DE102004059713A1 - Road accident telemedicine initiation system has network connected portable modular emergency box for cars with communications and data interfaces to call centre and regional emergency centre - Google Patents

Abstract

A road accident telemedicine initiation system has a network connected portable, modular telemedicine emergency box (20) for cars, including communication, data transmission (56), diagnosis (22) and therapy (24) modules and interfaces to internal car crash sensors (48) and other telemedicine systems including Call Centre (40), regional emergency centre (50), mobile emergency vehicles and aircraft (60) with access to digital patient records.

Description

The The invention relates to an arrangement for the beginning medical Supervision of traffic accident victims at the scene of the accident by lay helpers.

In spite of area-wide Emergency medical systems and faster deployment times, the incipient medical Care of accident victims in traffic is problematic The first aid and especially the medical care in the time until the beginning of the professional emergency care (arrival of the ambulance / rescue helicopter] are of many factors dependent and only rarely sufficient. Accident participants are under pressure and potential Helpers are afraid by wrong actions the situation of the injured To aggravate people.

• – keine, verzögerte, unvollständige oder falsche Unfallmeldung
• – keine oder schlechte Erstversorgung durch Laienhelfer (abhängig vom medizinische Ausbildungsstand)
• – mangelhafte Notfallausstattung – mit dem vorgeschriebenen Verbandskasten ist aus medizinischer Sicht nur eine eingeschränkte Hilfeleistung möglich
• – keine, langsame oder fehlerbehaftete Informationsflüsse
• – potentielle Helfer in der Nähe werden nicht informiert
• – unzureichenden Warnung des umgebenden Verkehrs – Gefahr von Folgeunfällen
• – unklare Zuständigkeiten (betrifft regionale Versorgungsnetz)
• – unzureichende Dokumentation

The notified order is intended to help solve the problems of providing medical care to injured people in the immediate post-accident period. Existing problems are:

• - no, delayed, incomplete or wrong accident report
• - no or poor initial care by lay helpers (depending on the level of medical education)
• - Insufficient emergency equipment - with the prescribed first aid kit, only limited assistance is possible from a medical point of view
• - no, slow or faulty information flows
• - Potential helpers in the vicinity are not informed
• - inadequate warning of surrounding traffic - risk of consequential accidents
• - unclear responsibilities (concerns regional supply network)
• - insufficient documentation

Within A disclosed telemedical device is a technical component and processes involved, their intelligent connections create a new, network - like system that helps to solve the contributes to the above problems and with that the primary one Emergency care at the accident a previously unknown, better Quality achieved.

• – Telemedizinisches Call Center – wird untenstehend (S. 7) näher beschrieben
• – Telemedizinsystem in der regionalen Notfallzentrale – dient dem Empfang, der Verarbeitung, der Anzeige und der Weiterleitung der Unfalldaten (technische und medizinische Daten)
• – Telemedizinsystem im Notarztwagen/Rettungs-hubschrauber – dient dem Empfang, der Verarbeitung, der Anzeige und der Weiterleitung der Unfalldaten [technische und medizinische Daten]

Disclosed telemedical device includes a network consisting of telemedical emergency cases - hereinafter referred to as TNK - and at least one of the following technical components:

• - Telemedical Call Center - is described in more detail below (page 7)
• - Telemedicine system in the regional emergency center - serves to receive, process, display and forward the accident data (technical and medical data)
• - Telemedicine system in the ambulance / rescue helicopter - serves to receive, process, display and forward the accident data [technical and medical data]

The mentioned components are summarized below as Called opposite.

• – Modul zur Kommunikation (Chatten, Audio-Kommunikation, audio-visuellen Kommunikation-Videokonferenz) – dient u. a. der Verständigung mit den Gegenstellen, der Erzeugung von Audio-, Bild- und Videodaten sowie der akustischen und visuellen Anleitung von Personen [Unfallführer] – in vorteilhafter Ausführung auch als Kopf-Kamera-Kommunikationsmodul („head mounted device") – ist aus dem TNK entnehmbar, besitzt eine separate Stromversorgung/Akku und kommuniziert im entnommenen Zustand drahtlos mit der mobilen TNK-Komponente (siehe unten)
• – Modul zur Datenübertragung – dient u. a. der drahtlosen Übertragung der Daten zu den Gegenstellen (indirekte Übertragung via Funkstation), zum Notarztwagen/Rettungshubschrauber und zu anderen TNKs [beides via direkter oder via indirekte Übertragung vermittels Funkstation)
• – Modul zur internen Datenverarbeitung und -speicherung – dient als zentrale Recheneinheit und zur Speicherung von Daten
• – Mittel zur Stromversorgung [Akku, Fahrzeugnetzanschluss etc.] – dienen der Versorgung eines TNK und seiner entnehmbaren Module – sind mehrfach vorhanden

A TNK used in the disclosed arrangement contains at least one

• - Module for communication (chatting, audio communication, audio-visual communication - videoconference) - serves among other things the communication with the remote stations, the generation of audio, image and video data as well as the acoustic and visual guidance of persons [accident leader] - in Advantageous embodiment as a head-camera communication module ("head mounted device") - is removed from the TNK, has a separate power supply / battery and communicates wirelessly in the removed state with the mobile TNK component (see below)
• - Module for data transmission - used, among other things, the wireless transmission of data to the remote stations (indirect transmission via radio station), the ambulance / rescue helicopter and other TNKs [both via direct or indirect transmission via radio station)
• - Module for internal data processing and storage - serves as a central processing unit and for storing data
• - Means for power supply [battery, vehicle power supply, etc.] - are used to power a TNK and its removable modules - are available multiple times

