Method and system of mass and multiple casualty triage

• US 20040078223A1
• Filed: 03/11/2003
• Published: 04/22/2004
• Est. Priority Date: 03/22/2002
• Status: Active Grant

• Current Assignee: Thinksharp Incorporated
• Original Assignee: Thinksharp Incorporated
• Inventors: Sacco, William J., Navin, D. Michael
• Granted Patent: US 7,761,309 B2
• Time in Patent Office: Days
• US Class Current: 705/2
• CPC Class Codes: G06Q 10/06 Resources, workflows, human or project management; Enterprise or organisation planning; Enterprise or organisation modelling
• CPC Class Codes: G06Q 40/08 Insurance
• CPC Class Codes: G16H 20/70 relating to mental therapies, e.g. psychological therapy or autogenous training
• CPC Class Codes: G16H 40/20 for the management or administration of healthcare resources or facilities, e.g. managing hospital staff or surgery rooms
• CPC Class Codes: G16H 50/30 for calculating health indices; for individual health risk assessment
• CPC Class Codes: G16H 50/50 for simulation or modelling of medical disorders
• CPC Class Codes: G16H 50/70 for mining of medical data, e.g. analysing previous cases of other patients
• CPC Class Codes: G16H 70/20 relating to practices or guidelines

Abstract

The present invention is a method and system of triage that assesses a severity score for each casualty, and determines a treatment prioritization plan to maximize the number of survivors. The present invention includes a score-based mathematical algorithm for resource-constrained triage, where an optimal number of survivors is determined through a methodology that can be mathematically modeled and solved, a methodology that considers victim survival probabilities, victim deterioration rates, and resource availability. First, each casualty is assessed and an RPM severity score is assigned based upon a sum of coded values for respiratory rate, pulse rate, and best motor response. Next, treatment priorities are determined from analytical or mathematical techniques, such as dynamic or linear programming, in consideration of survival probabilities associated with each RPM score, and deterioration-with-time rates for each RPM score for victims awaiting transport and treatment and the availability and timing of transport and treatment services.

Claims

1. A method of triage, comprising the steps of:

establishing a casualty severity score for each of a plurality of victims; and

determining an order of treatment for each of the plurality of victims through consideration of the casualty severity score and resource availability.

2. The method of claim 1, wherein the casualty severity score includes a sum of coded values, where a coded value is assigned for each of a victim'"'"'s respiratory rate, pulse rate, and best motor response.

3. The method of claim 2, wherein best motor response is a measure of neurological status.

4. The method of claim 1, wherein establishing the casualty severity score includes:

categorizing each of the plurality of victims into one of four categories, wherein the four categories are Ambulatory, Immediate, Expectant, and Delayed, as employed in a triage method known as START;

assessing, for each of the plurality of victims categorized in the Immediate and Delayed categories of START, respiratory, perfusion, and mental status in relation to a physiologic or anatomic region of the body incurring injury;

determining and assigning a survival probability rate for each of the plurality of victims categorized in the Immediate and Delayed categories, wherein the survival probability rate represents the casualty severity score.

5. The method of claim 4, wherein determining the survival probability rate considers the respiratory, perfusion, and mental status assessments in relation to the physiologic or anatomic region of the body incurring injury.

6. The method of claim 1, wherein determining an order of treatment employs a score-based mathematical algorithm for resource-constrained triage.

7. The method of claim 1, wherein determining an order of treatment for each of the plurality of victims involves analytical or mathematical programming techniques.

8. The method of claim 7, wherein the analytical or mathematical programming techniques consider a type of trauma experienced by each victim, a classification of each victim, and/or a type of care center appropriate for and available to each victim, to optimize the order of treatment determined.

9. The method of claim 7, wherein the analytical or mathematical programming techniques use a data-based estimate of casualty survival probability with each casualty severity score.

10. The method of claim 9, wherein the casualty survival probability is determined through consideration of factors selected from the group consisting of an availability of state-of-the-art, or lesser levels of, treatment;

a cause of a casualty incident;

a type of anatomic injury incurred by the victim;

an age of the victim;

treatment available at the incident scene;

treatment available at other facilities;

distances to the other facilities; and

, facilities or equipment available for performance of casualty management.

11. The method of claim 7, wherein the analytical or mathematical programming techniques include victim deterioration-with-time rates for each casualty severity score based upon an amount of time a victim awaits treatment.

12. The method of claim 11, wherein the victim deterioration-with-time rates are determined through consideration of factors selected from the group consisting of an availability of state-of-the-art, or lesser levels of, treatment;

a cause of a casualty incident;

a type of anatomic injury incurred by the victim;

an age of the victim;

treatment available at the incident scene;

treatment available at other facilities;

distances to the other facilities; and

, facilities or equipment available for performance of casualty management.

