GB2564529A

GB2564529A - System, Device apparatus and method

Info

Publication number: GB2564529A
Application number: GB1807825.3A
Authority: GB
Inventors: Morgan David
Original assignee: David Ward Morgan
Current assignee: David Ward Morgan
Priority date: 2017-05-12
Filing date: 2018-05-14
Publication date: 2019-01-16
Also published as: GB201807825D0; GB201807821D0; GB201707625D0

Abstract

The application relates to an entity management system, e.g. a patient triage system. A tag 120 having a machine-readable identifier, e.g. barcode 123 or NFC/RFID tag 121, is attached to the entity, e.g patient 100. Using mobile device 110, e.g. tablet PC or smartphone, the identifier is read and the entitys status is entered. A record is generated comprising the identifier and the status. The system receives a destinations availability to accept entities with a given status, and determines to which destination an entity should be assigned based on the entitys status. The system may be used to triage casualties at a major incident, and assign casualties to hospitals based on their status. Also claimed are: a mobile device that reads an identifier, receives entity status information, and transmits the identifier and status to remote storage; a storage system that receives an identifier, an entity status, and a destinations availability to accept entities with a given status, and determines to which destination an entity should be assigned based on the entitys status; and a tag comprising a machine-readable identifier and an audio or visual output 122, wherein the output depends on a received status.

Description

SYSTEM, DEVICE, APPARATUS AND METHOD

Field of Invention

This invention relates to a method of obtaining and processing multiple incident and/or victim information and an apparatus for processing such information. Some embodiments comprise the steps of physically attaching an electronic tag to a patient, capturing data at the scene of an incident using associated wireless devices and collecting data from supporting emergency services and receiving hospitals. The data is collated on a server where an embedded artificial intelligence work flow engine allocates the appropriate resources to cope with demand, including surge demand, depending on the defined scenarios. Some embodiments of the present invention allow real time tracking of the victim(s) through several locations.

Particularly but not exclusively embodiments of the present invention relate to identifying victims and managing Mass Casualty Incidents (MCI). Some embodiments may be applied to any emergency service (Police, Fire, Ambulance, Armed Forces etc) incident where data capture is required.

Background of the Invention A Mass Casualty Incident can be defined as a disastrous event or other circumstance which results in a large number of fatalities or injuries and has the potential to exceed the logistical capacity of local health care providers. Such an incident can be a natural disaster such as an earthquake, a tornado, flooding etc, civil disorder, a plane crash, major fire, terrorist events and so on.

To enable the available treatment and care capacity to be most efficiently used, it is known to cany' out a process known as triage in which casualties who are victims of an MCI can have their treatment needs assessed and be dealt with more efficiently. Essentially, triage aims to identify those who are seriously ill or injured as a direct result of the incident who require immediate treatment or care, particularly acute or emergency care, those affected by the incident who are not suffering any serious injury but will need assessment and treatment, and those who are neither ill nor injured but who still require information advice and reassurance.

Typically, if the incident is in a ‘hot zone’ or high risk/contaminated zone no information is recorded, due to time and constraints by using a protective suit, and a colour coded priority code wrist/slap band is attached to the victim. If the victim is then moved from the high risk area to a ‘cold zone’ or casualty clearing point the victim’s triage information consists of a paper form which a paramedic or other emergency services personnel located at the site of the MCI completes with information relating to the incident and casualty’s state. The initial incident and emergency services attending or required are recorded on paper and details radioed to the control centres. The triage process is typically performed at, or close to the MCI site. The triage form is then attached to the casualty, accompanies the casualty during transport to hospital and is used by the hospital staff to assist in deciding what acute care will be required. Typically, the document is passed off at the hospital upon arrival of the casualty and when responsibility is formally handed over.

Clearly, during an incident, it is possible for the paper form to become damaged or lost, or even issued to the wrong casualty. This can cause problems in misidentification, assessing the care required by the casualty, resulting in delay of treatment to that casualty, in efficient use of resources and could possibly put the casualty’s safety at risk. An inability to collate incident and casualty information by paper in real time leads to confusion, poor utilization of resources and inability to locate casualties during the evacuation process

Handover between responders using different paper systems can also lead to delay and loss of victim’s details including location within the system.

If the initial triage is performed in a darkened environment using paper triage cards subsequent location of the victim and identifying their triage status may prove difficult.

If there are large number of victims and/or multiple incidents it is possible to lose track of where the casualties are located in the evacuation chain or to which hospital they have been be sent to.

There is also a problem of locating the right resources or misallocating such resources to deal with the emerging demand due to poor communication or information overload e.g. one hospital might run out of resources such as bed places while an adjacent hospital has underutilised resources.

The paper based system can lead to mistakes in recording vital sign information from individual casualties when being assessed during the evacuation process as all readings are taken and recorded manually and therefore prone to human error.

There is also an inability to monitor multiple patients’ vital signs and detect which patients are deteriorating in real time if in a locked down environment if vital sign and clinical data is recorded manually and vital sign monitors are not available due to their size and weight.

There is a potential for the Triage Sieve score to be recorded inaccurately due to human error leading to misallocation of evacuation priority with potentially poor clinical outcomes.

Post event it may prove difficult to locate and identify the victims if only a paper based system is used to record victim details and subsequent location.

Recent domestic and international terrorist attacks have resulted in multiple victims spread over a large geographical area requiring fast assessment of victim’s injuries in order to allow the safe evacuation and the deployment of the most appropriate medical support and onward transfer to the most appropriate medical facility.

In some cases it may be necessary to treat and leave the victim due to constrained resources or due to operational threats. It may therefore be difficult on returning or if other resources are deployed to locate the casualties - ‘left behind’ scenario.

It is also difficult to keep track of victims that have been moved to another point of care or handed over from a restricted area again leading to a possible ‘left behind’ scenario.

If more than one First Responder triage team is deployed it is often difficult to have a full picture of the scale of the casualties by the various First Responder triage teams and effectively prevent better utilisation of resources if each team is unaware of the others workload.

There may be a difficulty in processing information from such multiple synchronous events such as a Marauding Terrorist Firearm Attacks due to existing radio and paper based methods resulting in lack of data visibility of the evolving scenarios.

There is an inability to filter sensitive information when recorded manually on paper and record witness identification for further investigation. The paper based system leads to administrative delays in collating data and reporting such as victim identification.

The proposed solution serves as a robust electronic means of swiftly managing the data capture from individual First Responders’ mobile devices during a major incident and transmitting that information to control centres and all responders’ devices to aid better casualty tracking, decision making and optimise resource allocation. GIS enabled hand held devices are carried by First Responders onto the scene and are used to capture incident data and triage victims including the recording of vital casualty data.

The associated electronic record is associated with a unique patient identifier tag that can be scanned using bar code/NFC/ RFID (or a combination) technology preventing misidentification. The GIS (Geographic Information System) function allows selected casualties to be located. Associated software allows positive identification of the casualty and the ability to monitor the vital signs of multiple casualties utilising wireless connected vital sign monitoring devices.

The hand held devices allow GIS location information to be displayed and receive the location and capacity of responding hospitals. The solution also allows surge planning using a work flow engine facilitating enhanced data visibility to allow interoperability with other agencies to provide a coordinated response.

If a Major Incident occurs over a wide geographical area the system will geotag the casualty to allow other resources to locate and evacuate if necessity has required the First Responder to initiate treatment and then move on.

Tracking of individual First Responder position and workload will also optimise casualty management.

Summary of the invention

Aspects of the invention may be understood with reference to the appended claims.

In one aspect of the invention for which protection is sought there is provided an entity management system comprising: at least one tag configured to be attached to an entity, the tag having at least one tag identifier element; at least one mobile device configured to determine by reference to the at least one tag identifier element of the tag an identity of the tag, the mobile device being further configured to receive entity information and to associate the entity information with the entity by reference to the identity of the tag attached to the entity, the entity information including entity status information indicative of a status of the entity, the system being configured to generate an entity record in respect of each entity, the entity record comprising the identity of the tag attached to the entity and the entity information, the system being further configured to receive information in respect of the availability of a plurality of destination stations to accept an entity of a given status, the system being configured to determine automatically to which destination station an entity should be assigned in dependence at least in part on the entity status.