• – Module zur internen Datenübertragung – dienen u. a. der drahtlosen Übertragung der Daten zwischen mobiler und fixierter Komponente eines TNK
• – Modul zur Ortsbestimmung (GPS, Galileo, GLONASS, Zellortung im GSM-Netz o. ä.) – dient der Lokalisierung des Fahrzeugs und somit der Unfallstelle sowie der zeitlich-örtlichen Signierung der Daten
• – Modul zur Diagnostik- dient der telemedizinischen Diagnostik (siehe S. 9) – ist aus dem TNK entnehmbar, besitzt eine separate Stromversorgung/Akku und kommuniziert im entnommenen Zustand drahtlos mit der mobilen TNK-Komponente
• – Modul zur Therapie – dient der telemedizinischen Therapie (siehe S. 10) – ist aus dem TNK entnehmbar, besitzt eine separate Stromversorgung/Akku und kommuniziert im entnommenen Zustand drahtlos mit der mobilen TNK-Komponente
• – Module zur Identifikation – dient der Identifizierung, Authentifizierung und Autorisierung von Personen über Identifikationsmittel (Karten, Chip etc.] oder biometrische Verfahren – sind an der mobilen TNK-Komponente und im Fahrzeuginnenraum vorhanden
• – Module zur Dateneingabe – dienen der Eingabe von Daten innerhalb des Fahrzeugs über Eingabegeräte (Tastatur, „Jog-Dial"-Steuerung, ggf. zusammen mit Anzeige als „Touch-Screen" o. ä. – sind an der mobilen TNK-Komponente und im Fahrzeuginnenraum vorhanden
• – E-F-Notfalltasten – dienen der manuellen Aktivierung des TNKs zur Abgabe einer automatischen Unfallmeldung (siehe S. 12) bei einem Unfall mit eigener [E] oder fremder [F] Beteiligung – sind an der mobilen TNK-Komponente und im Fahrzeuginnenraum vorhanden
• – Anzeigemodule – dienen der Anzeige von Daten und bei der Kommunikation, Anleitung von Personen und ggf. der Dateneingabe („Touch-Screen") – sind an der mobilen TNK-Komponente und im Fahrzeuginnenraum vorhanden
• – Modul zur Datenausgabe – dient der Weitergabe von wichtigen, unfallrelevanten und medizinischen Informationen (Dokumentation] an Personen und andere Gegenstellen, zu denen keine elektronische bzw, logische Schnittstelle besteht – kann im einfachsten Fall ein Drucker sein [„Fallback-Lösung"] – ebenso ist bei vorhandener Schnittstelle einer Gegenstelle eine drahtgebundene, serielle Datenübertragung möglich
• – Schnittstelle zur internen Fahrzeugsensorik (aktiver und passiver Insassenschutz, PreCrash-, Crash-Sensorik, Insassenerkennung u. ä.) – dient der Akquisition von Daten aus der Fahrzeugsensorik, die die Grundlagen für die automatische Unfallmeldung darstellen (siehe S. 11)
• – Schnittstelle zu TNKs in anderen Fahrzeugen – dient der Erkennung von anderen TNKs in Empfangsreichweite des Übertragungsmoduls (direkte Übertragung) bzw. in der nahen Umgebung (indirekte Übertragung via Funkstation) – Nutzung für Datenaustausch und Validierung von akquirierten Daten – Warnung des umgebenden Verkehrs
• – Schnittstelle zum Telemedizinischen Call Center – dient der Kommunikation zwischen dem TNK und dem System des Call Centers
• – Schnittstelle zur regionalen Notfallzentrale – dient der Kommunikation zwischen dem TNK und dem System der regionale Notfallzentrale
• – Schnittstelle zum Notarztwagen/Rettungshubschrauber – dient der Kommunikation zwischen dem TNK und dem System des Notarztwagen/Rettungshubschrauber
• – Schnittstelle zu einem digitalen Verkehrskanal (z. B. TMC – „Traffic-Message-Channel") – dient der Akquisition von aktuellen Verkehrsdaten und insbesondere aktuellen Unfallmeldungen
• – Schnittstelle zu einer digitalen Straßenkarte – dient der Akquisition von Daten zu Straßentyp und -zustand – Daten können auch vollständig oder teilweise, dauerhaft oder zeitweise im TNK gespeichert vorliegen und werden automatisch aktualisiert
• – Schnittstelle zum digitalen Wetterdienst – dient der Akquisition von aktuellen Wetterdaten [zeitlich-örtlich synchron]
• – Schnittstelle zu mobilen Telekommunikationssystemen – dient der Nutzung von im Fahrzeug vorhanden Telekommunikationssystemen
• – Schnittstelle zu medizinischen Informationssystemen (medizinische Datenbanken, Datenbank über regionale Gesundheitdienstleister] – dient der Akquisition von medizinischen Informationen und Informationen über regionale Gesundheitsdienstleister, wie Leistungsspektrum, Kapazitäten, Erreichbarkeit und weiteres – Daten können auch vollständig oder teilweise, dauerhaft oder zeitweise im TNK gespeichert vorliegen und werden automatisch aktualisiert
• – Schnittstelle zu einer digitalen Patientenakte/Patien-tenausweis, -karte (Chip-Card) – dient dem Zugriff auf unfallrelevante, medizinische Information [z. B. Medikation, Blutgruppe, Bluterkrankheit, Krampfanfallsleiden und weiteres] – Grundlage für die Generierung eines Notfalldatenblattes (Notfallrekord)
• – Schnittstelle zur Unfallmeldestelle der Polizei und der Verkehrsrechnerzentrale – dient der automatischen Unfallmeldung [siehe S. 11]

A TNK has a modular structure and consists of a mobile and a fixed component. In the simplest case, the fixed component in the vehicle is formed by the connection for the power supply / battery charge. Both components are connected to each other during storage of a TNK in the vehicle. When disconnected, there is a wireless connection between the two TNK components. TNKs can communicate with each other, recognize their functionalities, same information, validate correlated data, and share technical resources. A TNK contains the following modules and interfaces depending on requirements and depending on the equipment of the vehicle:

