Table 1 Dispatch criteria for the HEMS in Japan

1. Due to trauma

    (1) Severe trauma

① High-energy trauma (such as vehicle accidents with passenger fatalities, off-board release, crashing from a height)

② Multiple trauma

③ Obvious abnormality in vital signs (such as consciousness, breathing, blood pressure, pulse rate, and body temperature)

    Trauma

④ Penetrating trauma (such as puncture wounds, gunshot wounds, etc.)

⑤ Trauma with marked external bleeding

⑥ Finger amputation

    (2) Severe burn

① Burns over 15% of the body surface area

② Airway burns (including consciousness disorder, facial burns, injuries in enclosed spaces, etc.)

③ Chemical burns

④ Burns accompanied by external injuries (due to explosions)

    (3) Drowning and suffocation

    (4) Acute toxicosis

① Acute drug toxicosis (such as antidepressants, lithium carbonate, beta-blockers, calcium antagonists, acetaminophen)

② Carbon monoxide toxicosis

    (5) Anaphylaxis

    (6) Environmental obstacle(s)

    Decompression sickness, accidental hypothermia, heatstroke, etc.

2. Due to disease(s)

    (1) Consciousness disorder, convulsion, paralysis, and/or strong headache (including stroke, etc.)

    (2) Strong chest pain and/or abdominal pain (including myocardial infarction, aortic disease, etc.)

    (3) Dyspnea (including bronchial asthma, acute heart failure, etc.)

    (4) Obvious abnormality in vital signs (such as consciousness, respiration, blood pressure, pulse rate, and body temperature)

3. Cardiopulmonary arrest

    (1) Case of cardiopulmonary arrest in which the heartbeat is restarted by cardiopulmonary resuscitation (CPR)

    (2) Case of cardiopulmonary arrest in which the first electrocardiogram shows ventricular fibrillation or tachycardia (VT/VF) or pulseless electrical activity (PEA)

    (3) Case of cardiopulmonary arrest in which the instructing doctor judges that he is suitable for Doctor-Heli during online medical control

4. Perinatal emergency disease(s)

5. Others judged to be serious in the field-instructed

6. Case in which the instructing doctor judges that he is suitable for Doctor-Heli during online medical control