CHAPTER 4:First-aid, rescue operations

We want to save the lives that can be saved.

The required period of time for an ambulance to arrive at the site from an initial call in a fire department (119) is about 6 min. Would the result be different if first aid were performed during this period? Or, what if advanced first aid that is currently banned by law were given by Emergency Life-Saving Technician that rushes to the scene? The minutes required to transport a person to a hospital are precious for saving life. We are promoting the institutional improvement and provide support to improve the life saving rate.

001 Quick action determines life or death. Present pre-hospital care conditions in Japan.

The number of emergency call-outs in Japan was about 4.56 million in 2002 including call-outs using helicopters (3.6% increase from the previous year). The number of persons transported by ambulance is 12,482 a day on average. This means that ambulance teams go out once every 6.9 seconds. The number of persons transported by ambulance was about 4.33 million, which means that every 1 in 29 individuals was transported to a hospital by an ambulance team. This number is expected to increase in the future, so it is not an exaggeration to say that the first aid during the period from initial call at a home to arrival at the hospital might determine the destiny of a severely injured or sick person.
" A life saving chain system" for saving previous lives is a must. The starting point for such a chain is to form a system where a chain of activities from initial call to first-aid, transport and hospital for a severely injured or sick person are conducted quickly and smoothly. To promote building of such a system, Fire and Disaster Management Agency is encouraging the establishment of a higher medical control system for advanced rescue activities, such as an improvement in emergency treatment skills of rescue team members and cooperation with medical institutions. At the same time, we will promote the planned deployments of the emergency rescue equipment necessary for providing advanced first aid.

002 Improvement of Emergency Life-Saving Technician program and its effect

If a moving ambulance is a kind of general hospital, more persons might be saved. Or, even if it is difficult for it to be a general hospital, what if it has functions for sending electrocardiogram or X-ray data of severely injured or sick persons to medical doctors? In the near future, such a medical system might become a reality. The present concerns are how to transport severely injured or sick persons to a medical institution as soon as possible while improving the pre-hospital care that is provided. When transporting a severely injured or sick person, only an Emergency Life-Saving Technician can perform the approved advanced emergency care. If the range of pre-hospital emergency care were expanded, it is estimated that the precious lives of more than 1,000 persons a year could be saved.

Currently, about 13,000 ambulance team members out of about 58,000 have been qualified as Emergency Life-Saving Technicians. The emergency life saving technician program was introduced in 1991 to improve the approved first aid given at the rescue site and transport by ambulance and the range of approved treatments by rescue team members was expanded. They have produced great advancements in life saving for patients with cardiac and respiratory arrests as well as further developments in other areas of advanced life saving activities. And due to some expanding of the range of emergency care they can give, more improvement can be expected. The clearest improvement is an approval of electrical shock treatment since April 2003. Although only about one year has passed, many precious lives have actually been saved. At the same time, an additional new treatment for supplying oxygen by inserting a tube into the trachea via the mouth will be approved starting July 2004, and cardiac treatment, which is helpful in restoring the heartbeat, will be approved starting April 2006. However, it goes without saying that it is necessary for Emergency Life-Saving Technicians to update their medical knowledge and know-how to operate this medical equipment.