• - Modules for internal data transmission - serve, among other things, the wireless transmission of data between the mobile and fixed component of a TNK
• - Positioning module (GPS, Galileo, GLONASS, cell location in the GSM network or similar) - serves to localize the vehicle and thus the accident site as well as the temporal-local signing of the data
• - Diagnostic module - used for telemedical diagnostics (see page 9) - can be removed from the TNK, has a separate power supply / rechargeable battery and communicates wirelessly with the mobile TNK component when removed
• - Therapy module - used for telemedical therapy (see p. 10) - can be removed from the TNK, has a separate power supply / rechargeable battery and communicates wirelessly with the mobile TNK component when removed
• - Modules for identification - used to identify, authenticate and authorize people via identification means (cards, chip, etc.] or biometric methods - are present on the mobile TNK component and in the vehicle interior
• - Data input modules - are used to input data within the vehicle via input devices (keyboard, "Jog-Dial" control, possibly together with display as a "touch screen" o. Ä. - Are connected to the mobile TNK component and in the vehicle interior available
• - EF emergency buttons - are used for manual activation of the TNK to deliver an automatic accident report (see page 12) in the event of an accident involving own [E] or external [F] involvement - are present on the mobile TNK component and in the vehicle interior
• - Display modules - are used to display data and in the communication, guidance of persons and possibly the data input ("touch screen") - are available on the mobile TNK component and in the vehicle interior
• - Module for data output - is used to pass on important, accident-relevant and medical information (documentation) to persons and other remote sites that do not have an electronic or logical interface - in the simplest case can be a printer ["fallback solution"] - as well If there is an interface of a remote station, a wired, serial data transmission is possible
• - Interface to internal vehicle sensors (active and passive occupant protection, PreCrash, crash sensors, occupant detection, etc.) - is used to acquire data from vehicle sensors, which are the basis for automatic accident reporting (see p. 11)
• - Interface to TNKs in other vehicles - is used to detect other TNKs in reception range of the transmission module (direct transmission) or in the immediate vicinity (indirect transmission via radio station) - Use for data exchange and validation of acquired data - Warning of surrounding traffic
• - Interface to the telemedical call center - is used for communication between the TNK and the system of the call center
• - Interface to the regional emergency center - is used for communication between the TNC and the system of the regional emergency center
• - Interface to the ambulance / rescue helicopter - is used for communication between the TNK and the ambulance / rescue helicopter system
• - Interface to a digital traffic channel (eg TMC - "Traffic Message Channel") - is used to acquire up-to-date traffic data and, in particular, current accident reports
• - Interface to a digital road map - is used to acquire data on road type and condition - Data can also be stored completely or partially, permanently or temporarily in the TNK and are updated automatically
• - interface to the digital weather service - is used to acquire current weather data [temporally-locally synchronous]
• - Interface to mobile telecommunication systems - serves the use of existing in the vehicle telecommunication systems
• - Interface to medical information systems (medical databases, database of regional healthcare providers) - serves to acquire medical information and information about regional health care providers, such as capabilities, capacities, accessibility and more - data may also be stored in TNK in whole or in part, permanently or temporarily and are updated automatically
• - Interface to a digital patient record / card, card (chip card) - provides access to accident-relevant medical information [eg. B. medication, blood type, Hemophilia, seizure disorders and others] - basis for the generation of an emergency data sheet (emergency record)
• - Interface to the accident registration office of the police and the traffic control center - serves the automatic accident report [see p. 11]

All previously listed modules and interfaces can be both simple or as also be present several times. Should be present in the vehicle systems his [z. B. telecommunications system, location system, etc.] can TNK also this for use the appropriate functions and thus does not have its own Hold modules.

• – Schnittstelle zum TNK – dient der Kommunikation zwischen dem System des Call Centers und TNKs
• – Schnittstelle zur regionalen Notfallzentrale – dient der Kommunikation zwischen dem System des Call Centers und dem System der regionale Notfallzentrale
• Schnittstelle zum Notarztwagen/Rettungshubschrauber – dient der Kommunikation zwischen dem System des Call Centers und dem System des Notarztwagen/Rettungshubschrauber
• Schnittstelle zur Unfallmeldestelle der Polizei und der Verkehrsrechnerzentrale – dient der Kommunikation zwischen dem System des Call Centers und dem System der Unfallmeldestelle der Polizei und dem der Verkehrsrechnerzentrale
• – Schnittstelle zu digitalen Patientenakten – dient dem Abruf unfallrelevanter, medizinischer Informationen – setzt Autorisierung voraus
• Abrechnungssystem – dient der Erfassung und der Verrechnung erbrachter medizinischer und sonstiger Leistungen
• – Dokumentationssystem – dient der Erfassung aller versorgungs- und versicherungsrelvanter (insbesondere medizinischer) Prozesse
• – Monitoringsystem – dient der zeitkodierten Aufzeichnung sämtlicher Kommunikationen und erfassbarer Bildschirmaktionen im TCC – wird genutzt u. a. für Qualitätsmanagement und zur Absicherung

A telemedical call center, which is referred to as TCC in the following, contains at least one telemedical doctor's workstation. A TCC may also be implemented as a regional emergency center, as a technical unit in an ambulance / rescue helicopter, as a hospital facility, or otherwise. A TCC comprises - here simplified as an arrangement of telemedical doctor workstations considered - the following interfaces and systems:

• - Interface to the TNK - is used for communication between the system of the call center and TNKs
• - Interface to the regional emergency center - used for communication between the system of the call center and the system of the regional emergency center
• Interface to the ambulance / rescue helicopter - is used for communication between the system of the call center and the system of the ambulance / rescue helicopter
• Interface to the accident registration office of the police and the traffic control center - serves the communication between the system of the call center and the system of the accident registration office of the police and the traffic control center
• - Interface to digital patient records - is used to retrieve accident-relevant, medical information - requires authorization
• Billing system - used to record and clear medical and other services provided
• - Documentation system - serves to record all supply- and insurancerelated (especially medical) processes
• - Monitoring system - serves the time-coded recording of all communications and detectable screen actions in the TCC - is used among other things for quality management and for protection

