Experience on EMS (SAMU) in Japan: A short term trial of out-of hospital emergency medical regulation system (MERS) in Yokohama : Spécifités des urgences dans les pays du Pacifique

Background: Although EMS in Japan is essentially different from other advanced countries in terms of provider of pre-hospital EMS, We tried to perform the French like medical regulation system in the limited period and area in order to achieve quality improvement of pre-hospital EMS. Hence we analyzed fitness of this system and efficacy of attending physicians on scene and dispatch center. We call this system Medical Regulation system (MERS). Objectives: To clarify the efficacy of MERS in the city of Yokohama from a point of view of performance of medical regulation in dispatch center, quality of field triage by physicians, and efficacy of initial treatment on site by physicians. Method: Prior to a trial of MERS, we preliminarily investigated and classified patterns of actual 460 initial spoken expressions of callers to 119 in order to establish a simple flow chart for emergency call triage (ECT). Then, a short term MERS trail was performed to the area in 1-5 km around our critical care and emergency center. Subjects of out-of hospital care by MICU based on ECT were loss of consciousness, acute chest pain, and severe acute back pain. Results: Twenty nine cases were provided advanced medical care by MICU (4,74% [29/617]). Mean age of patients was 65.3 (58.6 - 72.0) yr-old. Male % was 58.6 (17/29). Diagnosis on admission of hospital of each patient was following, acute myocardial infarction 3, unstable angina pectoris 1, acute aortic dissection 1, bronchial asthma 1, atrial fibrillation 1, hypertension 1, intracerebral hemorrhage 1, cerebral infarction 1, and others 17. In those patients, mild cases were 12, moderate were 8 and serious were 8.