Method and system of rule-based triage

• US 20050177393A1
• Filed: 09/16/2004
• Published: 08/11/2005
• 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 7,899,682 B2
• Time in Patent Office: Days
• US Class Current: 705/2
• CPC Class Codes: G06Q 40/08 Insurance
• 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 50/20 for computer-aided diagnosis, e.g. based on medical expert systems
• CPC Class Codes: G16H 50/80 for detecting, monitoring or modelling epidemics or pandemics, e.g. flu

Abstract

A method and system for ordering treatment or transport of victims of a mass casualty incident, prior to the incident, by establishing simulated casualty severity scores for each of the victims and considering the casualty severity scores and simulated resource availability. The order of treatment is provided on a card, chart, table or graph. Ordering treatment occurs through an analysis of triage simulations using analytical or mathematical programming techniques considering the severity scores, time periods of treatment delay resulting from constrained resources, estimated survival probabilities, and/or deterioration rates applied to the severity scores due to treatment delay. Alternatively, the order of treatment can be determined through data mining, pattern recognition, or greedy algorithm optimization techniques analyzing survival probability estimates associated with the simulated casualty severity scores, and changes to the survival probability estimates due to time periods of treatment delay resulting from constrained resources.

Claims

1. A method of treating or transporting victims of a mass casualty incident in accordance with an order of treatment or transport achieved by the steps of:

providing a casualty severity score for each of a plurality of simulated victims; and

determining an order of treatment for each of the plurality of victims, prior to occurrence of the mass casualty incident, through consideration of the casualty severity score and simulated resource availability, where the order of treatment is provided on a rule-based card, chart or graph for use upon occurrence of the mass casualty incident.

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 greedy algorithm optimization technique.

7. The method of claim 1, wherein determining an order of treatment involves data mining techniques.

8. The method of claim 1, wherein the graph includes a ratio of a total number of victims over a number of victims that can be triaged per time period on one axis and a range of casualty severity scores on the other axis.

9. The method of claim 8, wherein the graph is used by locating on the one axis the ratio of the total number of victims at the scene over the number of victims that can be triaged per time period and correlating this ratio on the on the other axis with the associated casualty severity score, whereby the associated casualty severity score represents a lowest casualty severity score selected for treatment or transport in time period one.

10. The method of claim 1, wherein the order of treatment provided on the rule-based card is developed by analyzing triage simulations processed using analytical or mathematical programming techniques considering data-based estimates of casualty survival probability and victim deterioration-with-time rates.

11. The method of claim 10, 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.

12. The method of claim 10, 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 running triage simulations of randomly generated (from various distributions) “

victim state vectors” and

variable resources (number of victims that can be treated over time period).

14. The method of claim 1, wherein determining an order of treatment for each of the plurality of victims involves running triage simulations employing dynamic or linear programming formulations.

15. The method of claim 1, wherein the card, chart or graph displays an order of treatment listing casualty severity scores, and determining an order of treatment or transport for each of the plurality of victims involves employing data mining, greedy algorithm, or pattern recognition techniques.

16. The method of claim 1, wherein the card, chart or graph displays an order of treatment listing casualty severity scores, and determining an order of treatment or transport for each of the plurality of victims involves analyses of evidence based data of survival probability and deterioration-with-time estimates.

17. The method of claim 1, wherein determining an order of treatment for each of the plurality of victims involves determining a change in survival probability for each casualty severity score based upon a consideration of victim deterioration-with-time over an estimated time period to clear the mass casualty incident, and ordering treatment or transport by maximum change in survival probability.

18. A card, chart, table or graph for use in triage, the card, chart, table or graph providing the results of a method comprising the steps of:

providing a casualty severity score for each of a plurality of simulated victims; and

determining an order of treatment for each of the plurality of victims, prior to occurrence of a casualty incident, through consideration of the casualty severity score and resource availability, wherein the table illustrates an order of treatment by casualty severity score for each of a plurality of triage time periods associated the casualty incident.

19. A card, chart, table or graph displaying an order of treatment for prioritizing treatment or transport of victims of a casualty incident, the card, chart or graph created using a method comprising the steps of:

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

determining an order of treatment, prior to occurrence of the casualty incident, for each of the plurality of casualties through consideration of simulated resource availability, the casualty severity scores, and one or more factors selected from the group consisting of casualty severity score deterioration rates resulting from simulated 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.

20. The card, chart, table or graph of claim 19, 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.

21. The card, chart, table or graph of claim 19, wherein the order of treatment is by casualty severity score for each of a plurality of triage time periods associated with the casualty incident.

22. A card, chart, table or graph for use in triage, the card, chart or graph providing the results of a method comprising the steps of:

selecting a casualty severity score for each of a plurality of simulated casualties;

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, prior to occurrence of a respective casualty incident for use upon occurrence of the casualty incident, through an analysis of the simulated casualties using analytical or mathematical programming techniques, wherein the programming techniques consider the severity scores, time periods of treatment delay resulting from simulated constrained resources, the survival probabilities, and deterioration rates applied to the severity scores due to the time periods of treatment delay.

23. A card, table, chart or graph for use in triage, the card, chart, table or graph providing the results of a method comprising the steps of:

selecting a casualty severity score for each of a plurality of simulated casualties;

assigning a survival probability estimate to each severity score based upon trauma data associated with the severity score; and

determining an order of treatment, prior to occurrence of a respective casualty incident, for use upon occurrence of the casualty incident, through employment of greedy algorithm optimization techniques analyzing changes to the survival probability estimates over time due to victim deterioration-with-time rates resulting from simulated time periods of treatment delay.