• – direkte Kommunikation zwischen TNK (Unfall- oder Helferfahrzeug) und TCC – stellt den wesentlichen Kommunikationsweg dar – beinhaltet Unfallmeldung, Informationsvermittlung, Anleitung zur medizinischen Hilfeleistung (Diagnostik und Therapie) sowie technische Hilfe – parallel zur Kommunikation erfolgt die Datenübermittlung
• – direkte Kommunikation zwischen TNK (Unfall- oder Helferfahrzeug) und regionaler Notfallzentrale – entspricht der Kommunikation mit einem TCC
• – direkte Kommunikation zwischen TNK (Unfall- oder Helferfahrzeug) und Notarztwagen/Rettungshubschrauber – entspricht der Kommunikation mit einem TCC – parallel zur Kommunikation erfolgt die Übermittlung diagnostischer Daten
• – direkte Kommunikation zwischen den TNKs in Fahrzeugen an der Unfallstelle (Unfallfahrzeuge und nicht beteiligte Fahrzeuge) – dient der Alarmierung des umgebenden Verkehrs und dem Ruf nach Hilfe – dient der Kommunikation der TNKs untereinander, dem Abgleich von Informationen und der Validierung der Daten – TNKs erkennen einander automatisch und teilen sich technische Ressourcen
• – direkte Kommunikation zwischen TCC und regionaler Notfallzentrale bzw. Notarztwagen/Rettungshubschrauber – dient der Weitergabe von unfallrelevanten Informationen und Daten zur Einleitung der professionellen Notfallversorgung

The following communication channels are an integral part of the telemedical arrangement:

• - direct communication between TNK (accident or helper vehicle) and TCC - represents the essential communication path - includes accident reporting, information transfer, instructions for medical assistance (diagnostics and therapy) and technical assistance - parallel to the communication is the data transmission
• - direct communication between TNK (accident or helper vehicle) and regional emergency center - corresponds to communication with a TCC
• - direct communication between TNK (accident or helper vehicle) and ambulance / rescue helicopter - corresponds to the communication with a TCC - parallel to the communication, the transmission of diagnostic data
• - direct communication between the TNCs in vehicles at the accident site (accident vehicles and uninvolved vehicles) - serves to alert the surrounding traffic and the call for help - serves the communication of the TNKs among themselves, the comparison of information and the validation of the data - detect TNKs each other automatically and share technical resources
• - Direct communication between TCC and regional emergency center or ambulance / ambulance helicopter - is used to pass on accident-related information and data to initiate professional emergency care

• – Unfallmeldung – beinhaltet 2 Phasen: automatisch und halbautomatische Meldung [wird nachstehend näher erläutert]
• – Kommunikation [Videokonferenz] – dient der Verständigung des Helfenden bzw. der verunfallten Person mit einer der Gegenstellen – Nutzung bei der Unfallmeldung und der Anleitung zur medizinischen Hilfe
• – automatische Erkennung der TNKs untereinander – dient dem Datenaustausch, der Validierung der Unfalldaten, der Benachrichtigung von potentiellen Helfern sowie der Warnung des umgebenden Verkehrs – gemeinsame Nutzung von technischen Ressourcen
• – Identifikation, Authentifizierung, Autorisierung – dient der zweifelsfreien Feststellung der Identität von Personen, Dokumenten und der Zuordnung von Berechtigungen
• – Diagnostik – dient der Feststellung der medizinischen Status der verunfallten Personen, – medizinische Messparameter werden ermittelt und übertragen, – beinhaltet gerätediagnostische und manuelle Untersuchungen [nach Anleitung durch TCC oder TNK] – hier können beispielsweise TNK-Diagnostikmodule wie ein Elektrokardiograph, ein Blutdruckmessgerät, ein Pulsoximeter, ein Mini-Labor-Gerät und weitere eingesetzt werden
• – Therapie – dient der schnellen medizinischen Behandlung der verunfallten Personen (nach Anleitung durch TCC oder TNK) – beinhaltet gerätetherapeutische und manuelle Maßnahmen – hier können beispielsweise TNK-Therapiemodule wie ein Defibrillator, ein Sauerstoff-Inhalator und weitere eingesetzt werden
• – Anleitung der Erste-Hilfe-Maßnahmen – dient der Durchführung von medizinischen Sofortmaßnahmen zur Sicherung des Gesundheitszustandes von verunfallten Personen – Anleitung wird in der Regel durch das TCC vorgenommen, ist aber in eingeschränkter Form auch durch ein TNK möglich (automatische Führung)
• – Sicherung der Unfallstelle – dient der Vermeidung von Folgeunfällen – beinhaltet neben den üblichen Maßnahmen [Warndreieck, Warnblinkanlage] die Alarmierung des umgebenden Verkehrs (elektronisches Warndreieck) – direkte Alarmierung durch TNK-TNK-Kommunikation – Alarmierung des umgebenden Verkehrs nach Unfallmeldung durch den „Traftic-Message-Channel" – direkte Alarmierung des umgebenden Verkehrs nach Unfallmeldung durch ein TCC – Anleitung wird in der Regel durch das TCC vorgenommen, ist aber in eingeschränkter Form auch durch ein TNK möglich (automatische Führung)
• – Planung der professionellen Notfallversorgung – anhand der eingehenden Daten wird im TCC die professionelle Notfallversorgung geplant – die Planung betrifft die Dringlichkeit, und die Art und Weise sowie Umfang des Einsatzes
• – Datenbehandlung – wird untenstehend (siehe S. 12) näher beschrieben

Disclosed telemedical device includes a variety of methods that are dependent and independent between the above technical components and systems. The following methods are part of the disclosed arrangement:

