#DOCTOR HOSPITAL EMERGENCY SERIES#

These results suggest that causes of ambulance activation have changed from young trauma patients to older medical patients. Disease categories of the patients in emergency centers in 2011 consisted of trauma (18.3%), stroke (17.3%), cardiovascular disease (15.5%), digestive disease (11.0%), cardiac arrest (9.6%) and others. In contrast to the decreased numbers of trauma patients, the number of ambulance activations increased and was up to 6.2 million in 2018 (Fig. At the same time, the number of designated tertiary emergency/critical care centers increased throughout Japan to 289 centers in 2018. After 1971, the number of trauma patients decreased after the law required the use of seatbelts for cars and helmets for motorcycles and decreased even more after the institution of a “no drink and drive” rule (3904 fatalities/year in 2016). In 1967, the Osaka University Critical Care Center was founded to provide all necessary care for patients with multiple trauma at one location for the first time in Japan. As a result, the injured patients were diverted multiple times to provide specialty care for all of their needs.

#DOCTOR HOSPITAL EMERGENCY SERIES#

Instead of providing simultaneous trauma care, care was delivered sequentially by a series of specialists sometimes at different facilities. Difficulties in management arose when a trauma patient sustained multiple injuries and required simultaneous care from more than one specialty. At that time, emergency patients were seen by physicians of different specialties according to the perceived medical need. By 1970, the number of deaths by traffic accidents was reported to be 16,765. In the 1960s, the number of trauma patients in Japan rapidly increased as the economy developed. History and the changing demographic of emergency patientsįrom the 1930s, local governments hired paramedics and provided ambulance service to hospital emergency departments (EDs) at no cost to the general public. In this review, emergency medicine in Japan is described by reviewing its history, recent developments and current structure, present challenges, and future directions in a country facing an increasingly aging demographic. However, recent changes in the demographics of the population and the types of injuries sustained have considerably challenged this traditional system. The idea behind this structure was to centralize the transfer of the sickest patients to tertiary emergency centers to optimize their care. The traditional method of providing emergency care in Japan’s large metropolitan areas is organized according to three levels of emergency depending on the perceived acuity of the patient as evaluated by paramedics. The kinds of emergencies seen in Japanese hospitals have also changed as the safety features of automobiles have improved.

In fact, Japan has the largest population of people older than 65 years (26.3%) according to the 2018. Over time, the demographics of Japan have changed drastically as the population has grown older and the birth rate has steadily declined. There have been no recent reviews on the status of the development of emergency medicine in Japan. Emergency medicine in Japan needs to develop in a more flexible way to meet the upcoming robust challenges of the changing demographics. Possible solutions currently underway, such as a public helpline, smartphone app system, coordination by designated hospitals, and universal coverage/government support, are discussed as future directions. Challenges in triage, ambulance diversion, and staffing are discussed in this review. The focus has been shifting from critical care and trauma to medical and surgical conditions involving the elderly. A super-aged society has been developing in Japan, and the emergency care system needs to change according to these new demographics and society’s needs. These can lead to the recognition of the shortcomings of a society’s traditional systems and the various changes that are needed, especially in providing emergency medical care. Quite a few changes and challenges have arisen in society in general as technology has advanced and the aging population has increased.

Doctor hospital emergency