scholarly journals Technical Support by Smart Glasses During a Mass Casualty Incident: A Randomized Controlled Simulation Trial on Technically Assisted Triage and Telemedical App Use in Disaster Medicine (Preprint)

2018 ◽  
Author(s):  
Andreas Follmann ◽  
Marian Ohligs ◽  
Nadine Hochhausen ◽  
Stefan K Beckers ◽  
Rolf Rossaint ◽  
...  
Keyword(s):  
Augmented Reality ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Disaster Medicine ◽  
Technical Support ◽  
Control Group ◽  
Smart Glasses ◽  
Android App ◽  
Triage Algorithm

BACKGROUND To treat many patients despite lacking personnel resources, triage is important in disaster medicine. Various triage algorithms help but often are used incorrectly or not at all. One potential problem-solving approach is to support triage with Smart Glasses. OBJECTIVE In this study, augmented reality was used to display a triage algorithm and telemedicine assistance was enabled to compare the duration and quality of triage with a conventional one. METHODS A specific Android app was designed for use with Smart Glasses, which added information in terms of augmented reality with two different methods—through the display of a triage algorithm in data glasses and a telemedical connection to a senior emergency physician realized by the integrated camera. A scenario was created (ie, randomized simulation study) in which 31 paramedics carried out a triage of 12 patients in 3 groups as follows: without technical support (control group), with a triage algorithm display, and with telemedical contact. RESULTS A total of 362 assessments were performed. The accuracy in the control group was only 58%, but the assessments were quicker (on average 16.6 seconds). In contrast, an accuracy of 92% (P=.04) was achieved when using technical support by displaying the triage algorithm. This triaging took an average of 37.0 seconds. The triage group wearing data glasses and being telemedically connected achieved 90% accuracy (P=.01) in 35.0 seconds. CONCLUSIONS Triage with data glasses required markedly more time. While only a tally was recorded in the control group, Smart Glasses led to digital capture of the triage results, which have many tactical advantages. We expect a high potential in the application of Smart Glasses in disaster scenarios when using telemedicine and augmented reality features to improve the quality of triage.

scholarly journals Augmented Reality for Guideline Presentation in Medicine: A Crossover Simulation Trial for Technically Assisted Decision-making (Preprint)

2019 ◽  
Author(s):  
Andreas Follmann ◽  
Alexander Ruhl ◽  
Michael Gösch ◽  
Marc Felzen ◽  
Rolf Rossaint ◽  
...  
Keyword(s):  
Augmented Reality ◽  
Mass Casualty Incident ◽  
Modern Medicine ◽  
Mass Casualty ◽  
Tablet Pc ◽  
Additional Time ◽  
Smart Glasses ◽  
Significant Difference ◽  
The Difference ◽  
Time Critical

BACKGROUND Guidelines provide instructions for diagnostics and therapy in modern medicine. Various mobile devices are used to represent the potential complex decision trees. An example of time-critical decisions is triage in case of a mass casualty incident. OBJECTIVE In this randomized controlled cross-over study, the potential of augmented reality for guideline presentation was evaluated and compared with a tablet PC as a conventional device. METHODS A specific Android app was designed for use with Smart Glasses as well as with a tablet PC for presentation of a triage algorithm as an example for a complex guideline. 40 volunteers simulated a triage based on 30 fictional patient descriptions each, with technical support from data glasses and a tablet PC in cross-over trial design. The time to come to a decision and the accuracy were recorded and compared between the different devices. RESULTS A total of 2400 assessments were performed. A significantly faster triage time has been achieved with the tablet PC (12.8 sec) compared to the smart glasses (17.5 sec; P = .001) in total. Considering the difference in triage duration between both devices, the additional time needed with the smart glasses could be reduced significantly in the course (P = .001). In accuracy of guideline decisions, there was no significant difference comparing both devices. CONCLUSIONS The presentation of a guideline on a tablet computer, as well as in the form of augmented reality, achieved good results. The implementation using smart glasses took more time due to a more complex operating concept but could be accelerated in the course of the study after adaptation. Especially in a non-time-critical working area where hands-free interfaces are meaningful, a guideline presentation with augmented reality can already be implemented.