• - accident report - includes 2 phases: automatic and semi-automatic message [will be explained in more detail below]
• - Communication [Videoconferencing] - is used to communicate with the helper or the injured person with one of the remote stations - Use in the accident report and the instructions for medical assistance
• Automatic recognition of the TNKs among each other serves the data exchange, the validation of the Accident data, notification of potential helpers and warning of surrounding traffic - sharing of technical resources
• - Identification, authentication, authorization - serves the unequivocal determination of the identity of persons, documents and the assignment of authorizations
• - diagnostics - used to determine the medical status of the injured persons, - medical measurement parameters are determined and transmitted, - includes device diagnostic and manual examinations [as directed by TCC or TNK] - here TNK diagnostic modules such as an electrocardiograph, a blood pressure monitor, a Pulse Oximeter, a mini-lab device and more are used
• - Therapy - is used for the rapid medical treatment of accident victims (as directed by TCC or TNK) - includes device-therapeutic and manual measures - here, for example, TNK therapy modules such as a defibrillator, an oxygen inhaler and others can be used
• - Instruction of the first aid measures - serves to carry out immediate medical measures to secure the health of injured persons - instructions are usually made by the TCC, but is also possible in a limited form by a TNK (automatic guidance)
• - Securing the accident site - serves to avoid subsequent accidents - includes in addition to the usual measures [warning triangle, hazard warning lights] the alerting of the surrounding traffic (electronic warning triangle) - direct alerts by TNK-TNK communication - Alerting the surrounding traffic after accident reporting by the "Traftic -Message Channel "- direct alerting of the surrounding traffic after accident report by a TCC - guidance is usually made by the TCC, but is also possible in a limited form by a TNK (automatic guidance)
• - Professional emergency care planning - Based on the incoming data, the TCC will design professional emergency care - the planning will focus on the urgency, and the nature and extent of the deployment
• - Data Handling - is described in more detail below (see page 12)

Of the Process of the accident report in revealed order begins with a first message. This will be delivered automatically after an accident as soon as possible a TNK receives corresponding data from the vehicle sensor system (crash sensors) or a TNK manually over one of the two emergency buttons E and F is activated. The emergency buttons can in each case be present several times, are marked accordingly and are located both in the vehicle interior and on the mobile Component of a TNK. Unlike the F-key will be on your own Accident - activation of the TNK with the E key - too existing medical data of inmates resulting from a digital Patient record or from a patient card.

The first message contains Automatically acquired data and will automatically from immediately after the accident of sold to a TNK. Previously, however, a TNK tests for data validation is possible with participation of several vehicles.

The The following second message is supplemented with information requested by persons become. The latter is done by voice or by completing a electronic questionnaire at TNK.

immediate after the first, automatic notification is made by a TNK at the scene of the accident tries to connect to a remote site, preferably one TCC, to establish direct communication. The TNKs are voting for this Communication between each other. In contrast to direct communication a second message is issued by each TNK. A direct one Communication with a remote station can be people at the scene of the accident but also over start a manual dialing. The coordination of direct communications with a remote site takes over the remote station (especially a TCC) The second message and the Direct communication takes place independently of time.

• – Datenakquisition – dient der Zusammenführung von unfallrelevanten Informationen als Grundlage für die Unfallmeldung – betrifft Daten zu Fahrzeug, Personen, Personen- und Fahrzeugkennung, geografischer Lage, Zeit, Straßentyp und -zustand, Wetter, medizinischer Infrastruktur u. a.
• – Datenauswertung – dient der Erstellung eines Überblicks über die medizinischen Erfordernisse und die aktuelle Situation am Unfallort mit Hilfe der akquirierten Daten
• – zeitlich/örtliche Signierung der Daten zu Dokumentationszwecken – dient der zweifelsfreien Zuordnung der Daten zum jeweiligen Unfallvorgang – Zeitstempel wird von einem Zeitstempelserver bzw. zusammen mit den geografischen Koordinaten vom Ortungssystem empfangen
• – Validierung der Daten im TNK – dient der Erlangung einer höheren Zuverlässigkeit und Genauigkeit in den Angaben [Daten] bei der Unfallmeldung, – erfolgt über den Austausch von Daten zwischen den im Empfangsbereich befindlichen TNKs
• – Validierung der Daten im TCC – dient der Erlangung einer höheren Zuverlässigkeit und Genauigkeit in den Angaben (Daten] bei der Unfallmeldung, – Validierung der Daten von zeitlich und örtlich korrelierenden Meldungen – Zusammenfassung von zeitlich und örtlich korrelierenden Meldungen zu einem Unfallvorgang
• – Datenabhängige Prozesssteuerung im TCC – Auswahl der Prozessabläufe für Diagnostik, Therapie, Kommunikation und weiteres durch automatische bzw. semiautomatische Stratifikation anhand von Klassifikatoren [z. B. so genannte diagnostische oder therapeutische Pfade]
• – Übertragung der Unfallmeldung – Übermittlung der Unfallmeldung an ein TCC, eine regionale Notfallzentralen, ein Notarztwagen/Rettungshubschrauber, die Unfallmeldestelle der Polizei und die Verkehrsrechnerzentrale – standardmäßig erfolgt die Unfallmeldung zunächst an ein TCC und an die Unfallmeldestelle der Polizei und die Verkehrsrechnerzentrale – regionale Notfallzentralen und Notarztwagen/Rettungshubschrauber werden automatisch ohne Zeitverlust via TCC benachrichtigt – die erfolgreiche Übermittlungen der Meldungen werden von den Gegenstelle bestätig – bei Ausbleiben einer Bestätigung, erfolgt eine direkte Unfallmeldung an alternative Gegenstellen (Notfallzentrale und den Notarztwagen/Rettungshubschrauber]

The accident report includes the following sub-processes:

• - Data acquisition - serves to merge accident-relevant information as the basis for the accident report - concerns data on vehicle, persons, passenger and vehicle identification, geographic location, time, road type and condition, weather, medical infrastructure and others
• - Data analysis - serves to create an overview of the medical requirements and the current situation at the scene of the accident with the help of the acquired data
• - Time / local signing of data for documentation purposes - Used for the unambiguous assignment of data to the respective accident process - Timestamp is received by a time stamp server or together with the geographical coordinates of the positioning system
• - Validation of the data in the TNK - To obtain a higher reliability and accuracy in the data [data] in the accident report, - takes place via the exchange of data between the TNKs located in the reception area
• - validation of the data in the TCC - serves to obtain a higher reliability and accuracy in the data (data) in the accident report, - validation of the data of temporally and spatially correlated messages - summary of temporally and spatially correlated messages to an accident process
• - Data-dependent process control in the TCC - Selection of process flows for diagnostics, therapy, communication and further by automatic or semi-automatic stratification based on classifiers [z. B. so-called diagnostic or therapeutic pathways]
• - Transmission of the accident report - Transmission of the accident report to a TCC, a regional emergency centers, an ambulance / rescue helicopter, the accident report office of the police and the traffic control center - by default, the accident report is first to a TCC and the accident registration office of the police and the traffic control center - regional emergency centers and Emergency medical vehicles / rescue helicopters are automatically notified via TCC without losing time - the successful transmission of the messages is confirmed by the remote station - if there is no confirmation, a direct accident report is sent to alternative remote stations (emergency center and the ambulance / rescue helicopter)

