabayashi Hisashi Matsumoto Nobutaka Yamauchi Mitsunobu Nakamura Hiroshi Machida Kenji Fujizuka Naomi Otsuka Tomoko Satoh Hideaki Anan Hisayoshi Kondo Yuichi Koido

出版者

The Medical Association of Nippon Medical School

雑誌

Journal of Nippon Medical School (ISSN:13454676)

巻号頁・発行日

vol.85, no.2, pp.124-130, 2018-04-15 (Released:2018-05-02)

参考文献数

14

被引用文献数

5 9

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More than 6,000 people died in the Great Hanshin (Kobe) Earthquake in 1995, and it was later reported that there were around 500 preventable trauma deaths. In response, the Japanese government developed the helicopter emergency medical service in 2001, known in Japan as the "Doctor-Heli" (DH), which had 46 DHs and 2 private medical helicopters as of April 2016. DHs transport physicians and nurses to provide pre-hospital medical care at the scene of medical emergencies. Following lessons learned in the Great East Japan Earthquake in 2011, a research group in the Ministry of Health, Labour and Welfare developed a command and control system for the DH fleet as well as the Disaster Relief Aircraft Management System Network (D-NET), which uses a satellite communications network to monitor the location of the fleet and weather in real-time during disasters. During the Kumamoto Earthquake disaster in April 2016, 75 patients were transported by 13 DHs and 1 private medical helicopter in the first 5 days. When medical demand for the DHs exceeded supply, 5 patients, 8 patients, and 1 patient were transported by Self-Defense Force, Fire Department, and Coast Guard helicopters, respectively. Of the 89 patients who were transported, 30 (34%) had trauma, 3 (3%) had pulmonary embolisms caused by sleeping in vehicles, and 17 (19%) were pregnant women or newborns. This was the first time that the command and control system for aeromedical transport and D-NET, established after the Great East Japan Earthquake in 2011, were operated in an actual large-scale disaster. Aeromedical transport by DHs and helicopters belonging to several other organizations was accomplished smoothly because the commanders of the involved organizations could communicate directly with each other in person within the Aviation Coordination Section of the prefectural government office. However, ongoing challenges in the detailed operating methods for aeromedical transport were highlighted and include improving shared knowledge and training across the organizational framework. These are particularly important issues to address given the Nankai Trough and Tokyo inland earthquakes that are predicted for the near future in Japan.