In a further aspect of the invention for which protection is sought there is provided a system, optionally an entity management system, comprising: at least one tag configured to be attached to an entity, the tag having at least one machine readable tag identifier element; at least one mobile device configured to read the tag identifier element of the tag and determine an identity of the tag, the at least one mobile device being further configured to receive entity information and to associate the entity information with the entity by reference to the identity of the tag attached to the entity, the entity information including entity status information indicative of a status of the entity, the system being configured to generate an entity record in respect of each entity, the entity record comprising the identity of the tag attached to the entity and the entity information, the system being further configured to receive information in respect of the availability of a plurality of destination stations to accept an entity of a given status, the system being configured to determine automatically to which destination station an entity should be assigned in dependence at least in part on the entity status information.

It is to be understood that the entity may be a casualty (or victim) of an incident such as a bombing or accident at a chemical plant.

The at least one mobile device may comprise a mobile telephone, a mobile smartphone, a personal digital assistant, a tablet, a laptop computing device or any other suitable mobile device.

Embodiments of the present invention are particularly suited to mass casualty incidents (MCIs) in which a relatively large number of casualties (e.g. 10 or more casualties) suffer critical injury.

The system may be configured to provide an output indicative of the identity of the destination station to which an entity has been assigned.

Whilst the system may be configured automatically to determine to which destination station an entity should be assigned, it is to be understood that the suggestion provided by the system may be overruled by an operator such as an incident command and control operator or manager.

Optionally, the information in respect of the entity associated with the entity by the at least one mobile device includes location information indicative of the location of the device when the identity of the tag is determined.

The location information may be obtained by the device by means of a global positioning system (GPS) receiver comprised by the device, by reference to a General Packet Radio Service (GPRS) or by any other suitable means. In some embodiments location information may be input to the device by the user, for example in the form of a post code, zip code or other location information.

The mobile device may be configured to provide directions to a user to a particular entity for which an entity record has been established a mobile device based on a current location of the mobile device and the latest location of the entity stored in the entity record.

The system may be configured to determine to which destination station an entity should be assigned in further dependence at least in part on the location of the destination station and the location of the mobile device that was used to read the machine readable tag identifier element.

Optionally, each said at least one mobile device is configured to read the machine readable identifier element of a given tag and to determine whether an entity record already exists corresponding to the identity of the tag, in the event the system determines that an entity record exists, the system being configured to update the entity information corresponding to that tag to include the location of the mobile device that most recently read the machine readable identifier element of that tag.

This feature has the advantage that it enables tracking of the movement of a tag and therefore an entity where mobile devices are provided at different geographical locations. For example a mobile device may be provided at the scene of an incident where an entity that may be a casualty is first identified and a tag attached to the entity as described above, and in addition at one or more casualty staging areas to which casualties may be initially moved, personnel at the one or more staging areas being trained to scan the tags of entities arriving at the staging area to enable movement of the entities to be tracked. Mobile devices may also be carried by the crew of transportation means such as air or road ambulance crew, allowing transportation of entities to be tracked. Mobile devices may also be located at casualty destination stations, personnel at a given casualty destination station being trained to scan the tags of casualties arriving at the destination station, which may be a care centre such as a hospital, leading to a further update in entity location to be made so that the location information in respect of the casualty is visible to an operator or the system.

The system may comprise at least one biometric sensor device configured to be attached to an entity and to communicate wirelessly with the at least one mobile device to provide biometric information in respect of the entity, each said at least one biometric sensor device having a unique identifier associated therewith, the at least one mobile device being configured to associate the unique identifier of the at least one biometric sensor device with the identifier element of the tag attached to the entity thereby to associate a given biometric sensor device with a given entity.

The system may be configured to determine entity status by reference at least in part to biometric information received from the at least one biometric sensor device.

The system may be configured automatically to determine entity status by reference to information received from the at least one biometric sensor device and information input to the at least one mobile device by an operator.

Optionally, the system is configured to determine to which destination station an entity should be sent in further dependence at least in part on the biometric information received by the system from the at least one biometric sensor device associated with the entity.

The system may comprise a storage system remote from the mobile device, the storage system being configured to store the entity records and information in respect of the availability of a plurality of destination stations to accept an entity of a given status, the storage system being configured to determine to which destination station each entity should be assigned.

The storage system may comprise one or more servers. The storage system may comprise at least one server at each of a plurality of locations.

Optionally, the storage system is configured to provide an output indicative of the identity of the destination station to which an entity has been assigned, optionally wherein the storage system is configured to communicate the identity of the destination station to which an entity has been assigned to the at least one mobile device.

Optionally, the storage system is configured to update the corresponding entity record to indicate the identity of the destination station to which the entity has been assigned and to communication the updated entity record to the mobile device.

It is to be understood that the mobile devices may be carried by paramedics associated with a given transportation means such as a road vehicle such as an ambulance, an aircraft such as a helicopter or airplane, or any other suitable transportation means. The mobile device may be provided with information in respect of the transportation means available. This information may be used by the system to determine to which destination station an entity should be assigned.

The system may comprise printing means for generating a print-out including at least some entity information and identification information in respect of the entity corresponding to the entity information.

Optionally, the identification information printed by the printing means comprises a machine readable copy of at least one tag identifier element comprised by the tag associated with the entity.

Optionally, the at least one tag identifier element printed by the printing means comprises a machine readable bar code element corresponding to the bar code element carried by the tag associated with the entity.

Optionally, the tag comprises at least one output device configured to provide one of a plurality of respective different outputs indicative of respective different entity statuses, the tag being configured to receive information indicative of a current status of the entity and to cause the output device to generate a selected one of the plurality of respective different outputs that corresponds to the current entity status.

It is to be understood that the current status of the entity may be one of a predetermined number of possible statuses.

Optionally, the at least one output device is configured to provide at least one of a visual output and an audible output.

Optionally, the at least one output device comprises at least one lamp, and the respective different outputs comprise respective different colours of illumination of the at least one lamp. 7

The at least one lamp may be at least one light emitting diode of any other suitable illumination device. The at least one lamp may illuminate intermittently in order to preserve battery power and/or provide a more readily noticeable indication of entity status. The system may be configured to cause one lamp to illuminate in one of a plurality of different colours to indicate current entity status. Alternatively, a plurality of lamps of different respective colours may be provided, the tag being configured to illuminate the lamp having a colour corresponding to the current entity status.

In a further aspect of the invention for which protection is sought there is provided a method of managing an incident by means of a system, optionally an entity management system, comprising: attaching at least one tag to an entity, the tag having at least one tag identifier element; reading by means of a mobile device at least one said at least one tag identifier element of the tag and storing an identity of the tag, the method further comprising receiving by means of the mobile device entity information being information about the entity and associating the entity information with the entity by reference to the identity of the tag attached to the entity, the entity information including entity status information indicative of a status of the entity, the method further comprising generating by means of the system an entity record in respect of each entity, the entity record comprising the identity of the tag attached to the entity and the entity information, the method further comprising receiving by the system information in respect of the availability of a plurality of destination stations to accept an entity of a given status, the method comprising determining automatically by means of the systemto which destination station an entity should be assigned in dependence at least in part on the entity status.

In one aspect of the invention for which protection is sought there is provided a mobile device configured for use in an entity management system, the mobile device being configured to read a machine readable tag identifier element of a tag attached to an entity to obtain information indicative of an identity of the tag, the mobile device being further configured to receive entity information, the entity information including entity status information indicative of a status of the entity, the mobile device being configured to transmit the information indicative of the identify of the tag and the entity information to a storage system remote from the mobile device.

The mobile device may be further configured to generate an entity record comprising the information indicative of the identity of the tag and the entity information and to upload the entity record to the storage system.

The method may comprise downloading to the mobile device from the server one or more entity records generated by other mobile devices and storing the entity records. 8

In a further aspect of the invention for which protection is sought there is provided a method of processing entity information comprising reading by means of a mobile device a machine readable tag identifier element of a tag attached to an entity to obtain information indicative of an identity of the tag, the method further comprising receiving by means of the mobile device entity information, the entity information including entity status information indicative of a status of the entity, the method comprising transmitting the information indicative of the identity of the tag and the entity information from the mobile device to a storage system remote from the mobile device.

In an aspect of the invention for which protection is sought there is provided a computing system configured for use in an entity management system, the computing system being configured to receive from a mobile device information indicative of the identity of a tag attached to an entity and entity information, the entity information including entity status information indicative of a status of the entity, the computing system being further configured to receive information in respect of the availability of a plurality of destination stations to accept an entity of a given status, the computing system being configured to determine automatically to which destination station an entity should be assigned in dependence at least in part on the entity status information.

The computing system may comprise at least one server, the computing system being configured to store the information indicative of the identity of the tag and entity information in the form of an entity record, the computing system being configured to provide an output indicative of the identity of the destination station to which an entity has been assigned.