• – Validierung der Daten im TNK und im TCC – siehe Unfallmeldung (siehe S. 11)
• – zeitlich/örtliche Signierung der Daten zu Dokumentationszwecken – siehe Unfallmeldung (siehe S. 11) – sämtliche Daten die von einem TNK akquiriert bzw. erzeugt werden, inklusive der diagnostischen Daten und der Kommunikationsdaten, erhalten Zeit- und Ort-Stempel
• – Datenauswertung – siehe Unfallmeldung (siehe S. 11) – ausgewertete Daten geben Rückschlüsse auf den zu vermutenden Personenschaden, die Personenzahl, beteiligte Fahrzeuge etc.
• – Datenverschlüsselung – dient dem Schutz der Daten, insbesondere von Daten, aus digitalen Patientenakten
• – Datenaustausch zwischen verschiedenen TNKs – dient der Validierung der unfallrelevanten Daten – Voraussetzung: die TNKs erkennen sich und ihre Fähigkeiten (abhängig von der Ausstattung mit Modulen und Schnittstellen)
• – Übertragung von Daten zu den Gegenstellen – dient der Übermittlung der Unfallmeldung [inklusive der genannten akquirierten Daten], der medizinisch diagnostischen Daten der Ton, Bild- und Videodaten sowie der der Durchführung der Kommunikation

The process of data treatment within the disclosed telemedicine device includes the following subprocesses:

• - Validation of the data in the TNK and in the TCC - see accident report (see p. 11)
• - Time / local signing of the data for documentation purposes - see accident report (see p. 11) - all data acquired or generated by a TNK, including the diagnostic data and the communication data, receive time and place stamp
• - Data analysis - see accident report (see p. 11) - evaluated data give conclusions on the suspected personal injury, the number of persons, vehicles involved, etc.
• - Data encryption - protects data, especially data, from digital patient records
• - Data exchange between different TNCs - serves the validation of the accident-relevant data - Prerequisite: the TNKs recognize themselves and their abilities (depending on the equipment with modules and interfaces)
• - transmission of data to the remote stations - serves the transmission of the accident report [including the acquired acquired data], the medical diagnostic data of the sound, image and video data as well as the implementation of the communication

• – kein Unfall – technisches Problem – über ein TCC kann bei Bedarf auch Hilfestellung bei technischen Problemen mit dem Fahrzeug, TNK u. a. geleistet werden (ggf. erfolgt eine Weiterleitung an Service-Dienste, Reparaturanforderung) – der Hilferuf erfolgt über F-Notfalltaste – über das Kommunikationsmodul des TNK ist eine Video-Inspektion des Fahrzeugs möglich
• – kein Unfall – medizinisches Problem – auch ohne explizit vorliegendem Unfall kann mittels TNK durch ein TCC eine telemedizinische Betreuung vorgenommen werden – Betreuung und Überwachung (Monitoring) bei akuten Erkrankungen (z. B. auf Transport in ein Krankenhaus) vermittels TNK
• – eigener Unfall mit einem oder mehreren Fahrzeugen – sind mehrere Fahrzeuge am Unfall beteiligt und sind mehrere TNKs vorhanden, kommunizieren die TNKs untereinander (siehe S. 4) – die Unfallmeldung wird über die Fahrzeugsensorik oder über die E-Notfalltaste ausgelöst – vorhandene medizinische Daten von beteiligten Personen werden an die Gegenstellen übermittelt
• – fremder Unfall mit einem oder mehreren Fahrzeugen – sind mehrere Fahrzeuge am Unfall beteiligt und sind mehrere TNKs vorhanden, kommunizieren die TNKs untereinander (siehe S. 4) – die Unfallmeldung wird über die F-Notfalltaste ausgelöst
• – Unfall mit und ohne Laienhelfer – direkte Betreuung am Unfallort erfolgt vermittels offenbarter Anordnung vorzugsweise über einen von einer Gegenstelle angeleiteten Laienhelfer – eine Selbstversorgung durch die vom Unfall Betroffenen ist unter Nutzung eines TNK ebenso, wenn auch eingeschränkt, möglich [automatischer Unfallführer]

Apparent, telemedical arrangement can be applied within different and partially connected scenarios:

• - no accident - technical problem - a TCC can also provide assistance with technical problems with the vehicle, TNK, etc. (if necessary, a forwarding to service services, repair request) - the call for help via F-emergency button - on the Communication module of the TNK is a video inspection of the vehicle possible
• - no accident - medical problem - telemedicine care can be provided by TNC through TCC even without an explicit accident - care and monitoring (monitoring) of acute illnesses (eg transport to hospital) by TNC
• - own accident with one or more vehicles - if several vehicles are involved in the accident and there are several TNKs, the TNCs communicate with each other (see page 4) - the accident report is triggered by the vehicle sensors or the emergency button - existing medical data from involved persons are sent to the other parties
• - foreign accident with one or more vehicles - if several vehicles are involved in the accident and if several TNKs are present, the TNCs communicate with each other (see p. 4) - the accident report is triggered via the F-emergency button
• - Accident with and without lay helper - direct care at the scene of the accident by means of a disclosed arrangement preferably via a lay helper guided by a remote site - a self-care by those affected by the accident is possible, albeit limited, using a TNK [automatic accident driver]

The used in the disclosed arrangement components and the expiring Procedures and processes are already part of the state of the art been revealed. However, it is not yet known a system which has a intelligent linking the above components and processes would be able to do that mentioned in the introduction To solve problems. Inventive arrangement is along with the included procedures and processes for the solution of designed and also offers a considerable Added value the known prior art.

detailed Description based on an example

Based The following example situation and the accompanying sketches are intended to illustrate the relationships between the components and processes and processes disclosed, telemedical arrangement closer explained become. Show it:

1 schematically the procedure of the accident report

2 schematically the course of the communication and the measures

3 a schematic overview of the transmission links

4 schematically an embodiment of the arrangement of a TNK in driving convincing

5 schematically an embodiment of the structure of a TNKs

The present situation consists of a traffic accident involving two vehicles ( 12 ) on a little busy freeway. At the time of the accident, there are 12 ) two persons each with minor and moderate injuries. In addition, a person is in another vehicle ( 12 ) Witness the accident. One of the vehicles involved in the accident ( 12 ) and the vehicle ( 12) of the witness are using a TNK ( 20 ) fitted.

