OMNIA – Improving health assessment & communication in mass-casualty incidents
- Improving Health Assessment & Communication in Mass-casualty Incidents -
First-responders are a crucial part of our society, typically including paramedics, police officers and firefighters. As the first ones to arrive and provide assistance at a scene of emergency, like an accident, natural disaster or a crime, their actions can decide over life and death of the affected. Especially in mass casualty scenarios, situations with larger victim counts, the collaboration between the first-responder groups is especially crucial.
In these situations the main objective is to identify the most critical patients and transport them to the hospital as soon as possible. Therefore, the prioritization, or "triaging", of patients on scene is very important.
Omnia is a new health assessment system, designed to speed up the patient prioritization process by utilizing modern non-contact vital sign measuring camera technology and making the assessment process, which is currently mainly done by the paramedics, more accessible for all first-responders.
The Omnia System consists of two parts. One is the so-called "companion", a device worn by the first-responder to measure vital signs, prioritize patients and document the process. While the second one is a reduced assessment tag that identifies the patient and links the collected data to the patient.
The advantage of this concept is that the sensing technology is shifted completely onto the companion device, allowing for a simple, analog identification tag, which makes it accessible and easy to use by any first-responder.
By gaining information at an early point, the system allows first-responder groups that are on their way to the incident, as well as the hospital, to prepare for patient treatment ahead of time.
OMNIA was a ten-week collaboration project between FLIR and Umeå Institute of Design, exploring relevant design opportunities for new product solutions for synchronized collaboration between first-responders at an emergency site.
RESEARCH:Training Scenarios & Station Visits
The topic was approached through a very human- and user-centered design process, starting out with a trip to a first-responder training facility on the Swedish island Sandö, where police, ambulance and firefighter students from different Swedish towns met in a joint two-day practice with real-life scenarios. Observing this was extremely helpful to get a feeling for their work and the responsibilities and challenges the different groups face while working together. Later-on we got a more detailed, first-hand impression of a larger casualty incident by taking part (as observers, as well as in the role of the affected people) in an annual mass casualty practice for professional first-responders in Umeå, Sweden.
The collaboration with the local first-responders, continued throughout the project, which was extremely helpful to clear questions during the research process, and validate ideas through user-testings and interviews.
Throughout the ideation phase, creative methods like acting out scenarios, user journey mappings and sketching scenarios helped understand complicated collaborative actions and the the stakeholders involved.
Mass Casualty Incidents & the Triage Process
It became clear that collaboration between first-responders is especially challenging in larger incidents, in which all blue-light groups have to work effectively together. In mass casualties, time is the most valuable resource when it comes to saving the lives of the affected. Hence, the time it takes until paramedics can treat a patient, can decide over life and death. Even though it is clear that, in such a situations, all three blue-light groups are very important, it seemed like improving the work, currently done by the paramedics, would have the most impact on the outcome of such an incident.
Therefore the initial aim of this project was to find new tools, strategies or solutions to help paramedics, in collaboration with the other first responders (especially the group that arrives first on site), find the most critical patients as fast as possible, keep track of their condition, communicate more efficiently and thereby bringing the focus back to the most important – the treatment of the affected people.
"The triage has to be done really fast, it would be great if I could just scan the patients". – Lars-Åke Löfqvist (Paramedic)
The Current Method
Currently the patient prioritization is done by a process called "triaging", whereby patients are given numbers and colors to identify their health status and priority for treatment, which is mainly defined by theyr vital signs. The used triage tool is a stack of paper cards in a protective coat, that is attached to the patient's hand with a rubber band.
To capture the patient data the card has to be taken out of the plastic sleeve and all the data is written manually onto the paper.
DELAYED FIRST ASSESSMENT
The first people on scene are not paramedics, but often firefighters or police, which often don't feel qualified to do a health assessment. This means that it takes longer until patients are correctly assessed.
"We are trained to do the triage, but rather wait for the paramedics to arrive." – James Cooper (Firefighter)
DIFFICULT ASSESSMENT UPDATE
A patient's status can change any time. Updating the priority on the card is time consuming.
INFORMATION IS NOT SHARED
The main problem is that the information is only captured on the tag and not shared with other first-responders, that are not yet on sight, and most importantly not with the hospital. There is a clear information gap between the time when the first alarm is sent to the hospital (preparing the hospital for potentially large amounts of patients) and when they receive specific patient information to prepare for treatment. This information is mainly delivered through the card and verbally delivered through the paramedic delivering the patient, who often struggles to describe the situation
WHY DO THEY USE IT?
While this method is not ideal, it has some advantages:
ANALOG | VISIBLE| ACESSIBLE
In high stress situations pen and paper are easy to understand. The clear color coding makes the tag visible and seen by anyone. Lastly, it is an affordable and easily accessible product.
1. Enable an earlier, more reliable assessment.
2. Close the information gap to the hospital.
3. Faster update of priority.
4. Keep positive analog aspects.
While searching for ways to make vital sign measuring faster and more accessible, I came across non-contact vital sign measuring technologies, which utilize visible light cameras, as well as, infrared cameras. Currently this is used e.g. in baby monitors, fever scanners at airports, or for distanced measuring in case of infectious diseases.
As mentioned, the OMNIA system shifts the data collection to a device worn by the first-responder, called the "companion". It is accompanied by a reduced assessment tag, which identifies the patient and creates a link to the collected data.
The companion utilizes a visible light camera to identify the patient's vital signs, like pulse and heart rate, and an infrared camera for the temperature measurements. It gives a clear indication of the suggested priority through its indication lights in the front and back of the object. This speeds up the assessment process and helps first-responders, e.g. that are not paramedics, feel more confident to assess patients at an early stage. When the paramedics arrive, they already have an overview of the rough priorities and can do a more detailed assessment, focusing more on interactive aspects like speech, cognition and motor functions, which are faster observed by a human.
The easy snap on connector allows the companion device to be effortlessly worn on the chest and quickly taken off to check the last vitals signs on the back-facing screen. Treatments and medical information can be recorded on the go, while the camera feature allows paramedics to immediately record injuries for the hospital in a secure way.
The tags are attached to the patient and the priority color can always be manually updated. While checking the patient, the camera recognized the tag code and the priority color and adds a time stamp and the paramedic ID to the system. This way it prevents time-consuming documentation processes and verbal misunderstandings when describing the incident to the hospital.