Medico Sanitary Disaster Plans using the Maritime SAMU network for a Franco

Japanese and Chilian project Suggestions on french experience for Mass Medical Care Critical White Plans for Public

Halth Authorities and Maritime Civil and Navy Agencies

Miguel Martinez Almoyna SAMU de Paris Christian Drieu SAMU de Le Havre Francia

Npaoto Morimura SAMU of Yokohama

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Countries with maritime seashores potential medico sanitary disasters

• Natural disasters Earthquakes Volcan Erruptions and Typhoons , Tsunamis

• Man made disasters in the coast like Harbours and Industrial Hazards

• International traffic of Cruise Ships medico sanitary Emergencies

• Archipelago Islands

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Medical Emergencies Prehospital Care Principles 1

•Sanitary Prehospital Emergency Medecine is a part of Public Health and Physicians exclusive domain of competence •Are based Medical on ethic rules •The system must apply the democratic and autonomic and equitable justice principles

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Medical Emergencies Prehospital Care Ideal Principles 2

• An EMS must be Integrated with all other levels of Care in a network under autority of Public Health (IEMS) and under (SAMU) Physician direct Regulation of mobile and fixed resources

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The Network of Maritime SAMU in sea and coastal Medical and

Sanitary Emergencies

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• French maritime SAMU organization• Portugal , Spanish Sea Medical Emergencies

organization• Japan , Chile , Brazil, Mexico present projects

The Maritime project of SAMU of Japan Chilian and French SAMU joint venture

• The SAMU is the Emergency Center of Medical Regulation of all Medical Sanitary Emergencies on maritime area (high sea, costal, harbours, ferries , remote islands etc )

• This physician permanent regulation , can be called by anyone through a national or emergency wire ou radioed hot lines .

• The aim is to optimize access not only in rescue conditions but of all levels the medical emergency of care from primary to specialized critical care and even for only for telemedecinal assistance

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The SAMU Medical Regulation• The regional maritime SAMU is the regulation

center off all the Public Health Integrated Emergency System (IEMS)

• It Regulates the Demand and the Response of Sanitary Emergencies

• It Regulates and monitors all mobil ground , aerial, and maritime mobile emergency care resources (First aid, Ambulances and MICU) coordinate , orient them and for the last , the MICU, towards the best for the patient hospital intensive or specialzed care unities.

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SAMU and IEMS fromthe seashore cities of Japan?

A.- Maritime SAMU coordinated with Japanese Self Defense Force and Japanese Coast Guard ?

B.- Mobile Resources ships , helicopter ambulances , MICU and SAMU on board Advanced Medical Posts

C.- Common Training centers with Maritime agencies D.- National Surge Public Health disaster National

Reserve resources

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SAMU Medical Regulation in Maritime emergency medical cases

1.- Reception of the Medical Call emited from the ship by the captain Analize the Demand/ Medical Emergency Care Need

2.- Regulation of the resources and solutions of the case with the implicated maritime autorities

3.- Dispatching or Mobilizacion of Mobile and/or Fixed Resources with coastal implicated authorities

4.- Public Health continuous information and teleassistance

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SAMU Medical Regulator

• Is responsables all emergency operational medical care decisions

• Has the permanent Public Heath authority delegation of power for medical emergency decisiosn in front of Maritime Agency operations commanding Officer for emerhency tactical decisions

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Maritime SAMU Regulator and Maritime Authorities bilateral protocols and Standing orders

• Helicopter = EVAC Hoist ? or Ship Deck Landing? Towards where? Bed to bed Bed to an Ambulance?

• Maritime EVAC towards what Harbour = By the same diverted ship/other intervening ship?

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Protocols of Training and Cooperation SAMU of Yokohama (Japan)SAMU of 5ª

Region (Chile) and SAMU of Le Havre (France)

•

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Projects of Maritime SAMU in Chile and Japan

• Jornada de Emergencias Marítimas y Portuarias 2013 como plataforma para el desarrollo del marco teórico conceptual y relanzar Cooperación Franco Chilena

• Preparacion de los Planos Blancos de Desastres sanitarios entre Salud Publica y Defensa Naval

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What should be the future in Japan?