The output may be transmitted to the mobile device for display to a user when required.

In a further aspect of the invention for which protection is sought there is provided a method of processing entity information by means of a computing system, comprising receiving from a mobile device information indicative of the identity of a tag attached to an entity and entity information, the entity information including entity status information indicative of a status of the entity, the computing system being further configured to receive information in respect of the availability of a plurality of destination stations to accept an entity of a given status, the computing system being configured to determine automatically to which destination station an entity should be assigned in dependence at least in part on the entity status information.

The computing system may be referred to as a storage system since it is also required to store information. The computing system may comprise a server.

As noted above, the entity management system may be configured to receive information in respect of the availability of a plurality of destination stations to accept an entity of a given status, and to determine 9 automatically to which destination station an entity should be assigned in dependence at least in part on the entity status information.

In a still further aspect of the invention for which protection is sought there is provided a tag configured to be attached to an entity, the tag having at least one machine readable tag identifier element, the tag further comprising at least one output device configured to provide one of a plurality of respective different outputs indicative of respective different entity statuses, the tag being configured to receive information indicative of a current status of the entity and to cause the output device to generate a selected one of the plurality of respective different outputs that corresponds to the current entity status, wherein the at least one output device is configured to provide at least one of a visual output and an audible output.

The at least one output device may comprise at least one lamp, and the respective different outputs comprise respective different colours of illumination of the at least one lamp.

In some embodiments, artificial intelligence may be employed by the system, for example in a computing device such as a storage device, optionally a server. To achieve this, the system may have an artificial neural network (ANN) and a configuration store comprising configuration parameter information relating to the artificial neural network, the artificial neural network being configured in accordance with configuration parameter information, the system being operable to receive input data comprising entity status, entity location, and availably of each of a plurality of destination stations, including destination station location, to pass the input data to the ANN, and to receive an output from the ANN.

Optionally, the ANN is a probabilistic neural network and more specifically a constructive probabilistic neural network.

The input data may further comprise biomedical data received from one or more biomedical sensor devices indicative of at least one biomedical parameter. The biomedical data may be employed in a determination of entity status. The at least one biomedical parameter may be heart pulse rate, blood oxygen concentration, rate of breathing, body temperature or any other suitable parameter.

The mobile device may comprise one of a mobile telephone, a mobile smartphone, a personal digital assistant, a tablet, a laptop computing device or any other suitable mobile device. 10

The ANN may comprise a plurality of layers, the configuration parameter information comprising information relating to the connection weights between the layers of the ANN.

The system may be configured to receive configuration parameter information for the ANN. The system may be configured to store the received configuration information in the configuration store.

The ANN may be implemented by a storage system comprising server arranged to communicate with the at least one mobile device remote from the storage system.

According to an aspect of the invention, we provide a method of processing incident and casualty information comprising the steps of electronically recording such information on a mobile device and associating such information (which may be GIS enabled) by physically attaching one or more unique identifier such as a bar code/NFC/RFID tag to the casualty, which is then scanned to associate with the casualty’s electronic patient record. This process takes little time and can be performed even if the First Responder or victim is wearing a personal protection suit.

The slap band or bracelet that has the unique identifier tag(s) may be colour coded or allow illumination in different colours or flashing modes using a lighting system such as FED in the appropriate colour to the casualty’s triage status to allow easier identification especially in a darkened environment.

The method may comprise the step of entering the data on a hand held device, wherein the step of associating this data with the unique identifying methodology such as bar code/NFC/RFID tag comprises of scanning the tag using the hand held device.

The method may comprise the steps of obtaining the GIS (Geo location) automatically or entering such details manually and entering the incident information (eg METHANE message) indicating the location of the hand held device and associating the location information thus identifying the current location, details and needs of the incident. Multiple METHANE messages may be entered and viewed on the system and devices along with the associated casualty’s details.

Such information captured may include: • Exact location: The precise location of the incident and reference number • Timing and status - eg standby, declared, closed or new. • Type: The nature of the incident, including how many vehicles, buildings and so on are involved • Hazards: Both present and potential • Access: Best route for emergency services to access the site, or obstructions and bottlenecks to avoid 11 • Numbers: Numbers of casualties, dead and uninjured on scene • Emergency services: Which services are already on scene, and which others are required • Digital imagery - this method may also involve capturing digital imagery of the scene which is Geo tagged, time and device stamped prior to transmission to the server or other devices.

The method may comprise the step of transmitting the data with the GIS location identifier to a receiving system. Details including GIS position can be amended at any time.

The location information may also be transmitted to other devices via the receiving system or peer to peer to allow data transparency.

This list of casualties and associated data including GIS location can be viewed on other hand held devices to allow selection and geo location of the patient. As the responders mobile device is GIS enabled the route to the selected casualty is presented.

The method may comprise of scanning the tag which will then allow the mobile device to display the associated electronic record as the casualty moves through the evacuation chain. Once the tag has been scanned, the mobile device may store the tag unique identifier, date, time and location (GIS position) at which the tag was scanned, and optionally additional information such as a digital photograph of the victim and/or injury. This information, which includes the captured GIS position, allows real time tracking of the casualty’s location following scanning of the tag at different stages of movement of the casualty.

This method allow electronic handover of the casualty to a new treatment area or transport service thus ensuring traceability and preventing ‘left behind’ scenarios.

The method may comprise subsequently modifying the data encoded on the electronic patient record which may include reassigning a new triage status.

The method may be performed as part of a triage process including triage sieve and sort methodologies.

According to another aspect of the invention, we provide an apparatus operable to perform a method according to the first aspect of the invention.

The mobile device may comprise a ruggedized Personal Digital Assistant (PDA), mobile phone or a tablet PC with scanner technology such as bar coding, Near Field Communication or RFID and a camera.

The apparatus may include a GPS receiver.

The device may transmit the data in an encrypted form via a variety of communication means such as GPRS, 3/4/5G, ESN, WiFi, Bluetooth, Satellite, tactical radios etc. 12

If such networks are not available the data is cached on the device until communication is re-established.

The data may also be handed over to another party by device to device, device to server, via USB or printing thus guaranteeing data visibility.

The device may also communicate with other devices such as vital sign monitoring devices which may be wearable or other sensor devices via Bluetooth, wireless or wired connectivity.

The invention will now be described by way of example only with reference to the accompanying drawings, wherein:

Figure 1 is a diagrammatic illustration of apparatus according to an embodiment of the present invention;

Figure 2 is a diagrammatic illustration of a method according to an embodiment of the present invention;

Figure 3 is a diagrammatic illustration of a system according to an embodiment of the invention;

Figure 4 is a process flow diagram including a method according to an embodiment of the invention compared to the traditional triage method; and

Figure 5 is a diagrammatic illustration of the workflow engine matching demand to resources in an embodiment of the present invention.

Detailed Description

With reference to Figure 1, the apparatus comprises a mobile hand held device 110, in the present example comprising a tablet with NFC/bar code scanner 112 technology, a ‘tag’ in the form of a wrist/slap band 120 provided with one or more unique identifying elements 121, 123 providing a methodology for the hand held device 110 to uniquely identify that tag, and a receiving system in the form of a computing device 135. The receiving system may be a first incident data receiving system 135 located at the scene of an emergency, for example at an emergency scene command post, such as in a vehicle functioning as a local command post. Alternatively, the computing device 135 may be associated with a fixed (pre-existing) emergency services command/coordination centre, a hospital or any other suitable location.

In the present example, the unique identifying elements of the tag 120 are an NFC/RFID (Near Field Communication/Radio Frequency Identification Device) identifier 121 and a bar code identifier 123. The barcode identifier may be pre-printed onto the tag 121 or in the form of a self adhesive label. The tag be described as having ‘dual factor authentication’ in that it has two means of identification by the hand held device 110, the NFC/RFID identifier 121 and barcode identifier 123.

The tag also has a light emitting diode 122 provided thereon, which is visible when illuminated. 13

As illustrated by arrow 116, the handheld device 110 is operable to scan the NFC identifier 121 by an appropriate radio link when the handheld device 110 is sufficiently close to the tag (wrist band) 110. Advantageously the handheld device 110 has a relatively small portable form factor, a camera, a long battery life and a robust casing to enable the device to be used at an incident site for a prolonged period of time.

As illustrated by arrow 117 the hand held device 110 is further operable to establish a communication link with a first incident data receiving system 135, for example through a GPRS, 3/4G wireless, satellite, short range radio (e.g. WiFi) or telephony link. In the present embodiment the hand held device 110 communicates with the first incident data receiving system 135 via a WiFi link.

