Helicopter Emergency Medical Services (Doctor-Helicopter) in Fukushima Prefecture: Present State and Problems

Abstract

: The purpose of this study is to identify the problems in operating an emergency medical service helicopter with an emergency medicine doctor on board (doctor -helicopter) in Fukushima Prefecture, Japan, which covers wide regions and many rural areas. The study looked at the numbers of flights and patients during the 523 days since the start of the doctor -helicopter service at the Fukushima Medical University Hospital. The items investigated were : number of flights, number of helicopter dispatches per month, number of patients, the hospitals where patients were taken to, the fire department dispatch centers that requested the doctor -helicopter, and the number of times each doctor flew on the helicopter. There were 450 flights. When the service was started, there were a few flights, but they gradually increased. The majority of the flights were to emergency scenes (295), while 75 flights were interfacility transports of critically ill patients, 79 flights were cancelled after take -off, and one flight was for a disaster relief operation. The nature of requests differed greatly depending on the fire department dispatch center requesting the service. The majority of patients were trauma patients (62.2%). Stroke (8.5%) and acute coronary syndrome (5.2%) patients requiring emergency treatment were fewer than anticipated. The final destination hospitals were appropriate hospitals in the region. Because the number of flight doctors is small, the burden on individual doctors is large. A system for early on -site diagnosis and helicopter request by emergency rescue team is required to maintain a high quality of emergency care.

A 5-year analysis of the helicopter air mercy service in Richards Bay, South Africa

“…In terms of absolute numbers this is similar to other rural HEMSs (Japan 314 flights per year; Sweden 314 flights per year). [7,8] However, when the number of flights per population served was compared, the Richards Bay service has 1 flight per 11 930 people per year compared with 6 622 people per year in Japan and 828 people per year in Sweden. [7,8] There are several possible explanations for our low flight request rate.…”

“…[7,8] However, when the number of flights per population served was compared, the Richards Bay service has 1 flight per 11 930 people per year compared with 6 622 people per year in Japan and 828 people per year in Sweden. [7,8] There are several possible explanations for our low flight request rate. Firstly, the EMS system in rural KZN has severe staff shortages resulting in prolonged response times by ground crew (only 50% of rural response times for red-coded patients by road were less than 40 min in 2009).…”

“…Primary response comprises 65% of other rural HEMS activations, and is significantly higher than the 12% in this study. [7,8] As mentioned above, the HEMS in KZN currently uses a two-tiered system and alternative methods of primary activation of HEMS should be actively explored (subsequently, efforts have been undertaken to facilitate earlier activation). Algorithms have been designed to assist in deciding on the need for primary air transport in the UK, and the development of such an algorithm for an African setting should be investigated.…”

“…[6] Determining how best to incorporate a HEMS in each system should be done at a local level, as patient populations differ from region to region. Rural HEMSs in Europe and Japan transported a preponderance of medical and trauma patients, [7,8] while obstetrics and gynaecology patients dominated in New Zealand. [9] Descriptive studies of this nature permit assessment of the utility of a HEMS and are therefore important when deciding whether to extend or improve services.…”

“…[9] Descriptive studies of this nature permit assessment of the utility of a HEMS and are therefore important when deciding whether to extend or improve services. [7,8] This study describes the use of a HEMS in a rural African setting during its first 5 years of operation.…”