Development of the Japanese National Disaster Medical System and Experiences during the Great East Japan Earthquake.

After the Great Hanshin-Awaji Earthquake in 1995, the Japanese national disaster medical system (NDMS) was developed. It mainly consists of four components, namely, a disaster base hospital, an emergency medical information system, a disaster medical assistance team (DMAT), and national aeromedical evacuation (AE). The NDMS was tested for the first time in a real disaster situation during the Great East Japan Earthquake in 2011. Two airports and one base were appointed as DMAT gathering places, and approximately 393 DMAT members divided into 78 teams were transported by Japan Air Self-Defense Force (JASDF) aircrafts to two AE staging bases the following day. Staging care units were installed at Hanamaki Airport, Fukushima Airport, and the Japan Ground Self-Defense Force Camp Kasuminome, and 69, 14 and 24 DMAT teams were placed at those locations, respectively. In total, 19 patients were evacuated using JASDF fixed-wing aircraft. Important issues requiring attention became clear through the experiences of the Great East Japan Earthquake and will be discussed in this paper.