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The Digital Triage Assistant

The Digital Triage Assistant. Cameron Abt Peter Backeris Glenn Shevach. Customer Problem/Need. Emergency Department Triage Determines who is seen, how long to wait Effective triage is crucial in crowded ERs Vital Signs Poor vital sign recording during emergency department triage

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The Digital Triage Assistant

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  1. The Digital Triage Assistant Cameron Abt Peter Backeris Glenn Shevach

  2. Customer Problem/Need Emergency Department Triage • Determines who is seen, how long to wait • Effective triage is crucial in crowded ERs Vital Signs • Poor vital sign recording during emergency department triage • Vital signs incomplete or skipped • Respiration rate not automated • Errors in manual transcription

  3. Engineering Problem Incomplete Vital Signs • Not simultaneous • Not automated • Not integrated • Time consuming • Trained professional required • High cost • Not mobile Respiration Rate • Requires manual measurement • Inaccurate and often estimated Manual Transcription • Error prone • Time consuming • Unnecessary paperwork

  4. The Digital Triage Assistant • Solves current problems in emergency room triage • Four major subsystems • VSAD • PDA • PC Software Suite • Backend database vTriageTM

  5. Vital Signs Acquisition Device • Miniature, portable, ergonomic design • Measures 5 vitals through 3 points of contact • Blood pressure • Heart rate • Oxygen Saturation (SpO2) • Temperature • Respiration Rate • Combines COTS and proprietary circuits

  6. Vital Signs Acquisition Device • Custom designed motherboard • Based on dsPIC33 16 bit microcontroller • Responsible for • Power distribution and monitoring • Intelligent inter-module communication • Communication with PDA • Acquisition and analysis of respiration rate and temp

  7. Vital Signs Acquisition Device • PCB design • 2 layer, bottom ground plane • Digital and analog sections • SMT 0805 passives • Analog test points • Critical component selection • 2.5” x 3.8”

  8. Vital Signs Acquisition Device • Power monitoring • Tenergy Li-Ion battery • 7.4V, 2200 mAh • Proprietary voltage monitoring • Docking station with charging

  9. Vital Signs Acquisition Device • 3 commercial modules • SunTech Medical Advantage A+ • Non-invasive blood pressure, heart rate • 9600 baud UART connection • Nonin Medical OEM III (SpO2, HR) • Oxygen saturation, heart rate • 9600 baud UART connection • Parani ESD 200 Bluetooth Module • Class 2 • 30m nominal range • 115200 baud • Bluetooth serial port profile

  10. Respiration Rate • Measurable parameters • Chest expansion • Chest band/strain gauge • Airflow • Strain gauge • Sound • Bio-acoustic sensor • Exhaled air temperature • Thermopile

  11. Respiration Rate • Respiration rate measurement • Thermocouples: J-type (iron-constantan) • Interested only in ΔT from thermopile • Amplification using INA128, instrumentation amp

  12. Respiration Rate

  13. Respiration Rate

  14. Respiration Rate

  15. PDA • HP iPAQ 210 Enterprise Handheld • Communicates with VSAD through Bluetooth • Custom software (mTriageTM) • Touch screen UI • Windows Mobile 6 • Developed with .NET Framework 3.5, MSVS 2008 • SocketMobile barcode scanner • Wireless LAN connection

  16. PDA • mTriageTM • Patient identification and information display • Real-time data display • Intelligent data collection • Connects to SQL Server 2008 database

  17. vTriageTM • Administrative software suite • Uses: • Entering patient information • Patient registration • Printing triage reports • Real-time patient monitoring • Intelligent health alert system

  18. Network Database • Holds past and present patient information

  19. Future Work/Applications • Modular sensor suite • Healthcare data mining • Triage Decision Support • Mass casualty events • Sporting events • Military applications • Connect to database using 3G • Ambulance, police, fire trucks

  20. Conclusion • Designed and tested a novel respiration rate sensing technology • Developed a FULLY FUNCTIONAL system to streamline the triage process in hospital ERs • Come get triaged! Thank You!

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