Emergency Medicine in Japan

Hori, Shingo

doi:10.2302/kjm.59.131

Cited by 38 publications

(34 citation statements)

References 14 publications

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“…Japan has public EMS systems run by municipal governments throughout the country, with a free nationally uniform contact number (119); however, each municipality has its own discretion in managing the system 20. Therefore, the EMS systems vary by municipality, with different education levels, qualifications, and working arrangements for the dispatchers as well as the ambulance crews.…”

Section: Methodsmentioning

confidence: 99%

Effectiveness of dispatcher training in increasing bystander chest compression for out‐of‐hospital cardiac arrest patients in Japan

Tsunoyama

Nakahara

Yoshida

et al. 2017

Acute Medicine & Surgery

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AimThe Japanese government has developed a standardized training program for emergency call dispatchers to improve their skills in providing oral guidance on chest compression to bystanders who have witnessed out‐of‐hospital cardiac arrests (OHCAs). This study evaluated the effects of such a training program for emergency call dispatchers in Japan.MethodsThe analysis included all consecutive non‐traumatic OHCA patients transported to hospital by eight emergency medical services, where the program was implemented as a pilot project. We compared the provision of oral guidance and the incidence of chest compression applications by bystanders in the 1‐month period before and after the program. Data collection was undertaken from October 2014 to March 2015.ResultsThe 532 non‐traumatic OHCA cases were used for analysis: these included 249 cases before and 283 after the guidance intervention. Most patients were over 75 years old and were men. After the program, provision of oral guidance to callers slightly increased from 63% of cases to 69% (P = 0.13) and implementation of chest compression on patients by bystanders significantly increased from 40% to 52% (P = 0.01). Appropriate chest compression also increased from 34% to 47% (P = 0.01). In analysis stratified by the provision of oral guidance, increased chest compressions were observed only under oral guidance.ConclusionsWe found increased provision of oral guidance by dispatchers and increased appropriate chest compressions by bystanders after the training program for dispatchers had been rolled out. Long‐term observation and further data analysis, including patient outcomes, are needed.

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Section: Methodsmentioning

confidence: 99%

Effectiveness of dispatcher training in increasing bystander chest compression for out‐of‐hospital cardiac arrest patients in Japan

Tsunoyama

Nakahara

Yoshida

et al. 2017

Acute Medicine & Surgery

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“…A request for the delivery of an emergency patient is sometimes rejected, and this is a social problem in Japan 1–4. In Japan, the emergency transport system is managed by local governments 1…”

Section: Introductionmentioning

confidence: 99%

“…The patient is then transported by ambulance for free to the nearest emergency hospital that agrees to treat the patient. Emergency hospitals in Japan are classified into three levels: primary, secondary and tertiary 1. According to Article 19 of the Medical Practitioners' Law, physicians cannot refuse patients without good reason.…”

Section: Introductionmentioning

confidence: 99%

Effect of the number of request calls on the time from call to hospital arrival: a cross-sectional study of an ambulance record database in Nara prefecture, Japan

et al. 2016

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ObjectivesIn Japan, ambulance staff sometimes must make request calls to find hospitals that can accept patients because of an inadequate information sharing system. This study aimed to quantify effects of the number of request calls on the time interval between an emergency call and hospital arrival.Design and settingA cross-sectional study of an ambulance records database in Nara prefecture, Japan.CasesA total of 43 663 patients (50% women; 31.2% aged 80 years and over): (1) transported by ambulance from April 2013 to March 2014, (2) aged 15 years and over, and (3) with suspected major illness.Primary outcome measuresThe time from call to hospital arrival, defined as the time interval from receipt of an emergency call to ambulance arrival at a hospital.ResultsThe mean time interval from emergency call to hospital arrival was 44.5 min, and the mean number of requests was 1.8. Multilevel linear regression analysis showed that ∼43.8% of variations in transportation times were explained by patient age, sex, season, day of the week, time, category of suspected illness, person calling for the ambulance, emergency status at request call, area and number of request calls. A higher number of request calls was associated with longer time intervals to hospital arrival (addition of 6.3 min per request call; p<0.001). In an analysis dividing areas into three groups, there were differences in transportation time for diseases needing cardiologists, neurologists, neurosurgeons and orthopaedists.ConclusionsThe study revealed 6.3 additional minutes needed in transportation time for every refusal of a request call, and also revealed disease-specific delays among specific areas. An effective system should be collaboratively established by policymakers and physicians to ensure the rapid identification of an available hospital for patient transportation in order to reduce the time from the initial emergency call to hospital arrival.

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“…In Japan, tertiary hospitals that are accredited by the MHLW as emergency critical care centers (ECCCs) provide critical care to severely injured and ill patients 10, 11. Requirements for the accreditation are shown in Document S1.…”

Section: Methodsmentioning

confidence: 99%

Comparison of registry and government evaluation data to ascertain severe trauma cases in Japan

Nakahara

Sakamoto

Fujita

et al. 2017

Acute Medicine & Surgery

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AimsAccurate evaluation of health care quality requires high‐quality data, and case ascertainment (confirming eligible cases and deaths) is a foundation for accurate data collection. This study examined the accuracy of case ascertainment from two Japanese data sources.MethodsUsing hospital‐level data, we investigated the concordance in ascertaining trauma cases between a nationwide trauma registry (the Japan Trauma Data Bank) and annual government evaluations of tertiary hospitals between April 2012 and March 2013. We compared the median values for trauma case volumes, numbers of deaths, and case fatality rates from both data sources, and also evaluated the variability in discrepancies for the intrahospital differences of these outcomes.ResultsThe analyses included 136 hospitals. In the registry and annual evaluation data, the median case volumes were 120.5 cases and 180.5 cases, respectively; the median numbers of deaths were 11 and 12, respectively; and the median case fatality rates were 8.1% and 6.4%, respectively. There was broad variability in the intrahospital differences in these outcomes.ConclusionsThe observed discordance between the two data sources implies that these data sources may have inaccuracies in case ascertainment. Measures are needed to evaluate and improve the accuracy of data from these sources.

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Emergency Medicine in Japan

Cited by 38 publications

References 14 publications

Effectiveness of dispatcher training in increasing bystander chest compression for out‐of‐hospital cardiac arrest patients in Japan

Effectiveness of dispatcher training in increasing bystander chest compression for out‐of‐hospital cardiac arrest patients in Japan

Effect of the number of request calls on the time from call to hospital arrival: a cross-sectional study of an ambulance record database in Nara prefecture, Japan

Comparison of registry and government evaluation data to ascertain severe trauma cases in Japan

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