13. The method of claim 1, wherein determining an order of treatment for each of the plurality of victims involves a dynamic programming formulation.

14. The method of claim 13, wherein the dynamic programming formulation determines a subset of the plurality of victims to triage for treatment during each of a plurality of time periods to maximize a total number of survivors over all time periods.

15. The method of claim 1, wherein determining an order of treatment for each of the plurality of victims involves a linear programming formulation.

16. The method of claim 15, wherein the linear programming formulation determines a subset of the plurality of victims to triage for treatment during each of a plurality of time periods, and identifies a severity score to associate with each of the victims in the subset, to maximize a total number of survivors over all time periods.

17. Reference materials directed to training a method of triage to first responders, the method comprising the steps of:

establishing a casualty severity score for each of a plurality of victims; and

determining an order of treatment for each of the plurality of victims through consideration of the casualty severity score and resource availability.

18. An instructional program directed to training a method of triage to first responders, the method comprising the steps of:

establishing a casualty severity score for each of a plurality of victims; and

determining an order of treatment for each of the plurality of victims through consideration of the casualty severity score and resource availability.

19. The instructional program of claim 18, wherein the program includes case studies presenting the first responders with trauma scenarios and injury data, requiring the first responders to determine the order of treatment, and providing the first responders with a likely survivability result based upon their determined order of treatment.

20. The instructional program of claim 19, wherein hints, leading questions, or additional information is provided to the first responders subsequent to their determination of the order of treatment to improve the likely survivability result.

21. A triage method comprising the steps of:

establishing a casualty severity score for each of a plurality of casualties; and

determining an order of treatment for each of the plurality of casualties through consideration of resource availability, the casualty severity scores, and one or more factors selected from the group consisting of casualty severity score deterioration rates resulting from time periods of treatment delay, a type of trauma experienced by each casualty, a classification of each casualty, and a type of care center appropriate for and available to each casualty.

22. The method of claim 21, wherein the casualty severity score includes a sum of coded values, where a coded value is assigned for each of a victim'"'"'s respiratory rate, pulse rate, and best motor response.

23. The method of claim 21, further comprising the step of calculating a number of expected survivors of a casualty incident.

24. Reference materials directed to training a method of triage to first responders, the method comprising the steps of:

establishing a casualty severity score for each of a plurality of casualties; and

determining an order of treatment for each of the plurality of casualties through consideration of resource availability, the casualty severity scores, and one or more factors selected from the group consisting of casualty severity score deterioration rates resulting from time periods of treatment delay, a type of trauma experienced by each casualty, a classification of each casualty, and a type of care center appropriate for and available to each casualty.

25. An instructional program directed to training a method of triage to first responders, the method comprising the steps of:

establishing a casualty severity score for each of a plurality of casualties; and

determining an order of treatment for each of the plurality of casualties through consideration of resource availability, the casualty severity scores, and one or more factors selected from the group consisting of casualty severity score deterioration rates resulting from time periods of treatment delay, a type of trauma experienced by each casualty, a classification of each casualty, and a type of care center appropriate for and available to each casualty.

26. The instructional program of claim 25, wherein the program includes case studies presenting the first responders with trauma scenarios and injury data, requiring the first responders to determine the order of treatment, and providing the first responders with a likely survivability result based upon their determined order of treatment.

27. The instructional program of claim 26, wherein hints, leading questions, or additional information is provided to the first responders subsequent to their determination of the order of treatment to improve the likely survivability result.

28. A multiple and mass triage method comprising the steps of:

assessing a respiratory rate, pulse rate, and best motor response for each of a plurality of casualties and assigning a coded value for each based on the assessment;

establishing a severity score for each of the plurality of casualties by summing the coded values;

assigning a survival probability to each severity score based upon at least one characteristic of a respective casualty or of an incident responsible for the casualty; and

determining an order of treatment for each of the plurality of casualties through analytical or mathematical programming techniques, wherein the programming techniques consider the severity scores, time periods of treatment delay resulting from constrained resources, the survival probabilities, and deterioration rates applied to the severity scores due to the time periods of treatment delay.

29. The method of claim 28, further comprising the step of calculating a number of expected survivors of a casualty incident through the analytical or mathematical programming techniques.

30. Reference materials directed to training a method of triage to first responders, the method comprising the steps of:

assessing a respiratory rate, pulse rate, and best motor response for each of a plurality of casualties and assigning a coded value for each based on the assessment;

establishing a severity score for each of the plurality of casualties by summing the coded values;

assigning a survival probability to each severity score based upon at least one characteristic of a respective casualty or of an incident responsible for the casualty; and

determining an order of treatment for each of the plurality of casualties through analytical or mathematical programming techniques, wherein the programming techniques consider the severity scores, time periods of treatment delay resulting from constrained resources, the survival probabilities, and deterioration rates applied to the severity scores due to the time periods of treatment delay.