scholarly journals Augmented Reality (AR) Technology-Based Learning: The Effect on Physics Learning during the COVID-19 Pandemic

2022 ◽  
Vol 12 (2) ◽  
pp. 132-140
Author(s):  
Doni Ropawandi ◽  
◽  
Lilia Halim ◽  
Hazrati Husnin
Keyword(s):  
Augmented Reality ◽  
Physics Education ◽  
Teaching And Learning ◽  
Control Group ◽  
Technology In Education ◽  
Learning And Teaching ◽  
Face To Face ◽  
Significant Difference ◽  
Experimental Group

The COVID-19 pandemic has significantly disrupted education and has instantaneously shifted education from being conducted predominately ‘face to face’ to being totally ‘online’. For most teachers, this unexpected teaching approach has impelled them into finding ways to provide the same quality of education to their students. One way of doing this is by adopting educational technologies in learning and teaching, including the use of augmented reality (AR) technology. AR technology has been integrated into the field of physics education. In this study, the effects of AR technology on understanding of the concepts of electricity in an online learning environment for 11th-grade students was investigated. Pretest and posttest were carried out in the control group and the experimental group. The results showed that AR technology improved understanding of electrical concepts for the students in the experimental group compared to the control group, with a very significant difference between both groups. This research contributes to the development of AR technology in education, especially in relation to the teaching and learning of abstract physics concepts.

scholarly journals The SALT and START Triage System for Classifying Patient Acuity Level: A Systematic Review

2021 ◽  
Vol 11 (3) ◽  
pp. 413-427
Author(s):  
Hendri Purwadi ◽  
Katrina Breaden ◽  
Christine McCloud ◽  
Satriya Pranata
Keyword(s):  
Systematic Review ◽  
Grey Literature ◽  
Mass Casualty ◽  
Patient Acuity ◽  
Triage System ◽  
Wide Range ◽  
Simulation Based ◽  
System 2 ◽  
Triage Algorithm

Background: Two common triage systems have been widely used in mass casualty incidents (MCIs) and disaster situations, namely START (simple triage algorithm and rapid treatment) and SALT (sort, assess, lifesaving, intervention, and treatment/transport). There is currently controversy regarding the effectiveness of SALT over the START triage system.Purpose: This systematic review aims to compare the accuracy of the SALT and START triage systems in disaster and MCI settings.Methods: The literature was searched using a systematic search strategy for articles published from 2009 to 2020 in the Medline, CINAHL, Web of Science, Scopus, PubMed, ProQuest databases, and the grey literature. This review included simulation-based and medical record-based studies investigating the accuracy and applicability of the SALT and START triage systems in adult and child populations during MCIs and disasters. All types of studies were included. The PRISMA flowchart was used to retain the articles, and the Joanna Briggs Institute critical appraisal tools were used to assess the quality of the reviewed studies.Results: Of 1,450 articles identified in the search, 10 articles were included. It was found that the START triage system had a wide range and inconsistent levels of accuracy (44% to 94.2%) compared to the SALT triage system (70% to 83%). The under-triage error of the START triage system ranged from 2.73% to 20%, which was slightly lower than the SALT triage system (7.6% to 23.3%). The over-triage error of the START triage system (2% to 53%) was slightly higher than the SALT triage system (2% to 22%). However, the time taken to apply START triage system (70 to 72.18 seconds) was faster than for the SALT triage system (78 seconds).Conclusion: The START triage system was simpler and faster than SALT. Conversely, the SALT triage system appeared to be slightly more accurate, more consistent, and had a lower rate of under- and over-triage error than START. It appears that neither the SALT nor the START triage system is superior to the other. Further research is needed to establish the most appropriate disaster and MCI triage system, especially for the Indonesian context. 

