Page 157 - Journal of Special Operations Medicine - Spring 2016

To build consensus around tactical medicine in the re- The proliferation of terrorism worldwide has become
lated ministries, agencies, and the Japan Medical As- a major problem. Societies and organizations involved
sociation, we have set up a committee in JSEM. This in TEMS in each country have international ties, and
committee specifically addresses TEMS-related issues Japan is also a collaborative partner internationally. The
and is also proceeding with the plan to standardize the cooperation with the United States is imperative to de-
knowledge and skills in Japan. velop the TEMS system in Japan.

Current Operation of TEMS in Japan Conclusion
Since 2012, NMS is the only medical facility that has
an agreement with law enforcement to provide TEMS. The current status of TEMS in Japan has been described
5
In a tactical operation, the MPD commander on scene here briefly. To develop TEMS, it is crucial to train
would place a call for the TEMS team in NMS, called TMPs in law enforcement and physicians to become
Incident Medical Assistance Team (IMAT) of the MPD. medical directors of TEMS, and to cooperate with the
This call is made as early as possible via a direct call United States.
line when the commander expects casualties in a certain
condition, such as a raid. On scene, a liaison staff of the Disclosures
MPD is always with the IMAT. The scope of activity is
limited to tactical field care (indirect threat) and tactical The authors have nothing to disclose.
evacuation. The IMAT does not act during under fire
(direct threat), because the team functions as an exter- References
nal team and is unarmed and without arrest rights. The
IMAT provides triage in mass casualty incidents, hemo- 1. Carmona R. The history and evolution of tactical emergency
stasis using tourniquets, airway management, needle medical support and its impact on public safety. Adv Emerg
Nurs. J. 2003;25:277–281.
decompression, and shock management on scene. The 2. Fuse A, Yokota H. Akihabara massacre. Hospitals. 2010;69:
IMAT also provides the incident officer with medical 440–442. (Japanese)
recommendations about the environmental conditions 3. Fuse A, Igarashi Y, Watanabe A, et al. Current issue of tactical
to improve operational effectiveness. emergency medical support (TEMS) in Japan. JJSEM. 2013;16:
7–12. (Japanese)
At present, there are no advanced EMTs in the SAT. Our 4. Fuse A, Saito O, eds. Tactical medicine essentials (Japanese edi-
tion). Tokyo, Japan: Herusu Shuppan, Co. Inc.; 2015.
intent is to train SAT officers to have the license of ad- 5. Nippon Medical School Hospital. Incident medical assistance
vanced EMT in the near future. Medics in the Japanese team. http://hosp.nms.ac.jp/topic/2693.html. Accessed 2 Janu-
Defense Force often have the opportunity to drill with ary 2016.
US forces under the Japan–US alliance, and they will
permit advanced medical care in tactical fields. In the ci-
vilian setting, we still have limitations and must perform
TEMS under Japanese law. We will coordinate, how- Akira Fuse is with the Department of Emergency and Critical
ever, with Tactical Combat Casualty Care in the Japan Care Medicine, Nippon Medical School, Tokyo, Japan.
Defense Force for potential care in other settings.
Richard B. Schwartz is with the Department of Emergency
Medicine and Hospitalist Services, Medical College of Geor-
Current TEMS Status in Japan gia, Augusta, Georgia.
The provision of TEMS in Japan is still in its infancy.
Our intent is to standardize skill sets and training along Daizoh Saitoh is with the Division of Traumatology, Re-
with protocols for the provision of TEMS in Japan. search Institute, National Defense Medical College, Saitama
These issues have been discussed in the JSEM committee Prefecture, Japan.
and we are working toward consensus in the field. Fur-
thermore, for us to proceed with this process, we believe Sato Ogawa is with the Course of the Emergency Medical
it is important to have TMPs who are fully trained and Science, Faculty of Health-Medical Science, Nippon Sport Sci-
credentialed in law enforcement along with training and ence University.
licensure as advanced EMTs in Japan, rather than the Mitsuo Ohnishi is with the Department of Traumatology and
external medical teams. Our intent is to train some of Acute Critical Medicine, Osaka University Graduate School of
the officers in SAT as TMPs, including advanced EMTs, Medicine, Osaka Prefecture, Japan.
while physicians who currently support law enforce-
ment in TEMS will be medical directors. Each law en- Tetsu Okumurais with the Superintendent Chief of the Doc-

forcement agency and department will need to set up a tor’s Office, Metropolitan Police Academy, Tokyo Metropoli-
TEMS committee to support this operational structure. tan Police Agency, Tokyo, Japan.

Tactical Emergency Medical Support in Japan 141