It is to be understood that the NFC/RFID identifier 121 and bar code 123 are linked so that either may be employed to identify the casualty. For example, in the event of transfer of the patient from using a slap band 120 to a paper triage card later in the evacuation process, this allows the victim’s electronic record to be reconciled with the replacement paper triage card system.

In the present embodiment, the wrist band/slap band (tag) 120 has an illumination device 122 comprising a light emitting diode (FED) device. The tag 120 also has a radio signal receiver 120R and a battery. In the present embodiment the tag 120 is configured to cause the FED 122 to flash in one of five predetermined “colours” corresponding to the triage status (Pl, P2, P3, P4, dead) of the victim: Pl - red, P2- yellow, P3-Green, P4- blue, dead (deceased)- white. The receiver 120R comprised by the tag 120 receives from the hand held device 110 a signal indicative of the triage status of the victim (identified by the unique identifier code stored by the identifier elements 121, 123) and subsequently causes the FED 122 to flash in the colour corresponding to the received triage status. The receiver comprised by the tag 120 listens substantially continually for a signal indicative of the triage status of victim that the tag 120 is associated with. If the triage status changes, the tag 120 causes the illumination device 122 to emit light corresponding to the instant triage status. Thus the tag 120 listens for signals indicative of tag 120 identifier and corresponding victim status. When the receiver 120R recognises the tag identifier as that of the tag 120 to which the illumination device 122 is attached, the receiver 120R updates (if needed) the colour of the light flashed by the FED to that which corresponds to the triage status.

In some alternative embodiments, instead of having an illumination device 122, the tag may have another means of identifying casualty (victim) status such as a colour coding provided by means of a coloured pen, adhesive label, or a pre-printed colour or other indicator.

The advantage of an illumination device in the form of an FED 122 is that the status of the FED 122 may be set according to the current triage status of the victim. Thus if the victim deteriorates from state P3 to state P4, the illumination device 122 may be changed to flash blue instead of green. In addition, the same 14 tag 120 may be employed for victims in each of the five triage states. As described above, the tag 120 includes a wireless receiver 120R that communicates with the hand held device 110 in order that the colour of the LED 122 may be set. Once set, the LED 122 flashes the colour assigned to the tag 120 until a different triage status is assigned as noted above, in which case the colour of the LED 122 changes to the updated triage status, or the tag receives a command to turn off the LED 122. A method embodying the invention described with reference to Figure 2. At step 1, a wrist band 120 described above is attached to a casualty by a first responder as shown in Figure 1. As discussed above, each wrist band 120 has two unique identifying elements (in the present embodiment an NFC/RFID element 121 and a barcode element 123) so that each wrist band (or ‘tag’) 120 is uniquely identifiable from either element 121, 123.

In the present embodiment, the unique identifying elements 121, 123 of a given tag 120 have the same unique identifier code in the form of a sequence of alphanumeric characters such as “AAAA0001”, “AAAA0002”, and so forth.

At step 2, the first responder (for example a paramedic or other attendant medical person) enters casualty information into the hand held device 110, the casualty data including: 1. triage status data (Pl, P2, P3, P4 or Dead) data; 2. vital sign data; 3. whether a combat tourniquet has been applied to the casualty; 4. location of the casualty relative to the ground (e.g. GPS coordinates, latitude/longitude location coordinates) or entry point of the casualty holding area; 5. casualty status (eg hostile, victim, team, adult, child etc); 6. imagery (e.g. one or more photographs identifying the casualty and/or injury related, e.g. showing the site of injury of the casualty such as an area of open wound, a bum, or other injury).

In the present embodiment, location information at part (4) of step 2 is automatically displayed by the device 110 in the form of GPS coordinates obtained by reference to a GPS system comprised by the device 110 which the first responder may choose to accept and, if desired, add additional information to assist location of the casualty. In some embodiments, the GPS system also provides height information relative to ground, which may be useful in locating a casualty in a multi-storey building. The first responder may also input information in respect of the location of the casualty within a building such as an indication as to on which floor of the building the casualty is located. In some embodiments, when a first responder selects to view details of a casualty for which a casualty record has been generated and 15 stored by a hand held device 110, the device 110 may indicate the relative location of the casualty with respect to the first responder, including relative height information allowing the first responder to determine whether the casualty is on the same floor of a building as the first responder, or is above or below the first responder.

At step 3 the entries into the hand held device 110 are confirmed and, and at step 4, the one of the identifiers 121, 123 of the tag 120 that has been attached to the casualty is scanned and the data is associated with the tag 120 transmitted over wireless link 117 to the first incident data receiving system 135. If the scan of the identifier 121, 123 by the hand held device 110 is successful an audible and vibration signal is produced along with a confirmatory message on screen. Confirmation is also provided when the casualty data has been uploaded to the first incident data receiving system 135. Once the scan of the identifier 121, 123 has been successfully performed the screen 110S of the hand held device reverts back to its casualty detail capture state.

At step 6 the next casualty is processed in the same way resulting in a list of casualties stored on the device 110 and first incident data receiving system 135. The list of casualties may be filtered according to one or more predetermined criteria such as treatment priority, the time at which the casualty was processed, identity of the hand held device 110 that was used (each hand held device 110 may have a unique identity enabling the particular device 110 used and, in turn, the identity of the operator of the device 110 such as the person’s name or unique identifier, to be determined. Only live casualties are shown initially on the devices 110. However after the event the GIS information of the dead may be viewed to allow retrieval and forensic reconstruction including timelines.

As shown in FIG. 2 at step 7, a user of a hand held device 110 may select to display a list of all casualties on the screen 110S of the device 110 in line with the filtering process. At step 8 the user may select a particular casualty from the list and the GIS location in relation to the device may be displayed on the screen in the form of a location map together with directions. The directions may be provided with respect to the instant location of the device 110, the instant location being determined by reference to information obtained by means of GPS functionality carried by the device 110. Other sources of positional information may be useful, for example by reference to GPRS (General Packet Radio Service) positional information. This feature allows the first responder to locate the chosen casualty.

At step 9, upon locating the casualty the identity of the casualty is confirmed by scanning the identifying element 121, 123 ofthe casualty’s wristband 110.

At step 10 The first responder may then choose to handover the casualty to another care giver, thus assigning the casualty to another care process. At step 11, in the event the casualty is handed over to 16 another care giver / care process, the casualty is removed from the active patient list on the devices 110, and the number of remaining casualties at the scene is updated, along with their location.

It is to be understood that, when devices 110 upload data to the first incident data receiving system 135, the first incident data receiving system 135 then transmits updated patient lists to each hand held device 110. Each device 110 thus has a substantially identical patient list.

Each device 110 also allows the triage status of a given patient to be updated following reassessment. At step 12 the user (first responder) of the device 110 can rescan the identifying element 121, 123 of a tag 120 and updating the triage status data, i.e. whether the casualty is to be considered Pl, P2, P3, P4, or is dead. The data in respect of that casualty is then uploaded to the first incident data receiving system 135 and, in turn, the data stored on each hand held device 110 is updated following transmission of the updated information to each device 110. Subsequently the tag can be scanned by another hand held device 110 as illustrated in step 2, when the casualty is progressing through the evacuation pathway allowing identification and viewing the relevant electronic patient record and tracking of the casualty.

Once a tag 120 has been attached to a patient and data entered into a hand held device 110, the First Responder may decide to monitor one or more vital signs of the patient. The first responder may do this by associating the casualty record stored in the device 110 (and in turn the first incident data receiving system 135) with one or more wireless vital sign monitoring devices 128 (FIG. I) such as a Bluetooth (RTM) - enabled biometric plaster, an electrocardiogram (ECG) monitoring device and/or any other suitable vital sign monitoring device 128. At step 14 the vital sign monitoring device 128 is attached to the casualty. At step 15 the hand held device 110 carried by the first responder communicates wirelessly with the vital sign monitoring device 128 which has a unique identifier that is transmitted to the hand held device 110 by the vital sign monitoring device 128 and is associated with the casualty record stored by the hand held device 110. At step 16 the first responder confirms the unique identifier of the vital sign monitoring device 128, which the hand held device 110 displays on the screen 110S when a communication link has been established with a vital sign monitoring device 128. It is to be understood that the unique identifier is also written on the vital sign monitoring device 128, the operator of the hand held device 110 merely confirming the that the unique identifier written on the vital sign monitoring device (such as an alphanumeric character string) corresponds to that displayed on the screen 110S. At step 17 the device 110 shows a summary of the vital sign information provided by the vital sign monitoring device 128, e.g. pulse rate, respiratory rate, ECG data (electrocardiogram information such as an ECG trace), temperature, etc. At step 18 an algorithm run by the hand held device (in built algorithm) monitors any deterioration of the casualty by reference to the data received from one or more vital sign monitoring devices 128 attached to a given casualty and generates one or more alerts to inform a first responder that 17 the casualty requires attention. In the present embodiment the hand held devices 110 are configured to generate both visible and audible alerts.

