Integration of Information Technology, Wireless Networks, and Personal Digital Assistants for Triage and Casualty

Abstract

The purpose of this study was to evaluate a portable tool for use by first responders in documenting triage of victims in a mass casualty incident (MCI) more effectively. The tool presented in this study allows first responders to gather patients vital signs, injuries, and triage status in a prompt and accurate way, and enables first responders to wirelessly communicate vital health information throughout the entire care continuum. The architecture infrastructure for the portable device is called Triage and Casualty Informatics Technology (TACIT) and can expedite triage, transport and treatment procedures within an MCI. TACIT was developed by integrating handheld devices, wireless networks, global positioning system (GPS), digital cameras, and bar code scanners with customized triage software. Two MCI initial field trials verified that the TACIT software, battery life, data accuracy, and wireless transmission met the emergency response system requirements. Initial field trials also demonstrated robustness of operation, reduced triage collection time and improved collection accuracy. The TACIT system could work as an efficient prehospital response tool and platform.

A review of the literature on the validity of mass casualty triage systems with a focus on chemical exposures

“…19,26,35,66,77,87–94 No studies were identified that used actual outcome data to validate triage systems for radiological or nuclear incidents. The development of prototype handheld field triage instruments that include a radio frequency device (RFD) capability to track patients, equipment and responders as well as the ability to document care and triage status were discussed in several studies; 36,37,95,96 however, none has been validated under MCI conditions. Several studies also discuss the design and use of computerized disaster information systems 97–99 but none has been tested under an actual MCI.…”

The Clinical Application of Mobile Technology to Disaster Medicine

“…One way to work around this problem is for the rescuers' devices to store data and then automatically transmit it when they move into an area with network coverage. 12 To improve the data available to the incident commander, some systems track the geographic location of patients. The Global Positioning System (GPS) is one method for doing this but it does not work well inside buildings.…”

“…The Global Positioning System (GPS) is one method for doing this but it does not work well inside buildings. 12 Systems that use WiFi can instead use either the location of the nearest WiFi network node 11 or trilateration (calculating position using the distance from multiple nodes). 6,14 Alternatively, dedicated systems such as ultrasound beacons can be used to determine location.…”

“…Three studies comparing paper-based to electronic triage found the electronic system to be slightly faster: > 42 seconds per patient for paper triage vs. 38 seconds for electronic; 10 > 36.6 minutes for paper triage of all patients in a 40-casualty incident vs. 34.7 minutes using electronic triage, P 5 .0008; 26 > 5 minutes per patient for triage and data entry using paper vs. 3.4 minutes using electronic triage. 12 One study found that a lack of familiarity with equipment can lead to increased triage times (19 seconds per patient using paper triage vs. 25.9 seconds using electronic triage). 9 When considering the flow of patients throughout the whole disaster site, the benefits are clearer.…”

Patient tracking in earthquake emergency response in Iran: A qualitative study

“…[22] Literature review showed that there are different studies in the world, some focused on content and functions of patient tracking system in disaster, and the others introduced the application of information technology for patient tracking in disaster. For example, Zhao et al [23] conducted a study to assess a portable instrument with high efficiency for the rescuers' use in documenting victims' triage in mass-causality incidents. The first responders were able to record patients' vital signs, injuries, and triage status immediately and accurately and the patients could be transferred for continuum of care.…”