In this thesis an electronic triage tag with wireless interconnectivity is developed, implemented and tested. The tag submits triage information to the incident command center over a wireless mesh network which is built up by the tags themselves. Furthermore the tag is wirelessly interfaceable with vital value sensors to allow live monitoring of patients. The developed device works autonomously, without any user intervention and is attached to colored bracelets which are already used for triage. There is no need to change the triager’s work flow. The electronic triage tag is a time-efficient extension for existing triage tools to aid rescue forces in accelerated treatment and evacuation of victims.
Mass Casualty Incidents (MCI) overwhelm medical resources and require the treatment of a large amount of patients within a very short time. Triage is a process used in MCIs to assign scarce medical resources to victims so that as many as possible can survive. Currently, the triage process is carried out with the help of a Paper Based Patient Tag with a unique ID, signaling the victim’s treatment priority by its color (red, green, yellow or black). Paper-based triage strives for a fast and accurate treatment of victims, but it has problems with regard to the speed and accuracy of transmitting triage information. Live monitoring of victims’ vital values is not possible because of the paper-based process and the lack of medical personnel. An electronic approach promises a faster situation overview and, thus, faster treatment of victims. However, the introduction of new systems must be done in a sensible way, so that the triager’s process and workflow is not modified.
Contents
1. Introduction
1.1. Motivation
1.2. Scope
1.3. Outline
2. Background
2.1. Triage
2.1.1. The START Triage Method
2.1.2. Other Mass Casualty Triage Systems
2.1.3. Triage Tags
2.2. Issues With Current Triage Tags
2.3. Related Work
2.3.1. SOGRO MANV 500
2.3.2. AID-N
2.3.3. WIISARD
2.3.4. eTriage
2.3.5. More Related Projects
2.4. Analysis
3. Requirements for an Electronic Triage Tag
4. The eTriage Concept
5. Hardware Development
5.1. Selection of Communication Standard
5.2. The eTriage Tag
5.2.1. Selection of Soft- and Hardware Platform
5.2.2. Selection of Hardware Components
5.2.3. Communication Interfaces
5.2.4. PCB Design
5.2.5. Assembling the PCB
5.2.6. Case
5.2.7. Assembling the eTriage Tag
5.3. The eTriage Gateway
6. Software Development
6.1. Developing with Lightweight Mesh
6.1.1. Typical Application Structure
6.1.2. Basic Network Configuration
6.1.3. Data Transmission
6.1.4. Data Reception
6.1.5. Software Timer
6.2. The eTriage Tag Firmware
6.2.1. Application Task Handler
6.2.2. AD Conversion of Temperature Sensor Voltage
6.2.3. GPS Interface
6.2.4. Micro SD SPI Protocol
6.2.5. Address Initialization and Administration
6.2.6. Communication Protocol
6.2.7. Software Timer
6.2.8. LED Indicator
7. Testing
7.1. Hardware Functionality Test
7.1.1. Assembled Hardware Components
7.1.2. Operating Time
7.1.3. Range Test
7.2. Software Test
7.2.1. Module Test
7.2.2. System Test
8. Conclusion and Future Work
8.1. Conclusion
8.2. Future Work
A. Schematics and Layout
B. Software
B.1. AppMessage t Structure
B.2. Fuse Bit Settings
B.3. Introduction to Lightweight Mesh
B.4. Data Transmission Options and Status Codes
B.5. Data Reception Options and Status Codes
Objectives and Research Topics
The primary objective of this thesis is the development and prototype implementation of an electronic triage tag designed for use in Mass Casualty Incidents (MCI). The research focuses on creating a reliable, autonomous device that provides wireless interconnectivity to streamline patient data transmission, ultimately aiming to accelerate treatment and evacuation processes without modifying the existing workflow of rescue forces.
- Design of an electronic triage tag with wireless mesh network capability.
- Integration of GPS for victim tracking and temperature sensors for vital monitoring.
- Development of energy-efficient hardware and firmware using Atmel’s Lightweight Mesh.
- Implementation of data logging storage solutions on microSD cards.
- Validation of hardware and software performance through systematic bench and field testing.