As shown at step 19 another casualty may be selected and monitored by the same method as in step 13.

As shown at step 20 the first responder may select to display a summary screen on the screen 110S of a given device 110, which allows a summary of the vital signs of all casualties to be displayed and therefore monitored by any first responder having a hand held device 110.

As shown at step 21, if an alert is generated by a hand held device 110 a first responder can display greater detail in respect of the vital signs of the casualty for which the alert has been generated selecting the casualty (e.g. by name) from the list. This screen also allows greater casualty information to be displayed.

As shown at step 22, the first responder can enter further casualty information from one or more menus that may be displayed by the device 110.

In embodiments of the present invention, the casualty data stored in the electronic patient record may contain such information as may be appropriate, for example one or more of the following: • Casualty’s name, address and date of birth: • Chief complaint information; • Casualty’s relevant medical history, medication, allergies, etc; • Cardiac, respiratory, circulation and trauma information; • National Early Warning Score data may be collated using an embedded algorithm following entry of associated data either manually or via a wireless connection. The scoring system may be modified depending on the scenario e.g. whether chemical exposure has taken place at the scene. An associated alert can be generated when the device automatically detects casualty deterioration. • Drugs administered at the scene; • Other medical intervention at the scene. • Digital imagery and data from connected Point of Care/monitoring devices such as vital sign devices 128.

As shown at step 23 the first responder may transmit, print or electronically handover the selected casualty (or patient) details to other entities such as to medical transport providers such as ambulance crew. As shown at step 23, a paper triage card 137 (FIG. 1) may be printed from the hand held device 110, in the present embodiment by transmitting a print request to a printer 135P via the first incident data 18 receiving system 135 (FIG. 1). In some embodiments the hand held device 110 may communicate directly with a printer 135.

As shown at step 24, at handover the slap band 110 may be replaced by a paper triage card. In some situations the slap band 110 may be removed from the patient for disposal or reuse, for example following reconditioning such as cleaning and batter replacement.

To facilitate transfer of the victim’s electronic record one or both of the identifying elements 121, 123 of the slap band 110 may be scanned, e.g. bar code 123, and a unique identifier 137B displayed on the paper triage card 137 (e.g. in the form of a bar code 137) may also be scanned, and the two bar codes 123, 137B associated with the selected patent record on the hand held device 110 (also stored in the first incident data receiving system 135). Thus the unique identifier of the bar code 137B on the paper triage card 137 is associated with the bar code 123 on the tag 120 using the paramedic’s hand held device’s bar code scanner feature.

In some embodiments, when the paper triage card 137 is printed, a bar code is printed thereon that carries the same unique identifier code as the bar code 123 of the tag 120, for example the two bar codes may be identical.

As described above, the data input to each hand held device 110 in respect of a given casualty is transmitted to the first incident data receiving system 135 by means of a wireless connection. In some embodiments, in addition or instead, the data may be transmitted peer to peer, i.e. between devices 110 directly, in addition or instead.

The information stored by each hand held device 110 in respect of a given casualty may be referred to as a casualty record. The casualty record may be transmitted via the first incident data receiving system 135 to other hand held devices 110 as noted above. In addition, the first incident data receiving system 135 may transmit the casualty records to one or more casualty destination stations such as one or more receiving hospitals, to control or command centres associated with emergency services such as police, fire brigade, ambulance and/or any other emergency services, and control centres.

To allow for advanced planning, as described above casualty data such as casualty records can be transmitted from a given hand held device 110 to the first incident data receiving system 135 and back to any other devices 110 at the incident to allow complete data visibility at the incident in the form of a map showing a complete picture of the location of casualties and resources as well as a summary of casualty numbers and states. Further, the data held on a given hand held device 110 can be modified, for example to reflect care that the casualty has received following the initial input of data to a device 110 when the tag (120) was attached to the casualty. 19

The hand held device 110 acquires its location, for example through the use of the Global Positioning System (GPS) and records this data on the electronic casualty (patient) record linked to the unique identifier of the tag 120 attached to the casualty 100 thus identifying the current location of the casualty if the casualty is moved and the wrist band scanned again by a hand held device 110 as in step 23 of FIG. 2.

The casualty list and map of casualty location stored by each device 110 is updated automatically to reflect a change in casualty information including location input to any one of the hand held devices 110 via the first incident data receiving system 135.

As noted above, each hand held device 110 transmits the casualty data, the location information and tag unique identifier to the first incident data receiving system 135. FIG. 3 is a schematic illustration of a casualty management system 101 of which the elements of FIG. 1 form part. As shown in FIG. 3, the first responder hand held mobile devices 110 communicate with a first incident data receiving system 135 at the location of the incident.

In the embodiment shown, further second level hand held mobile devices 131 are carried by personnel at an initial treatment station. In the present embodiment the second level mobile devices 131 have similar functionality to the first level mobile devices 110 carried by the first responders but may have additional functionality. The first and second level hand held mobile devices 110, 131 are in communication with the first incident data receiving system 135 and receive the casualty records generated by means of the first level mobile devices 110 as described above. When a person at the initial treatment station approaches a casualty, the person scans one of the unique identifying elements 121, 123 of the tag 120 attached to the casualty using their second level hand held device 131, causing the casualty record stored by the device 131 to be updated with the instant location of the device 131. The change in casualty record is then reflected across all first and second level devices 110, 131 via the first incident data receiving system 135.

Third level hand held mobile devices 133 may be carried by casualty transport personnel as shown in FIG. 3. These devices 133 are substantially identical to the second level hand held mobile devices 131 and may be carried by medical personnel accompanying a casualty during transportation to a destination station.

Each hand held device 110, 131, 133 may also transmit the casualty information, e.g in the form of updated casualty records and/or the location information to a further receiving system (in addition to the first incident data receiving system 135), for example to a receiving system 161 at a co-ordinating command station located away from the scene of the incident, optionally via the first incident data receiving system 135 as described in more detail below. 20

In the present embodiment the hand held devices 110, 131, 133 have access to the location and capacity of casualty destination stations 147, 149 such as hospitals that may receive casualties in order to allow better evacuation planning. The hospitals may include care centres able to provide treatment to acute casualties (“acute centres”) 147 and care centres able to provide treatment to non-acute casualties (“nonacute centres”) 149.

The subsequent triage steps depend on the assessment made by the medic attending to the casualty (patient) who scans the casualty’s wrist band 120 to allow updating the relevant record on the device 110. Where the casualty (patient) 100 can be left at the site, the casualty 100 may subsequently be attended to and details of the subsequent treatment entered into a hand held device 110, 131, 133 carried by the person delivering the treatment, the person delivering the treatment being required to scan the tag 120 associated with the casualty in order to associate the data with the correct casualty. If it is decided to move the casualty 100 away from the site, then the casualty 100 may be moved to a transport staging area where the casualty’s tag 120 is scanned by a third level device 133 and then sent to a suitable casualty destination station such as an acute care centre 147 or a non-acute care centre 149. At the arrival at the care centre 147, 149, the unique identifier 121, 123 of the casualty’s tag 120 may be read by a care centre hand held device 141 in order to view the associated electronic patient record of the casualty that was generated at the scene of the incident by a first level mobile device 110 (or a second or third level device 131, 133 depending on the availability of medical personnel).

It is to be understood that if the casualty 100 can be treated at a field centre close to the MCI site, e.g. by initial treatment personnel carrying the second level hand held devices 131, the casualty is attended to at the field centre. Data reflecting the casualty’s treatment is entered into the electronic patient record via the device 131. The casualty's location information can also be updated.

