e-Triage

In the frame of the e-Triage project a system for the electronic registration of affected persons in a mass casualty incident (MCI) was developed and demonstrated. The e-Triage system is particularly applicable to large-scale disasters but can also be used in individual emergencies, i.e. for regular rescue service. The goal was to provide a communication and database system for all stakeholders involved in the rescue.

For this purpose, DLR-KN developed a robust self-synchronising database system which is able to handle intermittent network connectivity and varying link qualities. Key objective was to replicate and synchronise all data among all devices. I.e. all involved hand-held devices and (semi-)stationary network nodes share the same data. The technical details are explained in the final report.

Main ideas of the chosen approach were filed as German patents 10 2011 018 878.9 (DE) and 10 2011 107 508.2 (DE).

The gathered know-how in the area of MCI management was fed into two ETSI technical specifications:

ETSI TS 103 260-1 Satellite Earth Stations and Systems (SES); Reference scenario for the deployment of emergency communications; Part 1: Earthquake

ETSI TS 103 260-2 Satellite Earth Stations and Systems (SES); Reference scenario for the deployment of emergency communications; Part 2: Mass casualty incident in public transportation

Both specifications describe generic processes along wide-area incidents and/or MCIs based on two reference scenarios defined by ETSI. Results of the e-Triage project specifically fed into ETSI TS 103 260-2.

Motivation

In heavily populated areas, during major public events, in connection with the use of public transportation systems and in densely occupied public spaces of all kinds, accidents require effective and efficient crisis management. In such cases, the rescue resources normally used are suddenly no longer adequate and emergency forces have to draw on resources held in reserve. To begin with, the emergency control centres and rescue forces need information as quickly as possible on severity and number of injuries. In addition, the paths that affected take along the various stations of the rescue chain also have to be clearly traceable.

Scenario

Early e-Triage handheld prototype

A timely overview of the situation in a mass casualty incident (MCI) is of crucial importance for the effective and efficient use of rescue personnel, transport means, receiving hospitals, and shelters. According to commonly accepted procedures, inspection teams first classify the injured at the site (triage) recording the results on triage tags, which they attach to the victims. Rescue personnel subsequently use those inspection results to prioritise the treatment and transport of the affected persons. The inspection and registration of the victims, which necessarily takes place on a decentralised basis, makes disaster management considerably more difficult, since the information that the emergency control centres needs remains attached to the patients. Duplicating these data in paper form is a laborious and time-consuming manual process. Another problem in this context is the risk of simultaneous failure or overload of communication infrastructures. This can result in the loss of important data.

Innovations and applications

This research project converted the previous paper-based victim registration system into a consistent data management concept. The electronically recorded data are ransmitted using state-of-the-art communication networks and database systems allow an automatic documentation permitting a retroactive analysis of operations. The e-Triage system comprises a self-sufficient satellite-based communication system with radio cells that can be installed locally, matching end devices with application software for the registration of affected persons, and a distributed, self-synchronising database system.

e-Triage openday at DLR site Operpfaffenhofen

Apart from technical aspects, the degree to which emergency personnel accept the e-Triage system depends primarily on psychological factors. These factors were investigated as an integral part of the research project and made comprehensible through accompanying psychological research. In particular, this work studied the pre-emptive design of the technology, which accommodates the reduced cognitive abilities of emergency personnel working under extreme stress.

Partners

TriaGnoSys GmbH, Weßling, http://triagnosys.com/
Euro-DMS Ltd., Olching, http://www.euro-dms.de/
Ludwig-Maximilians-Universität München, Psychology Department, Munich, http://www.psy.lmu.de/e-triage/

Kindly supported by

Bayerisches Rotes Kreuz, Kreisverband Starnberg, http://www.brk-starnberg.de/
Berufsgenossenschaftliche Unfallklinik Murnau, http://www.bgu-murnau.de/
Landratsamt Starnberg, Fachbereich Verkehrswesen, Brand- und
Katastrophenschutz, http://www.lk-starnberg.de/