[[alternative]]Intervention Opportunities of Information Technology for Emergency Medical Service in a Disaster

[[abstract]]意外事件詩有所聞，其中突發性災難事件中，最令人擔憂的就是造成「大規模傷亡事件」(Mass casualty incidents, MCIs)，舉凡國內921地震，美國911事件，乃至於近日發生的四川地震皆屬之。本研究在國內外相關文獻探討基礎上，整合資訊技術及災難醫學領域，提出「緊急醫療救護」(EMS, Emergency medical service)在「大規模傷亡」情況下的作業程序與分析架構，並探討資訊技術介入的機會。本研究歸納「緊急醫療救護」程序，分四個階段，災難第一現場、現場檢傷站、後送運輸過程與後方醫療單位。在傷患救援資訊傳遞方面，採取實體資訊傳送與無線通訊綱路傳送的同步作業。結果提出兩項重要觀念，首先在檢傷站進行檢傷分類時，藉由個人資訊載體(Personal Information Carrier, PIC)取代傳統傷票記錄方式，隨著傷患到院前(pre-hospital)，能夠透過可攜式終端設備即時更新傷患生理資訊，進而記錄緊急救護介入過程之相關訊息；另一方面在檢傷站透過無線網路的訊息遞送機制達成「到院前的資訊傳遞」。結合這兩項觀念，能有效協助後方醫療單位於傷患送達前，參考傷患病況事先為送達後要進行之治療做準備，以省去不必要的重覆性介入或治療。研究結論亦提出「個人資訊載體介面型式」、「整合生理訊號擷取」與「訊息遞送機制」等三大資訊技術介入的機會，以提昇災難事件中「緊急醫療救護」的作業效率。[[abstract]]It's so many disaster events around the world, from which so-called mass casualty incidents (MCIs) are troublesome, for example, 911 in US, 921 in Taiwan, and recent earthquake in Sichuan, China. Based upon literature review, this paper proposes an emergency medical service (EMS) framework for mass-casualty scenarios. By integrating domains of information technology (IT) and disaster medicine, the framework offers an operation procedure for the scenarios, then highlights the intervention opportunities of IT on EMS. We conclude four EMS steps: they are the first scene, triage, evacuation, back-end hospitals. About information transferring of patients, both physical media and mobile wireless communications can be applied simultaneously. For the physical media transferring, using personal information carrier (PIC) instead of traditional medical tag is a new approach in triage step; the information kept in PIC can be monitored and updated constantly by portable devices in pre-hospital time interval. While up-to-date patients information can also be instantly transferred by mobile wireless communications to back-end hospitals for first time medical resource allocation. This paper also points out the opportunities of three IT, they are PIC interface format, integrated vital signs retrieve, and mechanism of information transferring, so that the IT enhance the efficiency of MES operations