JAPANESE EMERGENCY

CARE SYSTEM

Response Time for Critically Ill

Patients
Based on Japan Experience in 2015
Herdiani Sulistyo Putri
Department of Anesthesiology and Reanimation
Faculty of Medicine Universitas Airlangga

Emergency for Every Doctor Symposium - January 2017 1

Japanese Emergency Care System:
Response Time for Critically Ill
Patients
Based on Japan Experience in 2015

JAPAN EMERGENCY
MEDICAL SERVICE
SYSTEM

Emergency for Every Doctor Symposium - January 2017 2

 Universal emergency access number 1-1-9
Directly connected to fire department
Single tiered ambulance system
Each ambulance min. 3 EMS personnel, with at
least 1 Emergency Life-Saving Technician (ELST)
EMS personnel: trained in rescue, stabilization,
transportation, advanced care of traumatic and
medical emergencies.
ELST: permitted to put iv-line and RL solution, do
intubation, administer epinephrine for CPA patients
under online medical control.

Emergency for Every Doctor Symposium - January 2017 3

Japanese Emergency Care System:
Response Time for Critically Ill
Patients
Based on Japan Experience in 2015

CATEGORIZATION OF
HOSPITAL RESOURCE
CAPABILITIES

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 Classified into 3 levels based on resources,
administration, staff and education:
1. Primary Emergency Facilities
- Care for walk-in patients
2. Secondary Emergency Facilities
- In-hospital care for acute illnesses and trauma
3. Tertiary Emergency Facilities
- Life-saving emergency center
- Severe burns, acute intoxication, reconstruction
surgery, etc.

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Japanese Emergency Care System:
Response Time for Critically Ill
Patients
Based on Japan Experience in 2015

AMBULANCE
RESPONSE TIME

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 Sudden increase in the number of elderly people
increase the number of callouts every year.

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http://www.nippon.com/en/features/h00118/
Trends in the number of emergencies attended and
number of emergency response teams

http://www.fdma.go.jp/en/pdf/top/en_03.pdf

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Any form of response during this time can mean the difference
between life and death or some seriously injured patients

http://www.fdma.go.jp/en/pdf/top/en_03.pdf

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 In 2003 average response time of an ambulance
was 6 minutes 18 seconds
In 2014 7 minutes 54 seconds
Average time from calling 119 to arrive in hospital was
about 39 minutes in 2013 (FDMA)

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Emergency for Every Doctor Symposium - January 2017 12
Japanese Emergency Care System:
Response Time for Critically Ill
Patients
Based on Japan Experience in 2015

DOCTOR HELI

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 A helicopter boarded by doctor and nurse with
emergency medical rescue equipment, capable of
attending critically ill patient.
Benefits:
1. Begin its treatment onsite improve life saving
rate and prognostic conditions of emergency
patients
2. Minimized time loss
3. Patient can be selected from wider area
4. Can provide emergency medical care in remote and
isolate area
5. Wider rescue area in case of disaster

Emergency for Every Doctor Symposium - January 2017 14

Doctor Heli
Centre receive an emergency
call
Must take off within 3 to 5
minutes
Professional emergency
doctor and nurse on board
Maximum distance cover
around 30 minutes
Will not fly in case of raining,
thunderstorm, snow and at
night time

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Japanese Emergency Care System:
Response Time for Critically Ill
Patients
Based on Japan Experience in 2015

EMERGENCY
DEPARTMENT
RESPONSE

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 In generally, 6 hours is the maximum time ambulance
crew to ER
Prepare and contact other department (if needed)
Arrive in ER, get examined and diagnosed
Emergency OT, E-ICU, others
Hybrid ER reduce response time

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Japanese Emergency Care System:
Response Time for Critically Ill
Patients
Based on Japan Experience in 2015

CURRENT ISSUES AND

FUTURE DIRECTIONS

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 Indonesian EMS system vs Japanese EMS system
Developing vs well-established
Effective EMS system combined effort of multiple
organizations, agencies and specially trained
individuals.
How to have a well-established EMS system:
- Appropriate medical control
- Skills of pre-hospital and in-hospital medical personnel
- Cooperation and collaboration among associated
personnel and agencies

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What Can We Do and What Have We Done?
Categorization of hospitals (Type A, B, C, D)
developing
BLS Citizen Community more than 2000 lay people has
already been trained with BLS
BLS and GELS training for nurses and general
practitioners
Knowledge update from Emergency Symposium

Right now, Indonesia is in the same situation with Japan

20-25 years ago, so It will be you who develop Indonesias
health system start right now to become like Japan in the
next 20 years.
So,

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