-Case Reports-

Aeromedical Transport Operations Using Helicopters during the 2016 Kumamoto Earthquake in Japan

Tomokazu Motomura¹, Atsushi Hirabayashi¹, Hisashi Matsumoto¹, Nobutaka Yamauchi¹, Mitsunobu Nakamura², Hiroshi Machida², Kenji Fujizuka², Naomi Otsuka³, Tomoko Satoh⁴, Hideaki Anan⁵, Hisayoshi Kondo⁶ and Yuichi Koido⁶

¹Shock and Trauma Center, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
²Japanese Red Cross Maebashi Hospital, Gunma, Japan
³Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan
⁴Saga-ken Medical Centre, Koseikan Hospital, Saga, Japan
⁵Fujisawa City Hospital, Kanagawa, Japan
⁶Institute for Clinical Research National Disaster Medical Center, Tokyo, Japan

More than 6,000 people died in the Great Hanshin (Kobe) Earthquake in 1995, and it was later reported that there were around 500 preventable trauma deaths. In response, the Japanese government developed the helicopter emergency medical service in 2001, known in Japan as the "Doctor-Heli" (DH), which had 46 DHs and 2 private medical helicopters as of April 2016. DHs transport physicians and nurses to provide pre-hospital medical care at the scene of medical emergencies. Following lessons learned in the Great East Japan Earthquake in 2011, a research group in the Ministry of Health, Labour and Welfare developed a command and control system for the DH fleet as well as the Disaster Relief Aircraft Management System Network (D-NET), which uses a satellite communications network to monitor the location of the fleet and weather in real-time during disasters.
During the Kumamoto Earthquake disaster in April 2016, 75 patients were transported by 13 DHs and 1 private medical helicopter in the first 5 days. When medical demand for the DHs exceeded supply, 5 patients, 8 patients, and 1 patient were transported by Self-Defense Force, Fire Department, and Coast Guard helicopters, respectively. Of the 89 patients who were transported, 30 (34%) had trauma, 3 (3%) had pulmonary embolisms caused by sleeping in vehicles, and 17 (19%) were pregnant women or newborns. This was the first time that the command and control system for aeromedical transport and D-NET, established after the Great East Japan Earthquake in 2011, were operated in an actual large-scale disaster. Aeromedical transport by DHs and helicopters belonging to several other organizations was accomplished smoothly because the commanders of the involved organizations could communicate directly with each other in person within the Aviation Coordination Section of the prefectural government office.
However, ongoing challenges in the detailed operating methods for aeromedical transport were highlighted and include improving shared knowledge and training across the organizational framework. These are particularly important issues to address given the Nankai Trough and Tokyo inland earthquakes that are predicted for the near future in Japan.

J Nippon Med Sch 2018; 85: 124-130

Keywords
aeromedical transport, command and control, dynamic location monitoring, earthquake, helicopter

Correspondence to
Tomokazu Motomura, MD, Shock and Trauma Center, Nippon Medical School Chiba Hokusoh Hospital, 1715 Kamagari, Inzai, Chiba 270-1694, Japan
xcjwg823@yahoo.co.jp

Received, August 29, 2017
Accepted, November 1, 2017