Managing patients in the middle of a mass-casualty incident can feel like playing the game of telephone. Essential information is often passed from person to person, misheard, misunderstood, changed, lost, or even forgotten in the chaos.
Ideally, patient communication involves one continuous line of accurate, real-time information on each patient, flowing between EMS, hospital teams, public safety, public health, and emergency management personnel. A dedicated patient “channel” streamlines and improves care for routine cases and MCIs.
This is becoming a reality in several states. They’re implementing statewide patient wristband systems and pairing them with Pulsara, a health care communication and logistics platform, to simplify interoperability. Using Pulsara, responders scan patient wristbands to securely, quickly, and conveniently identify the injured, track what’s been done for whom, and provide the next caregiver a complete picture of the patient’s status – uniting all care teams and coordinators around each patient case in real time.
When William Rice, MBA, MLS, LP, market director of EMS and Air Med 12 at St. Joseph Health in Bryan, Texas, first implemented an effort to pair wristbands with Pulsara, he was met with skepticism.
“In the early days of the wristbands, I regularly had to remind folks in the region that they unanimously voted to support this project. People didn’t understand where the wristbands were going or how it would be helpful,” Rice said. “Once we added Pulsara, the value of the wristbands immediately sold itself because anybody who walks up to that wristband and scans it with Pulsara is now part of that patient care record.”
Pulsara lets first responders create a dedicated communication channel for each patient by scanning the barcode on the patient’s wristband. From there, the first on-scene uploads critical information and then, if appropriate, hands off the case to the transport team or caregivers. Other providers join the channel by scanning the patient’s wristband, enabling them to see previously entered information. Subsequent channels for patients later discovered to be connected to the incident – for instance, those who left the scene and self-transported to a hospital – can be started. As soon as patients are scanned, Incident Command has an immediate view of all patients from that event.
The functionality isn’t limited to within the four walls of the hospital, a county, or a region. “This goes beyond state lines,” said Corey Ricketson, senior vice president of strategic accounts at Pulsara. “Anyone on Pulsara can scan the wristbands. So if there’s a tornado in Texas and patients leave or are evacuated to other states, the receiving provider can scan the wristband and instantly view critical patient information.”
When everyone can see the same big-picture view, accurate information flows efficiently, no matter how many people are involved. Wristband IDs scanned into Pulsara provide everyone on the care team with instant knowledge of how many patients are tied to the event, how critical they are, where they ended up, and how they got there. The technology is secure, interoperable, and HIPAA-compliant.
COORDINATING MCIs WITH A BETTER COMMUNICATION SYSTEM
Our communication methods in our everyday lives are built for maximum efficiency. When we want to coordinate an event with friends, we use a group chat so everyone can participate and see what’s being said. Based on the same concept, Pulsara safely and quickly provides access to the right information, allowing those involved in the case to add details. This keeps everyone informed on new developments and background with the patient and enables them to treat the patient more appropriately.
Using the same tool every day creates muscle memory and forges competency for when larger events occur. Pulsara scales easily. For example, if there’s a car accident and someone is critically injured in a rural area, the first responder can place a wristband on the patient, scan it, and enter their basic information such as vital signs, photos, etc. Then the transporting EMS crew arrives and determines the patient needs to go to a trauma center 100 miles away. They quickly scan the same wristband, as does the trauma center team. As a result, everyone has visibility to the case; including the first responder and the transport agency’s images and assessment at the accident scene. These earlier providers can stay on the channel should there be questions.
“Everyone – from first responders to the surgery team – is all part of the health care continuum. Pulsara enables real-time, flexible interactions across organizations,” Ricketson said. “The chat goes across the spectrum, but the local region chooses who is included and how they communicate.”
Ricketson added that the concept was boosted during COVID-19, as some patients were transported many miles for definitive care: “We realized during the pandemic that we not only needed to leverage our neighbors, but also our neighbors’ neighbors, and our neighbors’ neighbors’ neighbors.”
FROM FLOODS TO FESTIVALS
Rice responded to Hurricane Katrina in 2005, and he is confident a system using wristbands could have saved lives and saved much heartache, time, and trouble if it had been available then.
“We didn’t know where everyone was, and it was difficult to know who needed what help, what facilities had available beds, and so on. The wristbands reduce the chaos and increase transparency and people’s confidence to make decisions,” he said.
Rice’s first use of Pulsara involved evacuating nursing home residents, and the system made triage and tracking much more efficient. It also reduced anxiety on the part of family members and staff, who could instantly find out where everyone was and what condition they were in.
“The wristbands are an excellent solution for those types of evacuations,” Ricketson said. “If there aren’t enough beds or a location to transfer patients, they can be placed in a virtual placement center where someone from across the state or even four states away can accept that patient.”
By using the wristbands with Pulsara, Rice noted, “You get complete situational awareness in real time that you wouldn’t get otherwise. This makes it easier for people to make operational decisions with all this information. There is no guesswork.”
St. Joseph Health EMS recently managed the Texas Renaissance Festival, an eight-weekend event with over 40,000 attendees per day – with only two weeks to prepare. Rice and his team used Pulsara and Texas’s statewide wristband system to track patients. “We saw 150 patients a day, and everyone got a wristband,” said Rice. After scanning the wristband in Pulsara, St. Joseph Health EMS staff could triage and track each person and use a color-coding system to identify those who refused treatment, those who were treated and released, and those who needed ambulance transfers.
“The dispatcher received all the information, so it was easy to coordinate transport, etc.,” said Rice. “Any clinician who scanned a wristband gained immediate access to the needed information.” At the same time, Rice stressed that nothing under the system is downloaded or stored on personal devices, so all patient information is secure and protected.
Rice’s team saw 200 patients in a few hours during one concert. “Thanks to the wristbands and Pulsara, I could tell you the status of each patient – age, gender, location,” he said. “If a concerned attendee was looking for a loved one, we could search by name or photo and locate them in seconds.
“We conducted a drill with five different agencies involved,” Rice continued. “We moved information on 112 patients to ER personnel for triage in under 20 minutes. It was unbelievable.”
A 360-DEGREE VIEW ACROSS JURISDICTIONAL LINES
“Health care is more interstate than ever,” said Ricketson, noting that the Pulsara technology makes it easy to track patients no matter where they ultimately are transported during a large-scale event. “We can communicate across regions we don’t normally communicate with, and the wristbands give interoperability to anyone with the Pulsara platform.”
With no more static lines and no more missed communication, the days of playing the telephone game when seconds matter are over.
For more information, visit Pulsara.
