Smoke, sirens, people randomly racing, desperate cries for help, rescue workers pushed to their limits – catastrophes such as London’s and Madrid’s terrorist bomb attacks, or major incidents such as the Kaprun cable car accident that killed 155 people – in most of these chaotic situations the same elements confront rescuers: they must not only control psychological pressures but also coordinate all who are suddenly involved. In addition, victim identification and tracking, transportation and the checking of hospital capacities must be undertaken against enormous time limitations. In the first hour, help given to traumatised patients governs life or death outcomes.
Up to now, due to a lack of electronic communication at disaster sites, interaction within a rescue chain is slow and therefore engenders critical delays. Non-documentation of the transfer of victims to hospitals also can lead to overload in some hospitals. Additionally, neither police nor victims’ relatives can obtain information quickly.
This dire situation is set to change. As a result of a joint project by Cisco, Orion Health and Von Bergh Global Medical Consulting, a Victim Tracking and Tracing System (VITTS) is being simultaneously introduced and tested in Germany, Belgium and the Netherlands.
During a large-scale simulation in Landstuhl, Germany, the system was demonstrated by Dr Martin von Bergh and Dr Thomas Luiz, who is medical head of the Rescue Services for Kaiserslautern’s local government.
In essence, the VITTS consists of a Mobile Access Router that feeds data from rescue workers using hand-held PDAs, via GPRS, digital radio or directly via satellite into a central database. The data includes a victim’s name, digital photograph, medical data, an identification number, and a treatment priority status, assigned to the victim as a barcode.
Parallel with the input into the hand-held PDA, the victim is equipped with a barcode and an electronic direction-finding transmitter. If continually worn, e.g. as a neckband, this transmitter will automatically indicate the victim’s location at any time. Each transportation of a victim is transmitted via GPS and GPRS to monitors in main control centres, hospitals and police. Is the injured person still at the accident site or en route to hospital? Which hospital? What is its capacity? What is the patient’s profile? These questions are answered and analysed in real-time, with a map showing the victim’s location. This victim tracking enables better coordination and use of rescue resources; prompt information for relatives and patient data for hospitals to prepare for a victim before the ambulance arrives.
The system also allows simultaneous monitoring of several different disaster sites at the same time – an important advantage if considering recent events in London where the simultaneous occurrence of terrorist attacks could not be monitored and co-ordinated in control rooms, so that it was not possible to make a reliable assessment of where rescue teams were needed and where they could be withdrawn.
Presently, much of the input is manual; hospital profiles must be entered in advance because active input by the hospitals is not yet possible, but this is being worked on. The companies are also working on a standardisation of the system across Europe, so that victim tracking and tracing can occur across borders. Plans are afoot to further develop the user module (which currently has to be fixed in a vehicle) with the aim of achieving mobile use within Europe.
Although we might hope there will be no occasions when this clever system will be needed, the reality is that in future years it will provide many advances in medical care at disaster sites. And because of this the number of people surviving disasters will increase.
This project’s success results from the collaboration of companies who have focused their specialist expertise on the various elements of communications needed to enhance disaster control. The soft/hardware company Cisco Systems provides the technical basis for victim tracking and tracing with its Router Cisco 3200 Series Wireless and Mobile Routers. Based in Australia, Orion Health creates workflow and integration solutions for medicine supplies, a software platform for the collection, processing and imaging of data, as well as solutions for hospitals, the police and control centres. Von Bergh Global Medical Consulting supplies the individual direction-finding transmitters needed for wireless transmission of data via GPS and GPRS systems, which monitor the location of victims.