Standard and Concept for Aeromedical Evacuation …

1 Standard and Concept for Aeromedical Evacuation in Japan Self-Defense Forces (Abstract )Masanori. FUJITAM asanori. FUJITA11, Shoichi TACHIBANA1, Sinsuke TAMURA , Katsuhiko OGATA 11 Division of Environmental MedicineDivision of Environmental Medicine, National Defense Medical College Research InstituteNational Defense Medical College Research Institute,3-2 Namiki , Tokorozawa ,Saitama 359-8513 JapanTel. +81-4-2995-1626 Fax. +81-4-2991-1612 e-mail. or 2 Department of Pediatrics, National Defense Medical College,3 General Flight Surgeon, Japan Aerospace Exploration Agency JAXA),May 15, 2013 ,Sheraton Chicago Hotel and Towers, The 84th Annual Scientific Meeting, Aerospace Medical AssociationPanel: Japan Session : Japan Mutual Interchange1 Disclosure Information84th Annual AsMA Scientific MeetingMasanori FUJITA, , have no financial relationships to will not discuss off-label use and/or investigational use in my presentation.

2 2 Medical and Health Care Personnel in Japan and USAJ apanUnited StatesRatio United States/JapanPopulations130,000,000312,00 0, ,000 km29,630,000 km225 Doctors300,000954, AssistantNo comparable license83,500-Nurse PractitionerNo comparable license180,000-NursesPublic health Nurse45,000 Statistics not found-Midwife30,000 Statistics not found-Registered Nurse953,0002,730, Nurse368,000 Statistics not found-ParamedicNo comparable licenseStatistics not found-Emergency Medical Technicians42,000270, and Dental Doctors in Japan and Self-Defense Forces(JSDFs)Ground SDFM aritime SDFAir SDFT otalin JSDFsAll JapanNo. of Personnel140,00042,00043,000226,000130,0 00,000No. of Medical Doctors 520180130830300,000No.

3 Of Dental Doctors 140404022010,000No. of Nurses1,1001801701,4501,396,000No. of Emergency Medical Technicians34012011057042,000 Reference: Heisei 22 Boei handbook, Asagumo-Shinbunsha (in Japanese) and White Paper 2011, Ministry of Health, Labour and Welfair,Japan rough number4US Military Bases in JapanTokyoMisawa Air BaseYokota ABKadena Air BaseFutenma Air BaseSasebo Naval Base Iwakuni BaseAtsugi Air BaseYokosuka Naval Base RussiaNorth KoreaSouth KoreaChinaTaiwan5 Japanese ArchipelagoTokyo508 islands3636059716852 islands (inhabited 400)Data resource: Japan Maritime Public Relation Center 6 Doctorless AreaTokyoIn the area around 4 km ( mile) radius ,population of 50 or over and no medical facilities anddifficult to receive health care service.

4 ( Japan Ministry of Health, Labour and Welfare )7800 area Aeromedical Patient Transport System in Japan Doctor Helicopter requested by fire dep. , or hospitals Fire and Disaster Management Agency requested by fire dep., or hospitals Japan Coast Guard 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 Major Airline Company Civil Patient Air Transport Service8 Search and Rescue Missions in Japan( Local Govt and Fire and Disaster Management Agency )TokyoOsaka City Fire Pref. Govt,Shizuoka City Fire City Fire City Fire City Fire Pref GovtHiroshima City Fire Pref GovtOkayama City Fire Pref GovtSendai City Fire City Fire City Fire Govt Sapporo City Fire Pref GovtKobe City Fire Dep.

5 Fire and Disaster Management Agency, Ministry of Internal Affairs and CommunicationsFire and Disaster Management Agency, Tokyo Metropolitan Govt9 Chiba Pref GovtAichi Pref Govt,Nagoya City Fire City Fire Dep. Japan white paper on fire and disaster,2012 Search and Rescue Missions in Japan(Japan Self-Defense Forces, Coast Guards and other) Tokyo15th Aviation Unit (JGSDF)Naha Helicopter Airlift Squadron and Naha Air Rescue Squadron (JASDF)Japan Coast GuardCivil Medical Evacuation Service1st Squadron(JMSDF)72th Helicopter Rescue Squadron , Kanoya Sub Squadron (JMSDF)72th Helicopter Rescue Squadron (JMSDF)22nd Flight Squadron (JMSDF)Ashiya Air Rescue Squadron (JASDF)3rd Tactical Airlift Group (JASDF)73th Helicopter Rescue Squadron (JMSDF) 21th Flight Squadron (JMSDF)71th Rescue Squadron (JMSDF)Northern Army Aviation Group(JGSDF)Chitose Air Rescue Squadron(JASDF)1st Tactical Airlift Wing JASDF)

6 10 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 required11 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 12 Who Can Make Decision for Aeromedical Evacuation ? Prime Minister Minister of Defense Commander of each level, (Division Commander, Base Commander, etc )13By the courtesy of Public Information Division, Minister s Secretariat, Japan Ministry of DefenseJapan Air Self-Defense Force, Aero Medical Evacuation Squadron14 Japan Air Self-Defense Force, Aero Medical Evacuation UnitInterior Interior Exterior Tie-down Ringventilation fan Emergency mWeight DoorOxygen cylindersThere is not necessary to consider EMI issue inside the unit.

7 15 By the courtesy of Aero Medical Evacuation Squadron, Japan Air Self-Defense ForceStandard of Electromagnetic Interference for Onboard Electronic Equipment MIL-STD-461 United States Military) RTCA/DO-160 US Radio Technical Commission for Aeronautics/Document-160) sequentially matched in US and Europe IEC60601-1-2(JIS T 0601-1-2) International Electrotechnical Commission (Japanese Industrial standards ) Japan National Defense Standard for evaluate electromagnetic compatibilities (NDS C0011 C) was compliant with MIL-STD-461. 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 to the Press December,2012 FCC said FAA to allow broader use of electronic device in flight.

8 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 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 To Develop Our Aeromedical Evacuation System Retrospectively , we have some cases with electromagnetically uncertified medical equipment. No EMI-related hazardous event were reported. Which Standard is suitable for efficient Aeromedical Evacuation ?

9 MIL-STD-461,RTCA/DO-160, IEC60601-1-2, other international Standard ? Is it possible to ease the Standard and waive the Standard with flight safety ?It is just started to discuss in