Standard and Concept for Aeromedical Evacuation in Japan Self-Defense Forces (Abstract No.433)

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1 Standard and Concept for Aeromedical Evacuation in Japan Self-Defense Forces (Abstract No.433) Masanori. FUJITA 1, Shoichi TACHIBANA 1, Sinsuke TAMURA 2, Katsuhiko OGATA 3 1 Division of Environmental Medicine, National Defense Medical College Research Institute, 3-2 Namiki, Tokorozawa,Saitama Japan Tel Fax fujitama@ndmc.ac.jp or bxb01424@nifty.com 2 Department of Pediatrics, National Defense Medical College, 3 General Flight Surgeon, Japan Aerospace Exploration Agency ( JAXA), ay 15, 2013,Sheraton Chicago Hotel and Towers, The 84th Annual Scientific Meeting, Aerospace Medical Association Panel: Japan Session : Japan U.S. Mutual Interchange 1

2 Disclosure Information 84 th Annual AsMA Scientific Meeting Masanori 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. 2

3 Medical and Health Care Personnel in Japan and USA Japan United States Ratio United States/Japan Populations 130,000, ,000, Area 380,000 km2 9,630,000 km2 25 Doctors 300, , Physician Assistant No comparable license 83,500 - Nurse Practitioner No comparable license 180,000 - Public health Nurse 45,000 Statistics not found - Nurses Midwife 30,000 Statistics not found - Register ed Nurse 953,000 2,730, Assistan t Nurse 368,000 Statistics not found - Paramedic No comparable license Statistics not found - Emergency Medical Technicians 42, ,

4 Medical and Dental Doctors in Japan and Self-Defense Forces(JSDFs) Ground SDF Maritime SDF Air SDF Total in JSDFs No. of Personnel 140,000 42,000 43, ,000 All Japan 130,000,00 0 No. of Medical Doctors No. of Dental Doctors , ,000 No. of Nurses 1, ,450 1,396,000 No. of Emergency Medical Technicians ,000 rough number Reference: Heisei 22 Boei handbook, Asagumo-Shinbunsha (in Japanese) and White Paper 2011, Ministry of Health, Labour and Welfair,Japan 4

5 US Military Bases in Japan Russia China North Korea South Korea Iwakuni Base Sasebo Naval Base Yokota AB Tokyo Misawa Air Base Atsugi Air Base Yokosuka Naval Base Kadena Air Base Taiwan Futenma Air Base 5

6 Japanese Archipelago 6852 islands (inhabited 400) 508 islands Tokyo a resource: Japan Maritime Public Relation Center 6

7 Doctorless Area 800 area Tokyo In the area around 4 km (2.5 mile) radius,population of 50 or over and no medical facilities and difficult to receive health care service. 7

8 Aeromedical Patient Transport System in Japan Doctor Helicopter requested by fire dep., or hospitals Fire and Disaster Management Agency Japan Coast Guard requested by fire dep., or hospitals 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 8

9 Search and Rescue Missions in Japan ( Local Govt and Fire and Disaster Management Agency ) Okayama Pref Govt Okayama City Fire Dep. Kyoto City Fire Dep. Hyogo Pref Govt Kobe City Fire Dep. Yokohama City Fire Dep. Kawasaki City Fire Dep. Hokkaido Govt Sapporo City Fire Dep. Hiroshima Pref Govt Hiroshima City Fire Dep. Tokyo Miyagi Pref Govt Sendai City Fire Dep. Fukuoka City Fire Dep. Kita-Kyushu City Fire Dep. Chiba Pref Govt Fire and Disaster Management Agency, Ministry of Internal Affairs and Communications Fire and Disaster Management Agency, Tokyo Metropolitan Govt Osaka City Fire Dep.. Aichi Pref Govt, Nagoya City Fire Dep. Shizuoka Pref. Govt, Shizuoka City Fire Dep. Hamamatsu City Fire Dep. Japan white paper on fire and disaster,2012 9

10 Search and Rescue Missions in Japan (Japan Self-Defense Forces, Coast Guards and other) 3 rd Tactical Airlift Group (JASDF) 1 st Tactical Airlift Wing ( JASDF) Northern Army Aviation Group(JGSDF) Chitose Air Rescue Squadron(JASDF) shiya Air Rescue Squadron (JASDF) 73th Helicopter Rescue Squadron (JMSD 21th Flight Squadron (JMSDF) Tokyo 72th Helicopter Rescue Squadron (JMSDF) 22 nd Flight Squadron (JMSDF) 71th Rescue Squadron (JMSDF) 5 th Aviation Unit (JGSDF) aha Helicopter Airlift Squadron and Naha Air Rescue Squadron (JASDF) apan Coast Guard ivil Medical Evacuation Service 1st Squadron(JMSDF) 72th Helicopter Rescue Squadron, Kanoya Sub Squadron (JMSDF) 10

11 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 11

12 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 12

13 Who Can Make Decision for Aeromedical Evacuation? Prime Minister Minister of Defense Commander of each level, (Division Commander, Base Commander, etc ) 13

14 Japan Air Self-Defense Force, Aero Medical Evacuation Squadron By the courtesy of Public Information Division, Minister s Secretariat, Japan Ministry of Defense 14

ventilation fan Door 2.5 m Oxygen cylinder s 2.

1m There is not necessary to consider EMI issue

15 Japan Air Self-Defense Force, Aero Medical Evacuation Unit Exterior Interior Emergency Light Tie-down Ring ventilation fan Door 2.5 m Oxygen cylinder s 2.4 m Weight 2.5 t 5.1m There is not necessary to consider EMI issue inside the unit. By the courtesy of Aero Medical Evacuation Squadron, Japan Air Self-Defense Force 15

16 Strict Standard of Electromagnetic Interference for Onboard Electronic Equipment MIL-STD-461 ( United States Military) Japan National Defense Standard for evaluate electromagnetic compatibilities (NDS C0011 C) was compliant with MIL-STD-461. Lax RTCA/DO-160 ( US Radio Technical Commission for Aeronautics/Document-160) sequentially matched in US and Europe IEC (JIS T ) ( International Electrotechnical Commission ) (Japanese 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

17 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? 17

18 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. 18

19 To Develop Our Aeromedical Evacuation System Retrospectively, we have some cases with electromagnetically uncertified medical equipment. No EMIrelated hazardous event were reported. Which standard is suitable for efficient aeromedical evacuation?? MIL-STD-461,RTCA/DO-160, IEC , Is it possible to ease the standard other international standard and waive the standard with flight safety? 19

Damage and Provision of Aid of Water Supply in Disaster-hit Areas, the Great East Japan Earthquake and Tsunami

Damage and Provision of Aid of Water Supply in Disaster-hit Areas, the Great East Japan Earthquake and Tsunami By Research and Publication Department, JAPAN WATER RESEARCH CENTER () Updated Wednesday March