Accuracy, Efficiency, and Inappropriate Actions Using JumpSTART Triage in MCI Simulations

2015 ◽  
Vol 30 (5) ◽  
pp. 457-460 ◽  
Author(s):  
Ilene Claudius ◽  
Amy H. Kaji ◽  
Genevieve Santillanes ◽  
Mark X. Cicero ◽  
J. Joelle Donofrio ◽  
...  
Keyword(s):  
A Priori ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Simulated Patients ◽  
Publication Type ◽  
Computer Based ◽  
Time Required ◽  
Triage Algorithm ◽  
Mean Time ◽  
Level Performance

AbstractIntroductionUsing the pediatric version of the Simple Triage and Rapid Treatment (JumpSTART) algorithm for the triage of pediatric patients in a mass-casualty incident (MCI) requires assessing the results of each step and determining whether to move to the next appropriate action. Inappropriate application can lead to performance of unnecessary actions or failure to perform necessary actions.Hypothesis/ProblemTo report overall accuracy and time required for triage, and to assess if the performance of unnecessary steps, or failure to perform required steps, in the triage algorithm was associated with inaccuracy of triage designation or increased time to reach a triage decision.MethodsMedical students participated in an MCI drill in which they triaged both live actors portraying patients and computer-based simulated patients to the four triage levels: minor, delayed, immediate, and expectant. Their performance was timed and compared to intended triage designations and a priori determined critical actions.ResultsThirty-three students completed 363 scenarios. The overall accuracy was 85.7% and overall mean time to assign a triage designation was 70.4 seconds, with decreasing times as triage acuity level decreased. In over one-half of cases, the student omitted at least one action and/or performed at least one action that was not required. Each unnecessary action increased time to triage by a mean of 8.4 seconds and each omitted action increased time to triage by a mean of 5.5 seconds.DiscussionIncreasing triage level, performance of inappropriate actions, and omission of recommended actions were all associated with increasing time to perform triage.ClaudiusI, KajiAH, SantillanesG, CiceroMX, DonofrioJJ, Gausche-HillM, SrinivasanS, ChangTP. Accuracy, efficiency, and inappropriate actions using JumpSTART triage in MCI simulations. Prehosp Disaster Med. 2015;30(5):457–460.

scholarly journals Hospital Disaster Preparedness in Switzerland Over a Decade: A National Survey

2018 ◽  
Vol 13 (03) ◽  
pp. 433-439
Author(s):  
Simone Dell’Era ◽  
Olivier Hugli ◽  
Fabrice Dami
Keyword(s):  
Public Health ◽  
Health Care ◽  
Disaster Preparedness ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Disaster Medicine ◽  
Disaster Plan ◽  
Root Cause ◽  
Swiss Health ◽  
Hospital Disaster Preparedness

ABSTRACTObjectiveThe present study aimed to provide a comprehensive assessment of Swiss hospital disaster preparedness in 2016 compared with the 2006 data.MethodsA questionnaire was addressed in 2016 to all heads responsible for Swiss emergency departments (EDs).ResultsOf the 107 hospitals included, 83 (78%) returned the survey. Overall, 76 (92%) hospitals had a plan in case of a mass casualty incident, and 76 (93%) in case of an accident within the hospital itself. There was a lack in preparedness for specific situations: less than a third of hospitals had a specific plan for nuclear/radiological, biological, chemical, and burns (NRBC+B) patients: nuclear/radiological (14; 18%), biological (25; 31%), chemical (27; 34%), and burns (15; 49%), and 48 (61%) of EDs had a decontamination area. Less than a quarter of hospitals had specific plans for the most vulnerable populations during disasters, such as seniors (12; 15%) and children (19; 24%).ConclusionsThe rate of hospitals with a disaster plan has increased since 2006, reaching a level of 92%. The Swiss health care system remains vulnerable to specific threats like NRBC. The lack of national legislation and funds aimed at fostering hospitals’ preparedness to disasters may be the root cause to explain the vulnerability of Swiss hospitals regarding disaster medicine. (Disaster Med Public Health Preparedness. 2019;13:433-439)

scholarly journals Use of the step-up action research model to improve trauma-related nursing educational practice

Curationis ◽  
2015 ◽  
Vol 38 (2) ◽  
Author(s):  
Ielse Seale ◽  
Johanna C. De Villiers
Keyword(s):  
Action Research ◽  
Nursing Students ◽  
Real Life ◽  
Educational Practice ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Research Model ◽  
Research Activity ◽  
Emergency Training