Immediately after the traffic accident, the TNK ( 20 ) of an accident vehicle, the data of the connected vehicle sensor system ( 22) and determines the accident. A short time later, TNK ( 20 ) manually by pressing an emergency button. After the mutual recognition of both TNKs ( 20 ), the comparison of the TNCs and the validation of a part of the acquired data - data on the geographical coordinates, time, weather, etc. - and the transmission of an automatic accident report to a TCC ( 40 ). In the TCC ( 40 ) the receipt of the message is registered and automatically confirmed. A direct message to the responsible regional emergency center ( 50 ) or to an ambulance / rescue helicopter ( 60 ) takes place only once a TNK ( 20 ) no acknowledgment of receipt from the TCC ( 40 ) receives.

Once in the TCC ( 40 ) receive multiple, non-validated and temporally-locally related data, the validation of the data in the TCC ( 40 ). All incoming accident reports relating to an accident (temporal-local relationship) are recorded in the TCC ( 40 ) summarized to an accident process.

This accident is sent to the responsible regional emergency center ( 50 ) or directly to an ambulance / rescue helicopter ( 60 ).

Based on the data received in the TCC ( 40 ) the planning of the emergency response. In this planning, in addition to the data of the automatic accident report, the information that is requested before the second accident report from persons at the scene of the accident is taken into account. Finally, the TCC transmits ( 40 ) the results of the deployment planning as before to the responsible regional emergency center ( 50 ) or an ambulance / rescue helicopter ( 60 ). Later, if available, up-to-date medical data or new information will be sent from the scene of the accident to the emergency center ( 50 ) and the ambulance / rescue helicopter ( 60 ) transmitted.

The regional emergency center ( 50 ) and the ambulance / rescue helicopter ( 60 ) are informed by the accident reports and by further data transmissions from the TCC ( 40 ) and directly from the TNKs ( 20 ) are constantly informed about changed situations at the scene of the accident and the state of health of the accident victims and can thus react to this with regard to the professional emergency care.

Immediately after the accident reports, TCC ( 40 ) or TNKs ( 20 ) a communication link between TCC ( 40 ) and accident location. Through this connection, the uninjured persons (witness) at the scene of the accident for first aid, diagnostic examinations (manual or device diagnostics) and therapeutic measures by the TCC ( 40 ). If no communication connection is established, a direct guidance of the person providing the help is also provided by the TNK ( 20 ) via the display and a voice output possible.

The mobile component of the TNK ( 20 ) is taken from the person providing the assistance and used to carry out communication with the TCC ( 40 ), for the transmission of image and video data and for Diagnosis and Therapy [including the First Aid measures] used. Diagnostic examinations, such as blood oxygen partial pressure, pulse rate, blood pressure, blood laboratory readings, electrocardiogram and others, can be used with TCC ( 40 ) or TNK ( 20 ) guided manual examinations a precise status (vital status) of the casualty person are collected. This then forms the basis for the implementation of any therapeutic measures. Again, if necessary, the instructions on a TCC ( 40 ) or a TNK ( 20 ). The measures that can be taken under instruction range from the storage of the injured person to the administration of oxygen by means of an oxygen inhaler to the defibrillation of a life-threatening ventricular fibrillation of the heart.

at accidents With many involved and many affected persons allows the Creation of fast vital status related to the communication with the TCC, a better coordination of actions and a more effective Emergency assistance.

With the beginning of the professional emergency operation at the ambulance / rescue helicopter ( 60 ) the diagnostic data either via a TCC ( 40 ) or directly from the TNK ( 20 ) transmitted wirelessly or by wire. If this is not possible, the data will be sent on arrival of the ambulance / rescue helicopter ( 60 ) stored on a suitable medium (memory chip, compact disk, etc.) or in the simplest case handed over in printed form.

10

Telemedicine arrangement

12

Passenger car

14

identification module in the vehicle interior

16

vehicle sensor

18

Data entry module in the vehicle interior / emergency buttons (E and F)

20

Tele Medical Emergency kit - TNK

22

diagnostic module

24

therapeutic module

26

Communication module, Data input, output, display

28

display module in the vehicle interior

30

interface to the in-vehicle telecommunication system

32

Transceiver station

34

Power / battery

36

headquarters Computing unit of the TNK

38

Ortbestimmungssystem

40

telemedicine Call Center - TCC

42

Tele Medical Doctor workplace

44

identification module mobile TNK component

46

module for internal data transmission

48

interfaces to the internal vehicle sensors

50

regional emergency center

52

Internal vehicle telecommunications system

54

Module connection: Data entry and edition and identification in the vehicle interior

56

module for wireless data transmission

60

Ambulance / rescue helicopter

62

Wireless transmission line

Claims (31)

