Issue link: https://read.dmtmag.com/i/46658
Spatial Decision-Support System Mass-casualty incidents typically are defined as inci- dents which by the sheer number and severity of casu- alties overwhelm the health-care system within a given community. In these situations, hospitals typically have difficulty providing adequate care because of the increased pressure from arriving casualties. A Spatial Decision-Support System (SDSS) aims to alleviate this pressure by more effectively managing the flow of patients into hospitals during a mass- casualty situation. In particular, an SDSS focuses on supporting the decision making leading to the choice of appropriate evacuation hospitals. In terms of determining the facility to which patients should be transported, three primary factors must be evaluated: 1. Whether the hospital has the capability to treat the casualty (i.e., the appropriate expertise and equipment). 2. How long it will take to transport patients to the hospital. 3. Whether the hospital has the capacity to provide care. An SDSS provides such information to paramedics at the scene of an incident through a combination of spatial analysis, data management and visualization. In doing so, it aims to make a chaotic and difficult process simpler and more effective. A Better System Hospital proximity is an important factor in deciding where mass-casualty patients should be evacuated. A prime example of this can be found in the series of mass casualties that occurred within the London transit system in 2005. From the four mass casualties that occurred, 56 critically injured patients were evacu- ated and distributed to six different hospitals. Hospital proximity, capacity and capability were the primary fac- tors in deciding where to evacuate patients. To date, there have been several attempts to develop SDSSs for emergency medical services (EMSs). One of the most well known of these being a location- allocation model that helps relocate ambulance and fire trucks to maximize coverage. To this point, at least as far as the literature is concerned, SDSSs haven't been used in the decision to evacuate patients during a mass casualty. Instead, decisions regarding the evacuation of critically injured patients typically are made by paramedics at the scene of the incident where the information required to make an informed decision (e.g., driving time to nearest hos- pital, capacity, trauma level, etc.) isn't always available. Although pre-hospital triage and treatment decisions are well within the expertise of the caregivers at the scene, decisions as to where patients should be evac- uated are less obvious and could be greatly assisted by more-detailed information concerning the capacity and capability of hospitals in the surrounding area. SDSS Goals A particular SDSS developed for the Vancouver, British Columbia, area intends to provide paramedics at the scene of an incident with real-time information con- cerning hospital capacity in addition to estimated driv- ing times from the incident location to each hospital in the surrounding area. As real-time traffic information, such as that provided by the recently released Google traffic layer, isn't yet at the point where it can be used operationally, or at least not reliably enough for EMS Figure 1. An illustration shows where the suggested SDSS will fit within the pre-hospital stage of mass casualty. Figure 2. An illustration shows the data flow among MCI locations and hospitals. OCTOBER 2O11 / WWW . GEOPLA CE . COM 23