31. The reference materials of claim 30, wherein the method further comprises the step of calculating a number of expected survivors of a casualty incident through the analytical or mathematical programming techniques.

32. An instructional program directed to training a method of triage to first responders, the method comprising the steps of:

assessing a respiratory rate, pulse rate, and best motor response for each of a plurality of casualties and assigning a coded value for each based on the assessment;

establishing a severity score for each of the plurality of casualties by summing the coded values;

assigning a survival probability to each severity score based upon at least one characteristic of a respective casualty or of an incident responsible for the casualty; and

determining an order of treatment for each of the plurality of casualties through analytical or mathematical programming techniques, wherein the programming techniques consider the severity scores, time periods of treatment delay resulting from constrained resources, the survival probabilities, and deterioration rates applied to the severity scores due to the time periods of treatment delay.

33. The instructional program of claim 32, wherein the method further comprises the step of calculating a number of expected survivors of a casualty incident through the analytical or mathematical programming techniques.

34. The instructional program of claim 32, wherein the instructional program includes case studies presenting the first responders with trauma scenarios and injury data, requiring the first responders to determine the order of treatment, and providing the first responders with a likely survivability result based upon their determined order of treatment.

35. The instructional program of claim 34, wherein hints, leading questions, or additional information is provided to the first responders subsequent to their determination of the order of treatment to improve the likely survivability result.

36. A computer readable medium that configures a computer system to perform a method of triage, the method comprising the steps of:

receiving or establishing a casualty severity score for each of a plurality of victims; and

determining an order of treatment for each of the plurality of victims through consideration of the casualty severity score and resource availability.

37. A computer readable medium that configures a computer system to perform a method of triage, the method comprising the steps of:

receiving or establishing a casualty severity score for each of a plurality of casualties; and

determining an order of treatment for each of the plurality of casualties through consideration of resource availability, the casualty severity scores, and casualty severity score deterioration rates resulting from time periods of treatment delay.

38. A computer-readable medium that configures a computer system to perform a method of triage, the method comprising the steps of:

receiving coded values for each of a respiratory rate, pulse rate, and best motor response for each of a plurality of victims;

establishing a casualty severity score for each of the plurality of victims; and

determining an order of treatment for each of the plurality of victims through consideration of resource availability and the casualty severity scores.

39. A computer readable medium that configures a computer system to perform a method of triage, the method comprising the steps of:

receiving a respiratory rate, pulse rate, and best motor response for each of a plurality of casualties and assigning a coded value for each based on the assessment;

establishing a severity score for each of the plurality of casualties by summing the coded values;

assigning a survival probability to each severity score based upon at least one characteristic of a respective casualty or of an incident responsible for the casualty; and

determining an order of treatment for each of the plurality of casualties through analytical or mathematical programming techniques, wherein the programming techniques consider the severity scores, time periods of treatment delay resulting from constrained resources, the survival probabilities, and deterioration rates applied to the severity scores due to the time periods of treatment delay.

40. The computer readable medium of claim 39, wherein the method further comprises the step of calculating a number of expected survivors of a casualty incident through the analytical or mathematical programming techniques.

41. A computer readable medium that stores a program for performing triage, the program comprising:

means for establishing a casualty severity score for each of a plurality of victims; and

means for determining an order of treatment for each of the plurality of victims through consideration of the casualty severity score and resource availability.

42. A computer readable medium that stores a program for performing triage, the program comprising:

means for establishing a casualty severity score for each of a plurality of casualties; and

means for determining an order of treatment for each of the plurality of victims through consideration of resource availability, the casualty severity scores, and casualty severity score deterioration rates resulting from time periods of treatment delay.

43. A computer readable medium that stores a program for performing triage, the program comprising:

means for receiving coded values for each of a respiratory rate, pulse rate, and best motor response for each of a plurality of victims;

means for establishing a casualty severity score for each of the plurality of victims; and

means for determining an order of treatment for each of the plurality of victims through consideration of resource availability and the casualty severity scores.

44. A computer readable medium that stores a program for performing triage, the program comprising:

means for receiving a respiratory rate, pulse rate, and best motor response for each of a plurality of casualties and assigning a coded value for each based on the assessment;

means for establishing a severity score for each of the plurality of casualties by summing the coded values;

means for assigning a survival probability to each severity score based upon at least one characteristic of a respective casualty or of an incident responsible for the casualty;

means for determining an order of treatment for each of the plurality of casualties through analytical or mathematical programming techniques, wherein the programming techniques consider the severity scores, time periods of treatment delay resulting from constrained resources, the survival probabilities, and deterioration rates applied to the severity scores due to the time periods of treatment delay.

45. The computer readable medium of claim 44, wherein the a program comprises means for calculating a number of expected survivors of a casualty incident through the analytical or mathematical programming techniques.