two maritime prone disasters countries are implementing their maritime SAMU network for planing the maritime agencies integration for Medico Sanitary disasters taking the SAMU of Le Havre organization in the Chanel Sea

1. 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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2. 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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3. 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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4. 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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5. 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

6. 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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7. 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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8. 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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9. 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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10. 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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11. 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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12. Protocols of Training and Cooperation
SAMU of Yokohama (Japan)SAMU of 5ª
Region (Chile) and SAMU of Le Havre
(France)
•
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13. 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
08/10/13 REG55ENGJAPAN 13

14. 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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15. 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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16. 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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17. Medical Regulacion for SAMU
operators training Slides N° 55
• Are also at your dispsition
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18. Explorer Cruize Ship in Antartic seas
2007
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19. 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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20. Mega Hospitals Ships
• US Confort
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21. Japanese Navy future resources for SAMU
Advanced Medical Post, Embarqued
hospitalization
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22. Japanese Helicopter carrier Hyūga
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23. 08/10/13 REG55ENGJAPAN 23
French Navy Mistral class amphibious assault ,
command (BPC) ships like BPC Tonnerre

24. Public Health Ressources Surge
through Sea Shore amphibous access
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25. Seashore access of Public Health
Resources
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26. http://en.wikipedia.org/wiki/List_of_amphibious_warfare_ships
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Amphibious warfare ships for coastal
accesses

27. 08/10/13 REG55ENGJAPAN 27

28. Spanish Medical Assistance and
Hospital for High seaFisher Ships,
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29. 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
08/10/13 REG55ENGJAPAN 29

30. RORO Ferry Ships and Medico Sanitary
disasters
• These ships can be the source and the
resource of Medico Sanitary Disasters
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31. Ferries PMA + Triage + Hospitalizacion + Centro de
Evacuacion Heliportado + PRA SAMU embarcados +
Transporte de Vehiculos y Recursos Sanitarios
Ferry
Amadeo
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32. Japanese Ferries Resources are
important for Public Health
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33. (Japanese) Ferries Hospitalization
Resources…
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34. Air and Maritime Resources are
dangerous
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35. 08/10/13 REG55ENGJAPAN 35
Ship Embarqued , Harbour , Seashore or
Aiport MEDEVAC Advanced SAMU Medical
Advanced Post is always the same

36. Japanese ,Chilian , French ,
Spanish remote Islands or
Archipelago SAMUs
have to plan , train, and integrate
the naval resources for Medico
Sanitary disasters
08/10/13 REG55ENGJAPAN 36

37. Mega Hospital Ships for Medico
Sanitary disasters?
• WORLD WIDE HOSPITAL SHIPS
http://www.globalsecurity.org/military/world
/hospital-ships.htm
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38. Medico Sanitary surge national
equipment and Disaster Planning
• French Postes Sanitaires Mobiles, Plans
Blancs, SAMU network
08/10/13 REG55ENGJAPAN 38

39. French AMP and ARP in a Truck and
Disaster Communication national
Chests
08/10/13 REG55ENGJAPAN 39

40. 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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41. 08/10/13 REG55ENGJAPAN 41

42. 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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43. War front wounded soldiers
evacuation towards Paris in fluvial
boats en 1914/1918
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44. French Army Ambulance/ Hospital
Barges in 1915
08/10/13 REG55ENGJAPAN 44

45. 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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46. 08/10/13 REG55ENGJAPAN 46

47. Tsunami threats in the world
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48. 08/10/13 REG55ENGJAPAN 48
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

49. 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
08/10/13 REG55ENGJAPAN 49

50. 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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PassengerSh

51. • See other SAMU Disaster Medical Regulation
curses in Slideshare
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