Emergency System: Past, Present, Future.

Department of Emergency Medicine at Kurashiki Central Hospital.

Tetsunori Ikegami, M.D.
Emergency medical system
 economics
politics

populations

Different emergency medical system

Common problem
 menu
A world-history of emergency medical systems
The history of emergency medical system in Japan
The ER problem
Future of emergency medicine in Indonesia

The time to repair the roof is when the sun

is shining. - John F. Kennedy
A world-history of emergency medical systems
Franco-German
model

Anglo-American model

1960s
The Franco-German Model
Iron lung
Iron lung from the 1950s in the Gtersloh Town Museum
The Franco-German Model
The Anglo-American Model
The history of Anglo-American Model

1960s
The Anglo-American Model
ER Doctors
The Anglo-American Model

In 1968
American College of Emergency
Physician(ACEP) was established.

In 1980
Emergency medicine was approved
as an independent major specialty.
The Anglo-American Model

30,000
The history of Emergency medical system in Japan
The history of Emergency medical system in Japan
Traffic battleground

Acute Trauma Care

WHITE PAPER ON TRAFFIC SAFETY IN JAPAN 2010

The history of Emergency medical system in Japan

Primary
Emergency Care

Secondary
Emergency Care

Tertiary
Emergency Care
Tertiary Emergency Care

ICU method
The history of Emergency medical system in Japan

Primary
Emergency Care

Secondary
Emergency Care

Tertiary
Respective
Emergencylevels
Care
The history of Emergency medical system in Japan

In 1973
Japanese Association for Acute
Medicine was established.
In 1980
Board certification for Acute
Care Medicine in Japan.
Population pyramid
Transportation to the emergency room
million

Number of Emergency transport

Number of emergency transport

1989
1989 2014

2014
1989

2014
University Hospital

Dispatch system
Emergency medical system in Japan
Around 2000 in Japan
Primary
Emergency Care

Secondary
Emergency Care

Tertiary
Emergency Care
James Miller Jr.,MD at Alexander Hospital in
Social Factors:
1.Population increase Institutional factors:
2.Aging population 1.Hospital based diagnosis
3.Increased chronic disease and treatment
4.Increased accidents/violence 2.Expensive technology
5.Favoring hospital care 3.24hours availability

Around 2000 in Japan

1960
ER problem
Physician factors:
1.Decreasd G.P.s
2.Increased specialists
3.Busier practice
Increased
Emergency
Dept.Visit
5.Less accessible

Anyone anything anytime

 ER problem
North America
Collapse of emergency medical care system
in 1960s
Construction of a new
emergency medical system

2017/1/28 31
The Anglo-American Model
The History of Anglo American model in Japan
Okinawa
~1972
Emergency medicine
=
Anglo American model
Prof. Hidekazu Terasawa
Fukui Prefecture
20 years!
JJAAM 2008; 19: 416-23
415 JJAAM 2008; 19: 416-23
112
JJAAM 2008; 19: 416-23
The Anglo-American Model
ER Doctors
Established in 2009

1500
Trainee ER physicians network
Regular conference
Sharing online medical materials
 The Current Emergency Medical System in Japan
The conventional Japanese emergency system(ICU method)

The Anglo-American model of emergency medicine(ER method)

 ER problem ER problem

ER problem

ER problem

ER problem?

ER problem
 ER problem

a long-term outlook

effective integration with the original healthcare

and emergency medical systems