1. Introduction

1 INTRODUCTION

1.1 Problem Statement

During mass casualty incidents (e.g., multiple injury vehicle accidents, mass shootings), emergency medical services (EMS) personnel must quickly assess the severity of each victim’s condition and assign each person a priority for immediate treatment. Today, this information is captured via a paper “tag” or card system; see Figure 1. We are asking for more advanced technology to be applied to this process to increase efficiency, expedite the process and, ultimately, save more lives. Patients’ status must also be captured and tracked from the initial call through treatment, transport, and discharge to receive proper care, as well as to identify how EMS systems can be improved after each event. Patient tracking also allows Incident Commanders (IC) and hospital staff to map patient locations and understand an event’s severity in real-time to improve incident management. You could help fill this vital need for improved emergency management and patient care by developing technology that streamlines the process and assists with capturing evidence that would inform potential changes to local and national EMS protocols.

Mass casualty incidents create chaotic scenes with injuries ranging from fatal to “the walking wounded.” The first EMS team to arrive on scene must immediately triage the patients; triage is the sorting of patients by priority for treatment, evacuation, or transport. This involves locating all the injured, conducting a quick assessment, and then “tagging” them in a way that indicates the injury’s severity and the urgency of getting follow-up treatment. This operation is critical to saving as many lives as possible without wasting time on fatal or minor injuries; “to optimize overall patient outcomes in a catastrophic situation, there is a shift from doing what is best for the individual patient to doing the greatest good for the largest number of people.”[1] Today, this happens by using a paper form and tag that is completed by hand and attached to the patient with string.

USE CASES

Mass casualty incidents are defined as situations that place a significant demand on medical resources and personnel. Local response capabilities are not overwhelmed; however, there are still a large number of patients requiring triage.[2] Use cases relevant to this challenge are as follows:

  • Multiple Vehicle Accidents — During a rain-soaked commute, a 20-car pile-up occurs on the local interstate. The first EMS team on the scene must locate all vehicles involved, victims in those vehicles, and those ejected or wandering. They must quickly assess the injuries and tag each victim for priority treatment.
  • Mass Casualties after Bombing — Through the news and social media, many of us are familiar with the images of the aftermath of the Boston Marathon bombing. The EMS teams already on scene for the race had to locate victims in and around the location of the blast, assess injuries, and tag each victim for priority treatment and transport.
  • Mass Shootings — Victims of a mass shooting in a school, mall, or outdoor venue have to be identified and a quick assessment done of the severity of their injuries. Gunshot wounds are often difficult to assess because of the internal damage that is not obvious.

1.2 Objectives

Provide EMS with an alternative method for locating, tagging, and tracking patients in mass casualty incidents.

  • Potentially use patient’s smartphone or smartwatch (e.g., Fitbit, Apple Device) to locate and identify victims and to provide medical data, name, address, doctor, and next of kin, as well as to populate forms
  • Possibly leverage disposable RFID tags (e.g., wrist bands, adhesive tags with QR codes) combined with a simple smartphone application that records initial assessment and allows for expansion as additional treatment and transport is provided
  • Solutions should be simple and user-friendly, leverage existing industry standards, and adequately address relevant HIPAA concerns

The expected solution is an application that can record a patient’s initial condition and generate a physical artifact that remains with the patient to inform follow-on care providers. The physical artifact may be a tag of some kind (e.g., RFID wrist band, adhesive decal, QR code) or a virtual marker that follow-on responders can view and update with additional information. Data input would include patient identification, description, vital signs, initial assessment, location, and triage status (i.e., deceased, immediate, delayed, minor). The application should also provide a dashboard display that summarizes all patient data by severity for Incident Command and hospital notification.

1.3 Resources

  • Sample mass crisis scenarios with sample patient data will be provided
  • Links to current Triage systems in use today will be provided
  • Links to HIPAA requirements will be provided
  • Any solution should be consistent with and support the Model Uniform Core Criteria for Mass Casualty Incident Triage (MUCC).[3],[4]

[1] https://journalofethics.ama-assn.org/article/disaster-and-mass-casualty-triage/2010-06

[2] Ibid.

[3] https://www.ems1.com/mass-casualty-incidents-mci/articles/376943048-How-to-standardize-mass-casualty-triage-systems/

[4] https://nasemso.org/wp-content/uploads/MUCC-Background.pdf

2. Evaluation criteria

Participants must adhere to the basic application requirements listed below. Failure to do so may result in non-grading of the application.

2. EVALUATION CRITERIA

Criteria #1

Rating: 20/100

  • The solution captures the initial assessment data and generates an artifact to “tag” the patient.
  • The solution allows the initial assessment data to be updated as treatment and transportation are performed.

Criteria #2

Rating: 20/100

  • The solution has a simple, effective user interface that is intuitive for EMS providers in a chaotic situation.
  • The solution offers enhanced security so only authorized personnel can view data.
  • The solution adheres to HIPAA and MUCC criteria.

Criteria #3

Rating: 20/100

  • The solution provided is easy to view and transfers summary patient/victim data (e.g., dashboard format) to IC and hospital staff.
  • The solution includes GPS location and tracking options to monitor geographic location of injured persons.

Criteria #4

Rating: 20/100

  • The solution automatically transfers data to existing electronic patient care reporting (ePCR) tools.

Criteria #5

Rating: 20/100

  • The solution can integrate with personal devices (e.g., Apple Watch, iPhone Health app, Fitbit) for relevant information.
  • The solution can send an alert to EMS if patient condition changes over time.
  • The solution demonstrates out-of-the-box thinking and immense creativity.

EXPECTED DELIVERABLES FROM PARTICIPANTS 

Review the How to Participate instructions in section 3 of this document to ensure that you are prepared for the in-person Regional Codeathon or Online Contest. The following deliverables will need to be included with the submission:

  • A completed submission form through techtoprotectchallenge.org
  • A 3-minute narrated PowerPoint file or 3-minute narrated video with the following sections:
    • A summary of the submission.
    • Basic information about the participant or participant’s team.
    • Specific requirements of the contest that are being addressed by the participants.
    • Two to four screenshots of the solutions or prototype.
    • Overview of key functions included in the submission.
  • Any available files or links to the developed solution or prototype.
  • Any additional files based on the contest description.
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