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.
Similar content being viewed by others
Explore related subjects
Discover the latest articles, news and stories from top researchers in related subjects.References
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.
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.
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.
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.
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.
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.
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.
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
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.
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
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.
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.
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.
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.
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.
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.
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.
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
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.
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.
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.
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.
Author information
Authors and Affiliations
Corresponding author
Additional information
This article is part of the Topical Collection on Mobile Systems
Rights and permissions
About this article
Cite this article
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
Received:
Accepted:
Published:
DOI: https://doi.org/10.1007/s10916-014-0065-6