• Installing a Center of reception of maritime medical emergency alerts for ships in coastal and high sea navigation and derricks

• First Medical Regulation in a national marítime SAMU in Yokohama based on Prefecture and Municipality Medical Regulation Team

• Training centers and White Plan Disaster exercices • Intervention teams for maritime sites : Sea shore, Lakes ,

Harbours , coastal and high sea , Isolated Islands • Joint maritime agencies and samu intervention teams for

mass disasters , rescue and individual medical emergencies

• National Surge Reserves of equipment and personals

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Typology of Medical Sanitary Maritime Emergencies

• Costal , Seashore and Ofshore installations accidents and pathologies

• Traveller Harbours accidents and pathologies• Civil and Military Ships accidents and

pathologies • Individual and Collective Ambulance and Buses

coastal evacuations • White Plans in case of Maritime response

needs

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Typology of Ships Emergency Telemedical Assistance

• Emergency Telemedical asssitance is yet organized from many years in several countries like France Portugal Spain

• France as a public health integrated syteme bases on SAMU medical regulation of emergencies call centers on the metropilitan and french islands coasts for dispatching the medical care givers if needed on booard or in the coast

• The ship captain is reseponsible of medical security and must call for assistance if needed on board

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Medical Regulacion for SAMU operators training Slides N° 55

• Are also at your dispsition

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Explorer Cruize Ship in Antartic seas 2007

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Chilian Navy ,Defense, Customs and Police maritime resources for Public Health

Disasters Hospitals of Army and Campaign Hospitals and Mobile resources

Rescue , Intervention and Transport Ships Ambulances and Aircrafts

Military Reserves

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Mega Hospitals Ships

• US Confort

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Japanese Navy future resources for SAMU Advanced Medical Post, Embarqued

hospitalization

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Japanese Helicopter carrier Hyūga

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French Navy Mistral class amphibious assault , command (BPC) ships like BPC Tonnerre

Public Health Ressources Surge through Sea Shore amphibous access

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Seashore access of Public Health Resources

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http://en.wikipedia.org/wiki/List_of_amphibious_warfare_ships

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Amphibious warfare ships for coastal accesses

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Spanish Medical Assistance and Hospital for High seaFisher Ships,

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Juan Carlos Spanish Ship• Juan Carlos Posee un dique inundable con capacidad para alojar

hasta cuatro transportes de desembarco anfibio LCM-1E y cuatro supercat o un "hovercraft" LCAC (landing craft, air cushion).

• Asimismo cuenta con un hospital con dos quirófanos, sala de odontología, enfermería, UCI, rayos X, laboratorio, farmacia. El garaje y el hangar están construidos en dos niveles de 6000 m² y son espacios versátiles, con capacidad para 6000 t de carga cada uno:

Garaje de vehículos pesados con 1410 metros cuadrados. Garaje de vehículos ligeros de 1880 metros cuadrados. Hangar: 990 m²

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RORO Ferry Ships and Medico Sanitary disasters

• These ships can be the source and the resource of Medico Sanitary Disasters

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Ferries PMA + Triage + Hospitalizacion + Centro de Evacuacion Heliportado + PRA SAMU embarcados +

Transporte de Vehiculos y Recursos Sanitarios

Ferry Amadeo

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Japanese Ferries Resources are important for Public Health

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(Japanese) Ferries Hospitalization Resources…

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Air and Maritime Resources are dangerous

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Ship Embarqued , Harbour , Seashore or Aiport MEDEVAC Advanced SAMU Medical

Advanced Post is always the same

Japanese ,Chilian , French , Spanish remote Islands or Archipelago SAMUs have to plan , train, and integrate the naval resources for Medico Sanitary disasters

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Mega Hospital Ships for Medico Sanitary disasters?

• WORLD WIDE HOSPITAL SHIPS http://www.globalsecurity.org/military/world/hospital-ships.htm

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Medico Sanitary surge national equipment and Disaster Planning

• French Postes Sanitaires Mobiles, Plans Blancs, SAMU network

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French AMP and ARP in a Truck and Disaster Communication national

Chests

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AMP as a Van or under tent on the Coast , on the Harbour or On board

(on the Shipdesk or on the Hold)

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Cruize ships passengers mass traffic medico sanitary disasters is growing in highsea, coasts and harbours

without sufficient medical security and disaster planning

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War front wounded soldiers evacuation towards Paris in fluvial

boats en 1914/1918

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French Army Ambulance/ Hospital Barges in 1915

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Passengers Transport Ships Medical Organization is poor

• http://www.salvamentomaritimo.es/wp-content/files_flutter/1368084313Evacuaci%C3%B3nHelic%C3%B3ptero.pdf

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Tsunami threats in the world

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Coastal Ferries and Passenger Maritime Transport hazards in the world have to improove their security organization and

their hability to surge of on board care capabilities in case of contingency

Harbour Passengers Terminals of Yokohama , Valparaiso or Le Havre could be used as a Public health Resource in case of

disaster and SAMU AMP installation

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Mass Passenger Ships traffic is growing up without sufficient security

norms and medico sanitary emergency plans

Passenger Ships can be solution for public health and medical care in

certain occasions

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Passenger Sh

• See other SAMU Disaster Medical Regulation curses in Slideshare

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