The method and apparatus as described herein are thus advantageous in that they protect the integrity of the obtained casualty information and ensures that it is not immediately separated from the casualty. It protects casualty confidentiality as the data held securely on the hand held device 110, 131, 133, 141 or downloaded from the service once the unique identifiable tag 120 has been scanned. The tag 120 can only be read by an appropriate person using a suitable hand held device 110, 131, 133, 141 and indeed the data can be protected by requiring a password or other access restriction. Any suitable handheld device may be used, such as a smart phone, tablet PC or any other suitable device. The unique identifying tag 120 may be attached to the casualty in any other suitable way if desired, such as a neck band or ankle strap. A system for responding to a mass casualty incident which uses the apparatus is described by way of an example with reference to Figure 2. 21

Figure 3 illustrates a three tier major incident management system according to an embodiment of the present invention. The top level of control, often referred to as "Gold Command", includes the operational command local server 161 and terminals 163 that enable viewing of data and input of commands. This is the top level of command and control and is responsible for co-ordinating the strategic allocation of resources for dealing with the incident. The command may also make operational decisions such as to which hospitals casualties should be sent. Gold Command 1 may also be responsible for receiving other data and communicating information to other organisations, particularly to a responding hospital. The server 161 may receive command and control system information such as the location of ambulances and emergency services personnel and enable communications with those personnel such as electronic messages to be sent and received.

The server 161 may also receive meterological information for example from a national or local meterological (MET) office.

In the example shown in FIG. 3 the care centres each have a local server 147 which communicates the information to and from the operational command local server 161 at the Gold Command. The care centre local server 147 may in turn pass and receive information to and from a health care provider's apparatus, such as a hand held devices 141, the data system of a responding department, such as the accident and emergency department 143, and the local co-ordinator 145 such as a major incident local coordinator. A computing device 141, 143, 145 at a care centre 147, 149 such as one accessible to an ambulance liason officer such as a hospital ambulance liason officer (HALO) or hospital staff s device 141 may have one or more of the following functions in some embodiments: a. Able to enter resources available prior/during event such as the number of beds available in an intensive care unit (ICU), acute care ward or other resources available such as operating theatres or incubators; b. Scan the tag 120 attached to a casualty 100 on arrival in order to confirm admission and optionally update the casualty record; c. If victims make their own way to hospital outside the Triage process a hand held device 141 or other device can perform a triage process in order to generate a casualty record for the casualty, enabling the casualty to be entered into (or “logged by”) the system 101 so system users have visibility of the casualty 100; d. On admissions all casualties may have a photograph taken of them and demographic details recorded, for example in their casualty record, which may be held by a ‘Casualty Bureau’ to allow relatives to locate the location of the casualty. The Casualty Bureau may have access to facial recognition 22 software that allows a photo of a casualty submitted by a friend or relative to be scanned and matched to images of casualties stored in casualty records, allowing matching of casualties with relatives thus speeding up reuniting of casualties with friends or relatives.

The information such as casualty records may be supplied to other bodies, such as the local health organisations such as non-acute care centres 149 and other local hospitals or organisations offering none acute care. Information may also be transmitted to other systems and organisations, such as the ambulance service 8, police 9, fire service 10 and news organisations 11 respectively.

Gold Command communicates with the tactical control level, referred to as Silver Command where the first incident data receiving system 135 is located. The role of Silver Command is to control operational resources at the site. Silver Command will be provided with appropriate communication resources preferably a wireless connection 13 between the local mobile devices 110, 131, 133, 141 and the first incident data receiving system (server) 135 as illustrated.

At the operational level, the teams responsible for the treatment of casualties and their transfer to the hospital as appropriate are referred to as Bronze Teams, and may include a team of first responders and paramedics 15 carrying the first level devices 110, a casualty clearing station 16 where personnel carry the second level devices 131, and a transport and site management team 17 carrying the third level devices 133. As shown, each of the members of the Bronze Teams are provided with suitable hand held devices 110, to enable them to transmit the casualty records to Silver Command (first incident data receiving system 135) by suitable link, in the present embodiment a WiFi link, the casualty records then being transmitted to Gold Command (operational command local server 161).

Accordingly, the casualty information obtained, stored using the device 110 and associated with the tag 120 is also made available to a central command control operation, the Gold Command. The Gold Command will be aware of hospital bed capacity information for paediatric, neurological, bums, general, orthopaedic trauma, ITU, vascular and isolation patients and other information such a facilities available supplied by the hospital system 147, 149 from the major incident co-ordinator 145. The allocation of hospital beds can be co-ordinated based on casualties who have been sent to hospital 147, 149 by the transport officer 17 of the relevant Bronze Team. The lists of casualties can be aggregated, used to track the location of casualties and keep track of the numbers and statuses of the casualties. To facilitate transport of casualties, Gold Command may also use other information, such as lists of transport access routes and rendezvous points for emergency service vehicles at the incident site, and weather information from an authoritative source such as a MET office as described above, which may be particularly important where a casualty incident includes a chemical or nuclear incident. The information allows Gold Command to therefore instruct the Bronze Team with the relevant transport officer as to where casualties 23 should be sent, using the transport information and hospital capacity and status information received from the hospitals. It will be apparent that by scanning the casualties’ tag 120, associating that data with the position and sending the data to Gold Command, the position and status of individual casualties can be easily updated and maintained, and resources efficiently allocated. FIG. 5 is a flow diagram illustrating operation of a server based work flow engine that allows matching of capacity and demand and utilises GIS information of the incident and receiving facilities such as hospitals in the event of large numbers of casualties from multiple locations requiring care in multiple hospitals. In the present embodiment this function is performed by the operational command local server 161 although the function may be performed by another server.

At step SI, the server 161 receives data on available resources from hospital personnel using hand held devices 141.

At step S2 the data is stored on the server 161 and updated if resources change.

At step S3 the specific configuration required by the scenario is loaded into the work flow engine e g. scale of incident and specific incidents e.g. chemical accidents.

At step S4 data is uploaded from the first responders handheld devices 110. This data may include as an example triage status, GIS location, electronic patient record data and inputs from various biometric sensor devices 128. Data from second and third level devices 131, 133 is also uploaded if available.

At step S5 the workflow engine then loads standard operating procedures and passes in input data as previously described. It then executes the SOP workflow.

At step S6, if the logic rules are satisfied, then step S8 is executed.

At step S8, appropriate end users’ devices 131, 133 such as the transport office or Silver Command are informed to match the allocations. In some embodiments the first responder devices 110 may also be informed.

At step S9, if necessary the measurement devices involved in the process can be updated to collect new data.

If the logic rules are not satisfied at step S6 then at step S7 there is a manual over ride. For example if hospital A does not have the appropriate facility but is nearest compared to hospital B the selected casualties will be directed to hospital B which does have the appropriate facilities. If the resources are overwhelmed the workflow engine will select a different hospital depending on number and types of casualties, distance from the incident and facilities available.

The safety of the casualty themselves is improved and the chance of the casualty information (e.g. in the form of casualty records) being lost causing a delay in treatment or the possibility of wrong treatment is reduced, and the method and apparatus also helps ensure efficient allocation of medical resources to the casualty and most importantly track each patient to avoid lost patients. As the wrist band 120 is 24 suitably rugged and is physically attached to the casualty 100, the chance of the information being lost is lowered, whilst the transmission of casualty information to a receiving station or system such as a hospital 147, 149 can speed up the treatment ofthe casualty and planning for the arrival of the casualty, thus allowing efficient handling of the casualties from the MCI. By logging a physical location associated with each casualty 100, should the casualty be in an unsuitable condition to be moved immediately, the casualty 100 can then be subsequently found by an appropriate medical team using the supplied position information.

In this scenario the responding medical team equipped with hand held devices 110, 131, 133 can view the list of triaged casualties according to their category. Once the casualty has been selected the GIS position relevant to the responder is viewed and the appropriate route selected. Once the casualty has been located the identifier element 121, 123 of the tag 120 is scanned to make a positive identification.

The method also allows the identified casualty’s vital signs to be monitored using a vital sign monitoring device 128 connected wirelessly to the hand held device 110, 131, 133. The association with a particular casualty allows multiple monitoring of casualties using different wireless devices 110, 131, 133 to be used.

The hand held device 110, 131, 133 allows the vital signs of multiple casualties to be viewed at the same time. If a vital sign deteriorates the paramedic can be alerted and act accordingly.

If the victim 100 is a fatality, the GIS location similarly allows subsequent recovery of the body. The stored position information from a number victims of the incident can be used in subsequent investigation and forensic reconstruction of the incident.

In the event of non-injury the solution allows the details of non-injured survivors to be collected at the survivor reception centre and a unique code and contact number issued to allow traceability and enhance victim support after the incident. FIG. 4 shows a comparison of steps that are employed in a traditional triage process (steps 1A to 7A compared with an embodiment of the present invention (steps 1A and 2B to 9B).

At step 1A a first responder such as a paramedic attends to a victim or casualty 100.

At step 2A the first responder selects a slap band and attaches it to the victim 100.

It is noted (step 3A) that no victim details or vital signs are collected in known triage processes.

