Emergency medical service systems in Japan: Past, present, and future

  • Koichi Tanigawa
    Correspondence
    Corresponding author. Tel.: +81 82 257 5585; fax: +81 82 257 5589.
    Affiliations
    Department of Emergency and Critical Care Medicine, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan
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  • Keiichi Tanaka
    Affiliations
    Department of Emergency and Critical Care Medicine, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan
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      Summary

      Emergency medical services are provided by the fire defence headquarters of the local government in Japan. There is a one-tiered EMS system. Ambulances are staffed by three crew members trained in rescue, stabilisation, transport, and advanced care of traumatic and medical emergencies. There are three levels of care provided by ambulance personnel including a basic-level ambulance crew (First Aid Class One, FAC-1), a second level (Standard First Aid Class, SFAC), and the highest level (Emergency Life Saving Technician, ELST). ELSTs are trained in all aspects of BLS and some ALS procedures relevant to pre-hospital emergency care. Further development of an effective medical control system is imperative as the activities of ambulance crews become more sophisticated. A marked recent increase in the volume of emergency calls is another issue of concern. Currently, private services for transportation of non-acute or minor injury/illness have been introduced in some areas, and dispatch protocols to triage 119 calls are being developed.

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      References

      1. Emergency Life Saving Technician Law. April 23, 1991. Japan.

        • Tanigawa K.
        • Tanaka K.
        • Shigematsu A.
        Outcomes of out-of-hospital ventricular fibrillation: their association with time to defibrillation and related issues in the defibrillation program in Japan.
        Resuscitation. 2000; 45: 83-90
        • Ambulance and Rescue Service Division, Fire and Disaster Management Defense Agency, Ministry of Home Affairs
        The national survey on medical control for ELSTs in Japan.
        J Jpn Assoc Acute Med. 1999; 10: 376-380
        • Tanaka K.
        The Kobe earthquake: the system response. A disaster report from Japan.
        Eur J Emerg Med. 1996; 3: 263-269
        • Okumura T.
        • Takasu N.
        • Ishimatsu S.
        • et al.
        Report of 640 victims of the Tokyo subway sarin attack.
        Ann Emerg Med. 1996; 28: 129-135
        • Nakagawa T.
        • Inoue Y.
        • Noguchi H.
        • et al.
        The strategy of mass gathering medicine in Expo 2005 Aichi Japan.
        Jpn J Disast Med. 2006; 10: 187
      2. Annual Report on Development of Emergency Services in Japan. Ambulance and Rescue Service Division, Fire and Disaster Management Defense Agency, Ministry of Home Affairs, Japan. 2005.