Arrangement of technical systems ( 10 ) for the beginning telemedical care of accident victims at the scene of the accident comprises at least one portable, modular telemedicine system ( 20 ) for motor vehicles ( 12 ), which is arranged in a network with at least one other network participant, advantageously with several, in particular a) medical receiving centers ( 40 ), advantageously designed as a telemedical call center, with at least one medical-technical workstation ( 42 ) for medical staff, b) medical-technical systems in a regional emergency call center ( 50 ) for receiving, processing, displaying and forwarding technical and medical accident data and c) medical-technical systems in mobile rescue vehicles and aircraft ( 60 ) for receiving, processing, displaying and forwarding technical and medical accident data, as well as interfaces between the components mentioned and the portable, modular telemedicine system, which enable the communication of the components with each other and the accident registration office of the police and traffic control center. Arrangement according to claim 1, characterized that the medical reception centers interfaces with digital Own patient records. Arrangement according to claim 1, characterized that the medical reception centers at least one documentation system have. Arrangement according to claim 1, characterized that the medical reception centers have at least one monitoring system have. Portable, modular telemedicine system ( 20 ) for motor vehicles ( 12 ) for the beginning of telemedical care of accident victims at the scene of the accident a) at least one module for communication ( 26 ) b) at least one module for data transmission ( 56 ) c) at least one diagnostic module ( 22 ) d) at least one module for therapy ( 24 ) e) Interfaces to internal vehicle sensors ( 48 f) Interfaces to other telemedical systems according to the invention, via which the systems communicate with one another, compare information, validate correlated data and mutually recognize their functionalities. Telemedical system according to the invention ( 20 ) according to claim 5, characterized in that the module for communication ( 26 a) inter alia serves the user for communication with the other participants in telemedical networks, b) serves for the generation of audio, image and video data, c) serves the acoustic and visual guidance of users in the manner of an accident leader, d) in can be advantageously carried out as a head-camera communication module, e) can be removed from the telemedicine system according to the invention, since it has a separate power supply and communicates wirelessly in the removed state. Telemedical system according to the invention according to claim 5, characterized in that the module for data transmission ( 56 ) of the portable, modular telemedical system ( 20 ) for motor vehicles ( 12 ) Data directly or indirectly via a forwarding radio station ( 32 ) transmits to or receives data from various remote sites, such as mobile rescue vehicles and aircraft or other portable, modular telemedicine systems for motor vehicles. Telemedical system according to the invention ( 20 ) according to claim 5, characterized in that at least one module for internal data processing and storage ( 36 ) is included. Telemedical system according to the invention ( 20 ) according to claim 5, characterized in that means for internal power supply ( 34 ), advantageously designed as accumulators, are included, which may be present more than once. Telemedical system according to the invention ( 20 ) according to claim 5, characterized in that it consists of a mobile and a motor vehicle ( 12 ) fixed component, which in the storage of the system in the motor vehicle ( 12 ) are in contact with each other and when using the system outside the vehicle via internal data transmission modules ( 46 ) communicate with each other wirelessly. Telemedical system according to the invention ( 20 ) according to claim 5, characterized in that there is at least one module for location ( 38 ) contains. Telemedical system according to the invention according to claim 5, characterized in that it comprises at least one module for identification, authentication and authorization ( 14 . 44 ) of persons. Telemedical system according to the invention according to claim 5, characterized in that at least one module each for data input, display and output ( 26 ) contains. Telemedical system according to the invention ( 20 ) according to claim 5, characterized in that it has at least two buttons ( 18 ) for manual activation of the telemedicine system according to the invention according to claim 5, so that it emits an automatic accident report. Telemedical system according to the invention ( 20 ) according to claim 5, characterized in that it has at least one interface to regional emergency centers ( 50 ), mobile rescue vehicles and aircraft ( 60 ) and other remote stations. Telemedical system according to the invention ( 20 ) according to claim 5, characterized in that it has at least in each case an interface to facilities that provide accident-relevant information, in particular a digital traffic channel, a digital road map, a digital weather service, mobile telecommunications systems, medical information systems, digital patient records and other facilities. Telemedical system according to the invention ( 20 ) according to claim 5 or any other preceding claim, characterized in that instead of in the telemedical system according to the invention ( 20 ) according to claim 5 modules and interfaces already in the motor vehicle ( 12 ) can be used. A method for the beginning telemedical care of traffic accident victims at the accident site comprises a plurality of sub-processes, in particular a) a two-part accident report, which automatically for the first part either by accident detection sensors integrated in the motor vehicle ( 16 ) or by manual operation of emergency buttons ( 18 ) is triggered by persons, b) automatic detection and functional coordination of participating telemedicine systems ( 20 ) with each other, allowing different functions c) measures of medical diagnosis and therapy, for the care of injured persons d) instructions for measures, in particular first aid measures by a telemedical reception center ( 40 ) or by a portable telemedicine system ( 20 ) at the location of the accident. The inventive method according to claim 18, characterized in that at the accident site via suitable systems ( 14 . 44 ) an identification, authentication and authorization of persons can be made. Inventive method according to claim 18, characterized in that within the guided measures also measures to Securing the accident site are included. Inventive method according to claim 18, characterized in that it is the planning includes professional emergency care. Inventive method according to claim 18, characterized in that within the inventive method according to claim 18 accident-relevant data are processed. Inventive method according to claim 18, characterized in that in the first part Accident report automatically contains accident-relevant data are. Inventive method according to claim 18, characterized in that in the second part Accident report contains information that is requested by persons. The inventive method according to claim 18, characterized in that the transmission of the accident report by the remote sites ( 40 . 50 . 60 ) is confirmed. The inventive method according to claims 18 and 22, characterized in that the data processing and evaluation of the accident-relevant data in the medical reception center ( 40 ) or in a telemedical system ( 20 ) occurs automatically at the scene of the accident, and that the comparison of correlated data results in validation of the data. Inventive method according to the claims 18 and 22, is characterized in that within the data processing and -auswertung the accident-relevant data, a temporal and local Signing of the data is done. Inventive method according to the claims 18 and 22, is characterized in that within the data processing and evaluation of the accident-relevant data, a data encryption he follows. Method according to claims 18 and 22, characterized in that via the data processing and evaluation of the accident-relevant data a dependent process control in the medical receiving center ( 40 ) he follows. The inventive method according to claim 18, characterized in that for a direct communication between a telemedical receiving center ( 40 ) and a person on a telemedical system ( 20 ) an automatic or a manual connection is established at the scene of the accident. A method according to claims 18 and 30, characterized in that direct communications between a telemedicine reception center and persons at telemedical systems at the scene of the accident are received by the telemedicine reception center ( 40 ).