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Design and Development of A Mobile-based System for Supporting Emergency Triage Decision Making

  • Mobile Systems
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Abstract

Emergency care for mass casualty incidents is a sophisticated multi-participant process. To manage this process effectively, many information systems have been proposed. However, their performance in improving the efficiency and accuracy of patient triage is not satisfactory. This paper is concerned with the development of a mobile-based system for supporting emergency triage in the emergency care process for mass casualty incidents. This system collects the patient’s emergency data throughout the whole emergency care process through a mobile application and data transfer mechanism. Using a Cox proportional hazard model, the system has the capacity to present the survival curve to the triage officer, helping him/her to make triage and transportation decisions. This system offers an alternative injury assessment tool based on the vital signs data of the injury patient. With the help of this system, the triage officer can more directly and comprehensively learn about each patient’s situation and deterioration without additional operations at the incident site.

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References

  1. Aylwin, C. J., Konig, T. C., Brennan, N. W., Shirley, P. J., Davies, G., Walsh, M. S., and Brohi, K., Reduction in critical mortality in urban mass casualty incidents: analysis of triage, surge, and resource use after the London bombings on July 7, 2005. Lancet 368(9554):2219–2225, 2006. doi:10.1016/s0140-6736(06)69896-6.

    Article  Google Scholar 

  2. Ryan, J. M., and Doll, D., Mass casualties and triage. In: Velmahos, G. C. C., Degiannis, E., and Doll, D. (Eds.), Penetrating Trauma. Springer, Berlin, pp. 151–159, 2012. doi:10.1007/978-3-642-20453-1_21.

    Chapter  Google Scholar 

  3. Gao, T., Massey, T., Selavo, L., Crawford, D., Chen, B. R., Lorincz, K., Shnayder, V., Hauenstein, L., Dabiri, F., Jeng, J., Chanmugam, A., White, D., Sarrafzadeh, M., and Welsh, M., The Advanced Health and Disaster Aid Network: a light-weight wireless medical system for triage. IEEE Trans. Biomed. Circ. Syst. 1(3):203–216, 2007. doi:10.1109/tbcas.2007.910901.

    Article  Google Scholar 

  4. Gao, T., and White, D., A next generation electronic triage to aid mass casualty emergency medical response. Conference proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society IEEE Engineering in Medicine and Biology Society Conference Suppl:6501–6504. doi:10.1109/iembs.2006.260881, 2006.

  5. Lenert, L. A., Kirsh, D., Griswold, W. G., Buono, C., Lyon, J., Rao, R., and Chan, T. C., Design and evaluation of a wireless electronic health records system for field care in mass casualty settings. J. Am. Med. Inform. Assoc. 18(6):842–852, 2011. doi:10.1136/amiajnl-2011-000229.

    Article  Google Scholar 

  6. Kahn, C. A., Schultz, C. H., Miller, K. T., and Anderson, C. L., Does START triage work? An outcomes assessment after a disaster. Ann. Emerg. Med. 54(3):424–430, 2009. doi:10.1016/j.annemergmed.2008.12.035. 430 e421.

    Article  Google Scholar 

  7. Sacco, W. J., Navin, M., Fiedler, K. E., Waddell, R. K., Long, W. B., and Buckman, R. F., Precise formulation and evidence-based application of resource-constrained triage. Acad. Emerg. Med. 12(8):759–770, 2005. doi:10.1197/j.aem.2005.04.003.

    Article  Google Scholar 

  8. Wu, H., Hamdi, L., Mahe, N., TANGO: A flexible mobility-enabled architecture for online and offline mobile enterprise applications. In: Mobile Data Management (MDM), 2010 Eleventh International Conference on, 23–26 May 2010. pp 230–238. doi:10.1109/MDM.2010.58, 2010

  9. Poulymenopoulou, M., Malamateniou, F., and Vassilacopoulos, G., Emergency healthcare process automation using mobile computing and cloud services. J. Med. Syst. 36(5):3233–3241, 2012. doi:10.1007/s10916-011-9814-y.

    Article  Google Scholar 

  10. Sasser, S.M., Hunt, R.C., Faul, M., Sugerman, D., Pearson, W.S., Dulski, T., Wald, M.M., Jurkovich, G.J., Newgard, C.D., and Lerner, E.B., Guidelines for field triage of injured patients: recommendations of the National Expert Panel on Field Triage, 2011. MMWR Recommendations and reports : Morbidity and mortality weekly report Recommendations and reports/Centers for Disease Control 61 (RR-1):1–20, 2012

  11. Boyd, C. R., Tolson, M. A., and Copes, W. S., Evaluating trauma care: the TRISS method. Trauma score and the injury severity score. J. Trauma 27(4):370–378, 1987.