Background: A lack of authentic learning opportunities influence the quality of emergency training of nursing students. The purpose of this article is to describe how the step-up action research model was used to improve the quality of trauma-related educational practice of undergraduate nursing students.Objectives: To reduce deaths caused by trauma, healthcare workers should be competent to provide emergency care and collaborate effectively with one another.Method: A simulated mass casualty incident, structured to support the integration of theory into practice, became a more rigorous action research activity which focused on the quality improvement of the mass casualty incident.Results: The results indicated improved student learning; partnership appreciation; improved student coping mechanisms, and increased student exposure. Quality emergency training thus results in better real-life collaboration in emergency contexts.Conclusion: The step-up action research model proved to be a collaborative and flexible process. To improve the quality and rigour of educational programmes it is therefore recommended that the step-up action research model be routinely used in the execution of educational practices.

scholarly journals Is there a triage sieve knowledge and application gap between clinical team leaders and their team members?

2019 ◽  
Vol 16 ◽  
Author(s):  
Glen Cuttance ◽  
Kathryn Dansie ◽  
Timothy Rayner
Keyword(s):  
Intervention Group ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Control Group ◽  
Theoretical Knowledge ◽  
Clinical Team ◽  
Team Leaders ◽  
Team Members ◽  
Significant Difference ◽  
Accuracy Rates

IntroductionAmbulance service team leaders may be required to provide organisational leadership at complex incidents, such as a mass-casualty incident involving triage sieve. It may be expected that team leaders have a greater understanding of, and should be able to better apply their skills, than their team members during such an incident. The objective of this study was to determine if team leaders have a higher theoretical knowledge and better triage sieve application skills than their team members.MethodsTeam leaders were allotted into one of two groups: the first (control) group completed a questionnaire without any supporting documentation (ie. aide-memoir), whereas the second (intervention) group completed the same questionnaire, as the control group, but utilising supportive documentation.ResultsThe results show that the team leaders from the control group achieved significantly better results than their team members when completing a questionnaire, without the use of supportive documentation. There was no significant difference between team leaders from the intervention group and their team members when completing the same questionnaire using supportive documentation.ConclusionIt has been shown that the use of printed supportive material in the form of an aide-memoir decreases the knowledge and application gap between team leaders and their team members, and increases triage sieve accuracy. The results from this study reinforces the results from previous studies, showing that supporting documentation should be used to ensure greater triage sieve accuracy rates and thereby reducing under- and over-triage rates.

Difference in First Aid Activity During Mass Casualty Training Based on Having Taken an Educational Course

2017 ◽  
Vol 12 (4) ◽  
pp. 437-440
Author(s):  
Youichi Yanagawa ◽  
Kazuhiko Omori ◽  
Kouhei Ishikawa ◽  
Ikuto Takeuchi ◽  
Kei Jitsuiki ◽  
...  
Keyword(s):  
Life Support ◽  
Initial Period ◽  
Fire Department ◽  
First Aid ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
Disaster Medicine ◽  
Ambulance Service ◽  
Medical Practitioners ◽  
The Difference

ABSTRACTBackgroundThe Japanese Association for Disaster Medicine developed a mass casualty life support (MCLS) course to improve cooperation among medical practitioners during a disaster, which is essential for reducing the rates of preventable disaster death. We investigated whether there was difference in first aid activity among members of the ambulance service during mass casualty training based on having taken the MCLS course.MethodsMass casualty training was held at the fire department of Numazu City. Twenty-one ambulance service parties participated in this training. They first evaluated the mass casualty situation, performed the appropriate services at the scene during the initial period, and then provided START triage for mock wounded patients. Throughout the training, 5 examiners evaluated their performance.ResultsRegarding the difference in first aid activity based on MCLS course attendance among the ambulance service members, the cooperative management (scored on a scale of 1 to 5) among the members who had taken the MCLS course was significantly better than that among those who had not taken the course (median [interquartile range]: 5 [0.5] vs. 4 [1.75], P<0.05).ConclusionAttending an MCLS course may help to improve outcomes in the face of an actual mass casualty incident. (Disaster Med Public Health Preparedness. 2018;12:437–440)

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