as well as performing light rescue operations). All crew members have one common goal, but contribute differently in achieving this. This demands knowledge and support of each other's tasks, Crew Resource Management-training, and more. • Externally-into the total chain of survival (early alarms, public first-aid competence, ambulance services, and definitive hospital treatment). HEMS systems are valueless if the other links of the chain are not strong enough to match that level. Various HEMS bases experience different patterns regarding activity rate, patient severity, primary vs. secondary transports, and more. This illustrates variations within the country's population pattern. The HEMS services should be tailored to the specific conditions and needs within any society.

We describe the development and introduction of a Patient Care Bridge—a mobile ICU for the transit care of the critically ill. This stretcher-mounted Patient Care Bridge is being used for intensive transit care of the critically ill in Northland, New Zealand. It carries all the basic intensive care monitoring accoutrements, is lightweight and is suited for pre-hospital, inter-hospital and intra-hospital transit care. It is ideal for patient evacuation from the scene of motor vehicle and sporting accidents, surface transportation of patients by surface ambulance and aeroevacuation of patients by the Helicopter Emergency Medical Service. This economic and space efficient unit has been used for transfer of more than one thousand critically ill patients.

Abstracts: 11th World Congress, Osaka, Japan S41 with continual heavy rain front 22 October to 02 November, 1998. Although the eye of the storm did not make landfall in our territory, the huge area of rainfall included the entire country. The rains were most severe in the coastal areas. Costa Rica had developed an integral and coordinated plan to face disasters and major emergencies. This plan was activated as soon as information was available regarding the potential risk to our country by Hurricane Mitch.Close and continual monitoring of previously identified flood-prone areas and a timely evacuation of people in those areas was coordinated through the National Emergency Commission. Results: 1) 16,500 people had to be evacuated, 5,500 to 99 shelters and the rest to friend's or relatives homes; 2) Four people were reported dead and four were missing; 3) 10 people suffered injuries that required medical care; 4) 74 major roads were either blocked by landslides or damaged by flooding; 5) 36 bridges were destroyed; 6) 39 schools were damaged; 7) 740 houses were destroyed or damaged; and 8) Agricultural production was affected, particularly rice, sugar cane, bananas, coffee, corn; dairy products, and fishing. Conclusion: Although Costa Rica was not directly affected by Hurricane winds, it suffered moderate to severe rains for 12 days. In spite of significant damage to crops and infrastructure, there were only minor consequences to human life and health.We believe that emergency and disaster reduction, preparedness, and planning, as well as increasing public awareness and education must play a significant role in the end results from a phenomenon such as Hurricane Mitch; and that this accounts for the minor death and injury toll that we experienced. Keywords: Costa Rica; disaster planning; Hurricane Mitch; infrastructure; preparedness; rain G-41 Domestic Disaster Relief Activities in the Japanese Red Cross SocietyNobuyuki Suzuki, MD; Mutuhiko Ouwaki; Toshiharu Maxima, MD; Yutaka Tanaka Nagoya Daini Red Cross Hospital, Japanese Red Cross Medical Center (Tokyo), Japanese Red Cross Headquarters Disaster relief has been one of the Japanese Red Cross Society's (JRCS) primary activities since it first dispatched a medical relief team to assist victims of the terrible Mt. Bandai eruption in 1888. The JRCS demonstrated its strength in disaster relief after the Great Kanto (1923) and the Great Hanshin-Awaji (1995) earthquakes, the UnzenFugen volcanic eruption (1991), and various other natural disasters. The JRCS also is involved in rescue operations in cases of major accidents, for example, plane and train crashes, gas explosions, and fires in public places such as hotels and department stores.Under the Disaster Relief Law and the Disaster Countermeasures Basic Act, the JCRS is required to give medical care, manage the handling of corpses, and also to play a role as the coordinating organization to cooperate with the government and other public agencies in relief operation.The author presents the JRCS disaster relief operatio...

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