    Article  Google Scholar 

  12. Purtill, M. A., Benedict, K., Hernandez-Boussard, T., Brundage, S. I., Kritayakirana, K., Sherck, J. P., Garland, A., and Spain, D. A., Validation of a prehospital trauma triage tool: a 10-year perspective. J. Trauma. 65(6):1253–1257, 2008. doi:10.1097/TA.0b013e31818bbfc2.

    Article  Google Scholar 

  13. Chawda, M. N., Hildebrand, F., Pape, H. C., and Giannoudis, P. V., Predicting outcome after multiple trauma: which scoring system? Inj.-Int. J. Care Inj. 35(4):347–358, 2004. doi:10.1016/s0020-1383(03)00140-2.

    Article  Google Scholar 

  14. Hirshberg, A., Holcomb, J. B., and Mattox, K. L., Hospital trauma care in multiple-casualty incidents: a critical view. Ann. Emerg. Med. 37(6):647–652, 2001. doi:10.1067/mem.2001.115650.

    Article  Google Scholar 

  15. Garner, A., Lee, A., Harrison, K., and Schultz, C. H., Comparative analysis of multiple-casualty incident triage algorithms. Ann. Emerg. Med. 38(5):541–548, 2001. doi:10.1067/mem.2001.119053.

    Article  Google Scholar 

  16. Wang, S.-T., Construct an optimal triage prediction model: a case study of the emergency department of a teaching hospital in Taiwan. J. Med. Syst. 37(5):1–11, 2013. doi:10.1007/s10916-013-9968-x.

    Article  Google Scholar 

  17. Shirabad, J. S., Wilk, S., Michalowski, W., and Farion, K., Implementing an integrative multi-agent clinical decision support system with open source software. J. Med. Syst. 36(1):123–137, 2012. doi:10.1007/s10916-010-9452-9.

    Article  Google Scholar 

  18. Killeen, J.P., Chan, T.C., Buono, C., Griswold, W.G., and Lenert, L.A., A wireless first responder handheld device for rapid triage, patient assessment and documentation during mass casualty incidents. AMIA Annual Symposium proceedings/AMIA Symposium AMIA Symposium:429–433, 2006

  19. Chan, T. C., Killeen, J., Griswold, W., and Lenert, L., Information technology and emergency medical care during disasters. Acad. Emerg. Med. 11(11):1229–1236, 2004. doi:10.1197/j.aem.2004.08.018.

    Article  Google Scholar 

  20. Navin, D. M., Sacco, W. J., and McGill, G., Application of a new resource-constrained triage method to military-age victims. Mil. Med. 174(12):1247–1255, 2009.

    Article  Google Scholar 

  21. Sacco, W. J., Navin, D. M., Waddell, R. K. I., Fiedler, K. E., Long, W. B., and Buckman, R. F. J., A new resource-constrained triage method applied to victims of penetrating injury. J. Trauma Acute Care Surg. 63(2):316–325, 2007.

    Article  Google Scholar 

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Acknowledgments

This work was supported by the National Natural Science Foundation (Grant No. 61173127), National High-tech R&D Program (No. 2013AA041201) and Zhejiang University Top Disciplinary Partnership Program.

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Authors and Affiliations

  1. EMR and Intelligent Expert System Engineering Research Center, Key Laboratory of Bio-medical Engineering, Ministry of Education, College of Biomedical Engineering and Instrument Science, Zhejiang University, Hangzhou, China

    Yu Tian, Tian-Shu Zhou, Yu Wang & Jing-Song Li

  2. Department of Emergency Medicine, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310009, China

    Mao Zhang

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  1. Yu Tian
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  2. Tian-Shu Zhou
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  3. Yu Wang
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  4. Mao Zhang
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Correspondence to Jing-Song Li.

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This article is part of the Topical Collection on Mobile Systems

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Tian, Y., Zhou, TS., Wang, Y. et al. Design and Development of A Mobile-based System for Supporting Emergency Triage Decision Making. J Med Syst 38, 65 (2014). https://doi.org/10.1007/s10916-014-0065-6

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  • DOI: https://doi.org/10.1007/s10916-014-0065-6

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