At step 4A the patient 100 is moved to a clearing station for handover to an ambulance service./

At step 5A a paramedic replaces the slap band with a paper triage card and starts filling in information. 25

At step 6A the patient 100 is transported to a hospital 147, 149.

At step 7A a manual handover of the victim 100 and trage card takes place.

In embodiments of the present invention, following step 1A then at step 2B a first responder attaches a slap band 120 according to an embodiment of the present invention to the victim 100 and enters data in respect of the victim into a hand held device 110.

At step 3B the first responder operates the hand held device 110 so as to read an identifier element 121, 123 of the slap band 120 such as a NFC element 121 or bar code 123. A unique identifier carried by the identifier element 121, 123 is associated with the victim data entered into the device 110. The data may be referred to as triage sieve status data.

At step 4B the device 110 acquires GPS location information and stores information indicative of device location in the patient record together with the time and date. The first responder may also attach a biometric sensor device 128 to the casualty (step 5B)and cause the device 128 to communicate with the hand held device 110 in order to receive an identifier of the biometric sensor device 128 and associated the sensor device 128 with the hand held device 110. The hand held device 110 may automatically upload the information acquired (slap band 120 identifier element 121, 123 unique identifier, casualty information, biometric sensor device identity and data acquired from the sensor device 128) to a storage device such as a server 135.

At step 6B the victim 100 is moved a clearing station (if not already at one) for handover to a transportation service such as a road or air ambulance service.

At step 7B a user (e.g. paramedic) associates the electronic casualty record generated by the hand held device 110 with a paper record (“triage card”) for example by printing all or part of the electronic record, or simply associates an identifier pre-printed on a paper card with the identifier of the slap band 120, the paper card then accompanying the casualty to the hospital or care centre.

At step 8B the casualty is transported to the hospital or care centre.

At step 9B, upon arrival at the destination the triage card is scanned (e.g. a bar code printed thereon is scanned) and data uploaded to hospital electronic patient records.

Some embodiments of the present invention may be understood by reference to the following numbered paragraphs: 1. A method of processing patient information comprising the steps of physically attaching a tag with a unique identifier to the casualty, obtaining casualty data, and associating the electronic patient record with a unique identifier tag on the casualty. 26 Ί. A method according to clause 1 comprising the step of entering the data on a handheld device, wherein the step of associating the data with the tag comprises using a scanner on the handheld device which can be used in personal protection suits. 3. A method according to clause 1 or clause 2 further comprising the step of obtaining location information indicating the location of the handheld device and associating the location information with the tag. 4. A method according to any one of clauses 1 to 3 wherein an electronic patient record is associated with the unique identifier tag. 5. A method according to any one of clauses 1 to 4 comprising a step of transmitting the data to a receiving system or in the event of loss of communication storing the data on the devices locally which may communicate using a local network. 6. A method according to clause 5 where dependent on clause 4 further comprising the step of transmitting the identifier with the data. 7. A method according to clause 5 or clause 6 wherein dependent directly or indirectly on clause 3 comprising the step of transmitting the location information to the receiving system. 8. A method according to any one of the preceding clauses further comprising subsequently modifying the data in the appropriate electronic patient record by scanning the casualty tag. 9. A method according to any one of the preceding clauses comprising the step of subsequently scanning the tag, thus positively identifying the casualty and handling the casualty accordingly. 10. A method according to clause 8 or clause 9 comprising the step of updating the location information and transmitting the updated location information to a receiving system. 11. A method according to any one of the preceding clauses wherein the method is performed as part of a triage process including the embedding of automated triage algorithms (eg CBRNE and Paediatric) including image analysis techniques to speed up the triage process and analysis of vital signs eg selecting the combat tourniquet application thus automatically identifying the casualty as Pl. 12. A method mobile that allows the capture of triage status (Pl, P2, P3, P4, Dead), victim identification (hostile, victim, team, unknown), photo identification, CAT application, pain medication and location including GIS location which is transmitted to the control center. 13. A method that allows positive victim identification alert to allow witnesses to be rapidly traced and identified to aid investigations. 27 14. A method to locate and determine the capacity of serving hospitals and other facilities. 15. A method of viewing multiple casualty details on multiple devices which are geo tagged to allow dynamic tracking of the user and static tracking of the casualty and allowing all users to see all data which may involve mapping technology. 16. A method that allows the filtering of multiple cases including a search facility in order to manage large numbers of casualties according to various filters such as geo location, severity, time, incident, device, status, type etc. 17. A method of displaying a list of the triaged casualties with their triage status, time of triage and location that can be viewed on all devices to allow their geo location to be identified in comparison to the responder’s device to allow navigation to the selected casualty. 18. A method of identification of the casualty is confirmed by scanning the casualty’s bar code. If the wrong casualty is selected the responder is informed of the scanned casualty’s correct identification. 19. A method if required to allow wireless monitoring of multiple casualties vital signs which can be commenced by associating the wireless monitoring device to the patient record and allow simultaneous monitoring of multiple patients with an alerting function in the event of patient deterioration. 20. A method of transmitting supplementary incident information such as but not exclusively a METHANE or 9 Liner message. 21. A method of capturing the GIS position on hand held devices of incident details such as but not exclusively of responding assets, zones and routes. The GIS location also allows the nearest hospitals with their status/facilities to be displayed. 22. A method of displaying GIS positions of the responding assets, and incident details such as access routes on hand held devices and web service maps. 23. A method transmitting and displaying incident and casualty details including GIS information on all devices associated with the responding emergency services and facilities using a secure web service which allows identification and tracking of the casualty including the ability to remove casualties from all lists and maps once removed or allocated away from the incident 24. A method that allows a server which may be remote or accessed via the cloud which has an embedded work flow engine that interrogates data from the mobile devices and available resource data from the emergency services and hospitals to allow embedded artificial intelligence work flow engine to allocate the appropriate resources to cope with the demand depending on the defined scenarios to avoid surge and misallocation of resources. 28 25. A method that allows the details of non-injured casualties to be collected at the survivor reception centre and a unique code and contact number to allow traceability and enhance victim support after the incident 26. A method that allows 2 unique identifiers to be linked to the same electronic record by scanning each unique identifiers when switching from a slap band to a paper triage card. 27. A method substantially as described herein and/or with reference to the accompanying drawings. 28. An apparatus to perform a method according to any one of the preceding clauses. 29. An apparatus according to clause 2 wherein the handheld device comprises a Personal Digital Assistant (PDA), mobile phone or a tablet PC with scanning technology and camera functionality which may be voice activated or allow manual input through a touch screen. 30. An apparatus according to clause 1 wherein the unique identifier tag comprises a bar code, NFC or RFID tag. 31. An apparatus according to clause 1 wherein the tag is mounted on a wrist band to be attached to the casualty's wrist. 32. An apparatus according to any one of clauses wherein the apparatus includes a GPS receiver and where suitable analysis of data from embedded or connected sensors allows real time tracking indoors independent of GIS information in order to allow real time monitoring and coordination of assets. 33. An apparatus that has a wireless or Bluetooth connection to allow secure connectivity with monitoring devices, sensors and point of care devices. The input of which may change the triage status and alert the responder appropriately. 34. The system allows integration of data with Patient Administration Systems, Point of Care devices, operating theatre digital technology and allows Command Centres to assess, analyse, manage and provide support to incidents worldwide. 35. Such data may be analysed using work flow engines or machine learning systems to automate capacity and demand management.

Some embodiments of the present invention provide a method of processing incident and/or patient data and an apparatus for processing such information including tracking of casualties.

The current (known) triage system suffers from the following short comings: • Recording details on a paper tag which may be displaced or removed in error leading to potential confusion or mistreatment. 29 • Time delay in the process of triaging casualties using paper based system. • Lack of visibility of data • Inability to monitor multiple casualties • Difficulty in allocating resources

The proposed solution serves as a robust electronic means of positively identifying and managing victims and transmitting that information to aid better decision making.

It may involve capturing data at the scene, from associated devices associated with specific casualties and from supporting emergency services and receiving hospitals. The data may be collated on a server where a work flow engine allocates the appropriate resources depending on the defined scenarios.

When used in this specification and claims, the terms "comprises" and "comprising" and variations thereof mean that the specified features, steps or integers are included. The terms are not to be interpreted to exclude the presence of other features, steps or components.

