This chapter proposes a triage system using radio-frequency identification (RFID) and wireless systems that can be used to manage disaster situations. Triage is a procedure used by emergency personnel to manage limited medical resources to benefit a large number of injured people using triage tags. The proposed system of using RFID triage tags and wireless sensors has many advantages. Effectiveness of the proposed system is evaluated through an assumed situation/experiment involving a complex car crash of five cars and more than eighty injured people. The comparative results show significant improvement. The system can be applied to other disaster situations such as earthquakes, storms, or floods.

/pdf/triage-with-rfid-tags-for-massive-incidents-37bedvk5ps.pdf

Triage with RFID Tags for Massive Incidents

Report to the National Co-ordinating Centre for NHS Service Delivery and Organisation R & D (NCCSDO)

Reducing the waits in emergency departments is important for patients
and is a government priority. In order to reduce waits the whole
system must be considered. The flow of patients before arrival at the
emergency department determines the workload of the department.
The staffing, resources and systems within the emergency department
are key to providing high quality timely care. The flow of patients after
leaving the emergency department until their return home will
determine whether they can be discharged from the department in a
timely manner. Despite the present focus on emergency care in the
NHS there have been no reviews of the literature to inform the present
changes to reduce waits.

Reducing attendances and waits in emergency departments : a systematic review of present innovations

Die Ersteinschatzung eines Patienten, der die Notaufnahme einer Klinik aufsucht, ist von zentraler Bedeutung. Sie legt die Dringlichkeit, mit der ein Patient arztlich gesehen werden muss, sowie die anschliesenden Prozeduren und damit auch den Ressourcenverbrauch fest. Obwohl es sich bei Notaufnahmen um Hochrisikobereiche handelt, ist der Ersteinschatzungsprozess in vielen deutschen Kliniken wenig standardisiert. Durch Einsatz klinischer Triagesysteme, wie der Manchester Triage Scale, wird ein standardisierter Prozess vorgegeben, der vor allem bei vermehrtem Patientenaufkommen kritisch Kranke zielsicher und schnell identifizieren sowie in einem vorgegebenen Zeitrahmen einer Behandlung zufuhren soll. Die Datenlage, besonders hinsichtlich Zuverlassigkeit und Validitat, ist begrenzt und heterogen, wird aber zunehmend besser und stutzt damit die weitere Etablierung solcher Systeme als Instrumente des Risikomanagements auch in Deutschland. In den Studien wird aber auch evident, dass der zentrale Baustein eines gut funktionierenden Triagesystems das qualifizierte und klinisch erfahrene Personal einer Notaufnahme bleibt, ohne welches eine zuverlassige Ersteinschatzung nicht moglich ist.

Triage in zentralen Notaufnahmen

In this paper, a triage system using RFID and its experiment are described. Triage is a procedure used by emergency personnel to ration limited medical resources to massive injured people, in which triage tags, are used to 1: classify and transport the injured effectively, and 2: obtain and publish the state and the scale of the casualty incident. We applied RFID tags and mobile devices with a wireless network to speed up and increase the accuracy of these applications, verified through an experiment assuming massive injured people, and demonstrated that it even accelerates the transportation of the injured people.

Triage with RFID Tags

Objectives—Developments in triage have led to patients being directed to triage rather than reception upon arrival in A&E. This study aimed to discover if attending triage or reception first, was preferable in terms of timeliness, clarity and safety. 

Methods—The study compared two consecutive four week periods during which patients were directed to attend triage first and then reception first. Observers recorded their actions on arrival. Questionnaires recorded the patients' perceptions of each strategy. High priority triage categories were audited during the reception first phase. 

Results—1850 patients were observed in the triage first phase with a mean door to triage time of 10.6 minutes, triage to reception 5.3 minutes and door to reception 15.8 minutes. A total of 1522 patients were observed in the reception first phase with a mean door to reception time of 0.5 minutes, reception to triage 12.4 minutes and door to triage of 12.9 minutes. Patients were more likely to present to the appropriate place during the reception first phase (88% versus 34%) and reported better understanding of instructions. No case given triage category one or two suffered an adverse outcome resulting from delay associated with attending reception first. 

Conclusion—Directing patients to attend reception first is timely and less confusing. It is safe provided booking in does not delay assessment by more than 15 minutes.

https://emj.bmj.com/content/emermed/18/6/441.full.pdf

Should ambulant patients be directed to reception or triage first

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Should ambulant patients be directed to reception or triage first