Japan updates emergency medical helicopter guidelines

Japan’s Ministry of Health, Labour, and Welfare (MHLW) has announced plans to revise its operational guidelines for rescue helicopter operations by the end of the fiscal year (31 March).

The aim of the revised guidelines is to improve the efficiency of response by rescue helicopters in the event of a major disaster. They will see the creation of coordination centers for air ambulance operations at disaster response headquarters in each prefecture.

The revisions will also clarify the division of roles between the disaster response headquarters and the responding hospitals with which the air ambulance helicopters are affiliated.

Under the new arrangement, the disaster response headquarters will manage takeoff and landing sites, and will assign helicopters to specific callouts. Hospitals will focus on sharing information about patients and the situation in the affected area.

The MHLW will also call on prefectural governments to take a greater role in the training of rescue helicopter crew, and the establishment of specific landing and refueling sites.

A massive increase in air ambulance providers

The changes come in the wake of last year’s Noto Peninsula earthquake, which occurred on 1 January 2024 and killed over 500 people.

MHLW explained that it became clear after that earthquake that existing operational guidelines – formulated in 2016 – were ineffective, with response times being longer than required due to an inability to determine suitable landing and takeoff sites.

There was also reportedly a lack of information being shared between fire departments and the Self-Defense Forces (Japanese military), with multiple helicopters heading to the same landing sites.

It also follows a rapid expansion in air ambulance provision across the country in the past 14 years – the Ministry reported that in 2011, at the time of the Great East Japan Earthquake, there were 26 air ambulance providers nationwide. This has now more than doubled, to 57. Kagawa was the final prefecture to establish an air ambulance service of its own, in April 2022.

Further complicating the issue, many prefectural air ambulances have begun entering into mutual support agreements to provide assistance outside of their usual territory.