The features disclosed in the foregoing description, or the following claims, or the accompanying drawings, expressed in their specific forms or in terms of a means for performing the disclosed function, or a method or process for attaining the disclosed result, as appropriate, may, separately, or in any combination of such features, be utilised for realising the invention in diverse forms thereof. 30

Claims

1. An entity management system (101) comprising: at least one tag (120) configured to be attached to an entity (100), the tag (120) having at least one machine readable tag identifier element (121, 123); at least one mobile device (110) configured to read the tag identifier element (121, 123) of the tag (120) and determine an identity of the tag (120), the at least one mobile device (110) being further configured to receive entity information and to associate the entity information with the entity (100) by reference to the identity of the tag (120) attached to the entity (100), the entity information including entity status information indicative of a status of the entity (100), the system (101) being configured to generate an entity record in respect of each entity (100), the entity record comprising the identity of the tag (120) attached to the entity (100) and the entity information, the system (101) being further configured to receive information in respect of the availability of a plurality of destination stations (147, 149) to accept an entity of a given status, the system (101) being configured to determine automatically to which destination station (147, 149) an entity (100) should be assigned in dependence at least in part on the entity status information.

2. A system according to claim 1 configured to provide an output indicative of the identity of the destination station (147, 149) to which an entity has been assigned.

3. An entity management system (101) according to claim 1 or claim 2 wherein the information in respect of the entity (100) associated with the entity (100) by the at least one mobile device (110) includes location information indicative of the location of the device (110) when the identity of the tag (120) is determined.

4. A system according to claim 3 configured to determine to which destination station an entity (100) should be assigned in further dependence at least in part on the location of the destination station and the location of the mobile device (110) that was used to read the machine readable tag identifier element (121, 123).

5. A system according to claim 4 wherein each said at least one mobile device (110) is configured to read the machine readable identifier element (121, 123) of a given tag (120) and to determine whether an entity record already exists corresponding to the identity of the tag (120), in the event the system determines that an entity record exists, the system being configured to update the entity information corresponding to that tag (120) to include the location of the mobile device (110) that most recently read the machine readable identifier element (121, 123) of that tag (120).

6. A system (101) according to any preceding claim further comprising at least one biometric sensor device (128) configured to be attached to an entity (100) and to communicate wirelessly with the at least one mobile device (110) to provide biometric information in respect of the entity (100), each said at least one biometric sensor device (128) having a unique identifier associated therewith, the at least one mobile device (110) being configured to associate the unique identifier of the at least one biometric sensor device (128) with the identifier element (121, 123) of the tag (120) attached to the entity (100) thereby to associate a given biometric sensor device (128) with a given entity (100).

7. A system (101) according to claim 6 configured to determine entity status by reference at least in part to biometric information received from the at least one biometric sensor device (128).

8. A system (101) according to claim 7 configured automatically to determine entity status by reference to information received from the at least one biometric sensor device (128) and information input to the at least one mobile device (110) by an operator.

9. A system (101) according to any one of claims 6 to 8 wherein the system (101) is configured to determine to which destination station an entity (100) should be sent in further dependence at least in part on the biometric information received by the system (101) from the at least one biometric sensor device (128) associated with the entity (100).

10. A system (101) according to any preceding claim comprising a storage system (161) remote from the mobile device (110), the storage system (161) being configured to store the entity records and information in respect of the availability of a plurality of destination stations (147, 149) to accept an entity of a given status, the storage system (161) being configured to determine to which destination station (147, 149) each entity (100) should be assigned.

11. A system (101) according to claim 10 wherein the storage system (161) is configured to provide an output indicative of the identity of the destination station (147, 149) to which an entity has been assigned, optionally wherein the storage system is configured to communicate the identity of the destination station (147, 149) to which an entity has been assigned to the at least one mobile device (110), optionally wherein the storage system (161) is configured to update the corresponding entity record to indicate the identity of the destination station (147, 149) to which the entity has been assigned and to communication the updated entity record to the mobile device (110).

12. A system according to any preceding claim comprising printing means (135P) for generating a print-out (137) including at least some entity information and identification information in respect of the entity corresponding to the entity information.

13. A system according to claim 12 wherein the identification information printed by the printing means (135P) comprises a machine readable copy of at least one tag identifier element (123) comprised by the tag (120) associated with the entity.

14. A system according to claim 13 wherein the at least one tag identifier element (123) printed by the printing means (135P) comprises a machine readable bar code element (123) corresponding to the bar code element (123) carried by the tag (120) associated with the entity (100).

15. A system according to any preceding claim wherein the tag (120) comprises at least one output device (122) configured to provide one of a plurality of respective different outputs indicative of respective different entity statuses, the tag (120) being configured to receive information indicative of a current status of the entity and to cause the output device (122) to generate a selected one of the plurality of respective different outputs that corresponds to the current entity status.

16. A system according to claim 15 wherein the at least one output device (122) is configured to provide at least one of a visual output and an audible output.

17. A system according to claim 15 or claim 16 wherein the at least one output device (122) comprises at least one lamp, and the respective different outputs comprise respective different colours of illumination of the at least one lamp.

18. A method of managing an incident by means of an entity management system (101), comprising: attaching at least one tag (120) to an entity (100), the tag (120) having at least one tag identifier element (121, 123); reading by means of a mobile device (110) at least one said at least one tag identifier element (121, 123) of the tag (120) and storing an identity of the tag (120), the method further comprising receiving by means of the mobile device (110) entity information being information about the entity and associating the entity information with the entity (100) by reference to the identity of the tag (120) attached to the entity (100), the entity information including entity status information indicative of a status of the entity (100), the method further comprising generating by means of the system an entity record in respect of each entity (100), the entity record comprising the identity of the tag (120) attached to the entity (100) and the entitv information the method further romnrisiiiff reeeivina hvthe svstem information in resneet of the availability of a plurality of destination stations to accept an entity of a given status, the method comprising determining automatically by means of the system (101) to which destination station an entity (100) should be assigned in dependence at least in part on the entity status.

19. A mobile device (110) configured for use in an entity management system (101), the mobile device (110) being configured to read a machine readable tag identifier element (121, 123) of a tag (120) attached to an entity (100) to obtain information indicative of an identity of the tag (120), the mobile device (110) being further configured to receive entity information, the entity information including entity status information indicative of a status of the entity (100), the mobile device (110) being configured to transmit the information indicative of the identity of the tag (120) and the entity information to a storage system (161) remote from the mobile device (110).

20. A mobile device (110) according to claim 19 further configured to generate an entity record comprising the information indicative of the identity of the tag (120) and the entity information and to upload the entity record to the storage system (161).

21. A method of processing entity information comprising reading by means of a mobile device (110) a machine readable tag identifier element (121, 123) of a tag (120) attached to an entity (100) to obtain information indicative of an identity of the tag (120), the method further comprising receiving by means of the mobile device (110) entity information, the entity information including entity status information indicative of a status of the entity (100), the method comprising transmitting the information indicative of the identity of the tag (120) and the entity information from the mobile device (110) to a storage system (161) remote from the mobile device (110).

22. A storage system (161) configured for use in an entity management system (101), the storage system (161) being configured to receive from a mobile device (110) information indicative of the identity of a tag (120) attached to an entity (100) and entity information, the entity information including entity status information indicative of a status of the entity (100), the storage system (161) being further configured to receive information in respect of the availability of a plurality of destination stations (147, 149) to accept an entity (100) of a given status, the storage system (161) being configured to determine automatically to which destination station (147, 149) an entity (100) should be assigned in dependence at least in part on the entity status information.

23. A storage system (161) according to claim 22 comprising at least one server (161), the storage system (161) being configured to store the information indicative of the identity of the tag (120) and entity information in the form of an entity record, the storage system (161) being configured to provide an output indicative of the identity of the destination station (147, 149) to which an entity (100) has been

24. A method of processing entity information by means of a storage system (161), comprising receiving from a mobile device (110) information indicative of the identity of a tag (120) attached to an entity (100) and entity information, the entity information including entity status information indicative of a status of the entity (100), the storage system (161) being further configured to receive information in respect of the availability of a plurality of destination stations (147, 149) to accept an entity (100) of a given status, the storage system (161) being configured to determine automatically to which destination station (147, 149) an entity (100) should be assigned in dependence at least in part on the entity status information.

25. A tag (120) configured to be attached to an entity (100), the tag (120) having at least one machine readable tag identifier element (121, 123), the tag (120) further comprises at least one output device (122) configured to provide one of a plurality of respective different outputs indicative of respective different entity statuses, the tag (120) being configured to receive information indicative of a current status of the entity and to cause the output device (122) to generate a selected one of the plurality of respective different outputs that corresponds to the current entity status, wherein the at least one output device (122) is configured to provide at least one of a visual output and an audible output.