Excerpt from the Book
1.1. Motivation
A Mass Casualty Incident (MCI) is any incident in which regularly available medical emergency resources are overwhelmed in terms of rescue personnel, transport vehicles and hospital capacity[59]. A large amount of patients spread out across a sizeable area needs to be treated within a very short time. Disasters like the 9/11 attack in September 2001 where 2.996 people were killed, the 2005 London bombings where 52 people were killed and over 700 severely injured, or natural disasters like the Haiti earthquake in 2010 which led to over 200.000 deaths are just a few examples. Incidents of lesser extent can also overwhelm rescue services of a particular region. Examples are the Oktoberfest attack in 1980 with 211 injured and 13 death, the train accident in Santiago de Compostela in 2013 where 97 people died or the incident at the Loveparade in Duisburg in 2010 causing 21 deaths and 541 injured. In general such situations are rather complex, putting high demands on rescue forces at the scene. In order to ensure a good coordination and speedy response, clearly structured processes and techniques have been developed over time. Triage is one of these techniques. It aims to assign scarce medical resources to victims so that as many as possible can survive. As there are many victims and not enough medics available in MCIs, an individual treatment can not be ensured in most cases. Instead, the order and priority of victim’s treatment and transport to a hospital is determined based on the severity of their injuries. The process of categorizing victims according to their need for medical attention, hence their chance for survival, is called triage.
At first contact during the triage, the condition of each victim is quickly assessed and he or she is assigned to one of four categories representing the urgency of treatment and transport. Currently, a Paper Based Patient Tag (PBPT) with a unique ID is attached to each victim signaling the assigned category by its color (red, green, yellow or black)[1]. After triage is finished for all victims, they are transported to a local medication center, where he or she will be further medically treated and registered by name before he or she will be transported to a hospital.
Summary of Chapters
1. Introduction: Discusses the motivation behind electronic triage systems in mass casualty incidents and defines the scope of this development work.
2. Background: Provides an overview of existing triage methods and technologies, analyzing problems with current paper-based systems and reviewing related research projects in the field.
3. Requirements for an Electronic Triage Tag: Derives the essential technical and functional specifications for the electronic device based on interviews with experts and previous project outcomes.
4. The eTriage Concept: Explains the architectural integration of the new tag within the overall communication system, including descriptions of the gateway and relay components.
5. Hardware Development: Details the selection of the communication standard, microcontroller, sensors, and the physical design and assembly of the PCB and protective case.
6. Software Development: Outlines the firmware development process using the Lightweight Mesh stack, covering task handlers, timers, communication protocols, and LED control logic.
7. Testing: Describes the testing procedures used to validate individual hardware/software modules as well as the integrated functionality of the eTriage system.
8. Conclusion and Future Work: Summarizes the achievements regarding the project requirements and provides recommendations for potential future enhancements.
Keywords
eTriage, Mass Casualty Incident, MCI, Triage, Wireless Mesh Network, ZigBee, Lightweight Mesh, Microcontroller, ATmega256RFR2, GPS, Data Logging, Rescue Forces, Electronic Triage Tag, Patient Monitoring, Firmware Development
Frequently Asked Questions
What is the core purpose of this work?
The work aims to develop an electronic triage tag that transmits victim information wirelessly to aid rescue forces, without altering the established triage workflow used in Mass Casualty Incidents.
What are the central themes of the research?
The research emphasizes optimizing hardware size and energy efficiency, implementing reliable mesh network communications, and maintaining intuitive, automated operation for emergency personnel.
What is the primary goal regarding existing systems?
The goal is to provide a supplement to existing paper-based triage tools that resolves issues like delayed reporting, unreadable information, and the inability to perform real-time monitoring of victim vital signs.
What technology is used for wireless communication?
The project employs the IEEE 802.15.4 standard and uses Atmel’s Lightweight Mesh (LWM) stack for robust, decentralized communication between tags and the incident command gateway.
How is the electronic tag powered and maintained?
The tag uses a rechargeable lithium polymer battery and features an integrated Qi-based wireless charging receiver to ensure that it remains dust- and spray-proof while avoiding complex cable connections.
Which keywords categorize this research?
Key areas include Triage, Mass Casualty Incident (MCI), Wireless Mesh Network, Electronic Triage Tag, Data Logging, and Firmware Development.
Why was the ATmega256RFR2 microcontroller chosen?
It was selected due to its integrated 2.4 GHz transceiver, low power consumption, familiarity with the AVR architecture, and compatibility with the Lightweight Mesh development platform.
How does the tag automatically detect the triage category?
The tag uses GPIO pins exposed on the PCB that are set to specific states when connected to colored bracelets, allowing the device to automatically detect the injury severity based on the attached bracelet type.
Why is a custom GPS parsing method used?
Because existing libraries were difficult to port to the specific microcontroller or consumed too many resources, a custom, optimized parser was developed to handle NMEA 0183 strings efficiently.
How are connectivity issues handled in the field?
The system is designed to form a mesh network that automatically bridges connectivity islands. If an isolated tag loses direct connection to the gateway, data is relayed via other tags or dedicated triage relays to ensure no information is lost.
- Arbeit zitieren
- Julian Quandt (Autor:in), 2015, An Electronic Triage Tag with Wireless Interconnectivity. Design and Implementation, München, GRIN Verlag, https://www.grin.com/document/1305586
