A real-time communication and information system for triage, positioning, and documentation (TriPoD) in mass-casualty incidents: a qualitative observational study.

Abstract

Background: In mass-casualty incidents (MCIs), command centers often rely on oral or written reports, leading to communication gaps, misunderstandings, and inadequate logistics of available resources. This study developed a real-time communication and information system for Triage, Position, and Documentation (TriPoD) via action research in collaboration with end-users to ensure high usability. TriPoD integrates commercially available technology, utilizing a digital triage tag with a unique ID that attaches to each individual with an injury. Emergency medical service (EMS) providers scan the electronic triage tag (e-triage tag) via a mobile app, instantly sending data to command centers through a web portal. The developed TriPoD enables seamless sharing of patient information from the MCI scene during transport to and within hospitals.

Aim: This study aimed to explore the usability of TriPoD during a simulated MCI with figurants.

Methods: A qualitative observational design was employed, with non-participant observers stationed at the incident site, a regional command center, and a hospital command center. The observers compared TriPoD with standard procedures and management, and collected user perspectives on the system evaluated. A thematic analysis was used to guide the analysis.

Results: The results revealed that command centers receive real-time updates on patient count, triage status, and location faster and with more accurate numbers of injuries than traditional methods do. Data transmitted through the web portal was updated each time a new patient was scanned, enabling continuous real-time monitoring and informed decision-making. EMS providers and command center users observed TriPoD usability, with delays when EMS providers did not consistently scan injured individuals.

Conclusion: This study demonstrates that seamless information sharing from the scene of an MCI enhances reliable communication and management efforts. Although TriPoD shows strong potential for improving MCI response and management, further development, testing, and collaboration with intended end-users are essential for its continued improvement. The study was approved by the Swedish Ethical Review Authority (No: 2023-04615-01). International Registered Report Identifier (IRRID): PRR1- https://doi.org/10.2196/57819 .

Clinical trial number: Not applicable.