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September 13, 2006

APL-Developed Disaster Aid Network Showcased in Mass Casualty Exercise

During a mass casualty disaster, emergency medical personnel often become overwhelmed with the large number of patients they have to track. A small team from APL's National Security Technology Department's Systems Concepts and Analysis Group has developed and recently demonstrated new technologies that would automate patient monitoring and tracking during emergency situations, enhancing the ability of medical personnel to effectively care for large numbers of patients concurrently.

Through a $3 million grant awarded by the U.S. National Library of Medicine, the team developed the Advanced Health and Disaster Aid Network (AID-N)—a network of electronic devices automating the initial triage (patient counting and sorting) process used to monitor and track patients, and display vital information to users in remote facilities, such as hospitals or incoming ambulances.

First responders have for years performed those critical tasks with paper triage tags, clipboards of notes, and voice communications using phones and hand-held radios. That workflow has proven labor intensive, time consuming, and prone to human error. AID-N, the only technology of its kind that automates the entire tracking process for providers, vehicles, and patients, greatly improves the process of reassessing patients.

Algorithms developed by the team enable the devices to continually monitor a patient's vitals and alert a responder when immediate attention is required. Using a digital-assistant-like device, with its embedded camera and Blue-tooth scanner, responders can quickly record a patient's identification information (often by simply scanning the barcode on a driver's license), triage details, treatments, photographs and locations, and view real-time sensor readings.

Using sensors that communicate via a wireless industry standard known as Zigbee, the electronic tags transmit data to GPS-equipped laptops installed inside ambulances, at care facilities, and at designated areas of a disaster site. Through this network of devices, a patient can be tracked to a particular area of a disaster scene (such as treatment or decontamination areas), an ambulance while being transported, or an admitting care facility.

Technology Demonstration

The project recently culminated in a mock disaster exercise held at Blair High School in Silver Spring, MD, in collaboration with the Montgomery County Emergency Medical Services (EMS) group and Bethesda-based Suburban Hospital. The scenario—a large school bus accident at a high school—was developed by APL.

Two teams of responders — one using the current paper-based triage method, the other using the electronic devices—tracked the "patients". One incident commander manually tallied the number of patients from each team, alerting the hospital to the number being transferred. The hospital and ambulances, both outfitted with the team's monitoring equipment could track patients' location and medical status via a web site.

The AID-N technology demonstrated its value during the recent drill when the incident commander miscounted the number of patients being transported. But the hospital—monitoring actual data on the website—realized fewer patients were incoming, enabling them to provide adequate care without over-allocating hospital resources.

A Joint Effort

APL led a national team of researchers including Harvard University, which developed the software mesh networking capabilities that run the triage tags; the University of Maryland, which developed software for the devices; and the University of Virginia, which designed the tag hardware. Suburban Hospital; JHU Medical Center and EMS groups from Baltimore, Montgomery, and Arlington (VA) counties helped define user requirements and review prototypes, in addition to providing personnel and ambulances for the drill.

APL's team is now preparing a report to be published by the National Library of Medicine and seeking funding to support further technology development, such as modifying the sensors to detect hazardous chemical or biological agents.