Advances in MCI Technology
There are some exciting new technologies on the horizon for MCI management. Several offer the potential to make our job much easier. What constituted science fiction only a few years ago is now quite literally science fact. Remember the biometric scanner or Tricorder from Star Trek? We are far closer to such technology than you might think. New technologies are poised to make many of our most difficult challenges in a disaster more manageable.
The Science and Technology Directorate (S&T), in cooperation with Boeing and Washington University's School of Medicine, is developing The Standoff Patient Triage Tool of SPTT. The SPTT uses laser doppler vibrometry to monitor key physiologic parameters from some distance. The vibrometer can measure the velocity and displacement of vibrating objects, converting these measurements into indications of physiological status. Someday soon it may be possible to use something that looks like a radar gun to "shoot" a dozen different victims from a distance. But other technological advances are nearly ready right now.
The NcIQ Casualty Management System from NMT, Inc., uses a MP4-player sized device to capture electric signals reflected from moving anatomical structures in the chest. You just place it over the heart and in a few seconds, it takes a reading right through the victim's clothing. NMT's patented IQ monitoring technology extrapolates and trends cardiac output, heart rate, and respiration. Then it transmits the score wirelessly to a remote monitor. One medic can monitor multiple patients simultaneously, and know exactly which one is changing for the worse and when. It even has a radio-locator so one individual knows where all of the victims are. This technology could revolutionize multiple casualty clinical management. NMT also manufactures the revolutionary Zoe hydration status monitor.
What happens when your system is overloaded in a disaster and responders from other jurisdictions come to help? We want and desperately need the help. But sometimes utilizing the full capabilities of the volunteers coming from another state can be highly problematic. The RAPTOR ID Advanced Authentication and Validation system is a trusted secure personal identification and credentialing platform. It allows emergency managers to effectively assign personnel, while also better protecting them on the scene. The system consists of a hand-held device that reads the RAPTOR ID system’s smart ID cards. Identification, Training, and Certification data is stored directly onto the smart cards' memory chip, allowing that information to be viewed later in a disconnected environment. Not only can you verify who they are, but with one swipe you could even know if their CPR card is current.
Another huge problem is medical records. When we move people from an affected area to somewhere else, we usually leave everything else behind. Someday all our medical information will be on the internet, once security challenges and privacy issues are resolved. But until then, the C.A.R.E. Memory Wristband is a great solution. The C.A.R.E. Memory Wristband is a durable plastic bracelet with a hidden USB port and memory chip. You can plug it into any computer and view the HTML read-only files from any web browser. The patient is in physical control of the data along with who they share it with. I recently heard about a fire chief who ordered a special bracelet with the complete medical records of everyone in his command. If someone gets hurt or sick on the job, hospital workers need to know everything from the patient's blood type to his allergies, all of which can be found on his wrist. Other agencies have concentrated on finding creative ways to provide them to at-risk populations in their service areas.
EMS professionals need good basic disaster skills and simple tools for the most critical first few minutes. One of the most important of these is triage. Triage is defined as the sorting and identification of patients according to their levels of injury. The goal is to facilitate the right people being moved to the right place in the right order. I'm really not convinced a traditional triage tag does this very well. I suggest we re-name it more appropriately to "Tracking Tag." For patient tracking, they are great. You can document, scan, and send the tag with the patient to the destination. But for early sorting, they present a problem because you can’t see them very well. They are also painfully slow to affix.
A better idea is to use colored surveyor’s tape, or the AllMed RapTag. Both systems use rapidly affixed red, yellow, and green color codes to signify injury severity. Both are very fast and inexpensive. Both can be seen at some distance and in the case of the reflective RapTag (which I designed), you can see them up to 60 yards away at night. The idea is for the next team of litter bears to be able to see the one patient that needs them most.
Modern technologies are great, but they are no panacea. Without training, careful planning, and a financial commitment, you cannot expect to be fully prepared for a real disaster. It matters little if you have a great EMS system but only a two-day reserve supply of N-95 respirators. You need to have the capabilities and equipment staged in advance to meet any reasonably foreseeable disaster.
Once the basics of sorting, treating, and transporting are responsibly addressed, then you can move to incorporating high technology. Some of these new devices will very soon be commercially available. Several offer the hope to give EMS professionals new ways to be more efficient and effective at managing mass casualty events.