Care of the Critically ill and Injured During Pandemics and Disasters: Functioning Information Network
Wireless local area networks are suggested, as they may be less vulnerable to damage, can be used for monitoring patients and for high-speed data applications (eg, picture archiving and communication system), and are capable of supporting most portable or handheld hardware (Fig 1). Cellular-based solutions maybe less preferred, as cellular networks are not available in all circumstances.
There are no ready-made disaster network solutions, but effective network communication systems have been implemented under actual disasters and in training exercises.’’’ An example implemented after the Haiti earthquake in 2010 was a field hospital that used laptop computers with a wireless local area network powered by gas generators, which was operational within 6 h after arrival; a wired network was added within 48 h and was capable of managing data-intensive applications, such as picture archiving and communication systems. Generators may maintain electrical power even under extreme circumstances, but plans for alternative power sources should include sufficient battery power, or possibly even solar power.
In any dire circumstance, providing available power for immediate clinical needs must be balanced with the benefit of maintaining a functioning information network.
Patient identity and tracking may be done using paper bar-coded or electronic tags, which may carry some information, or be dependent on mobile provider handheld technology, and can be used to electronically input patient data and used for tracking. Other portable IT software applications are available, are faster than paper in entering patient information completely and accurately, and are effective for patient monitoring and tracking and useful for improving initial triage functions.
For providers, easily portable equipment is preferred, although potential limitations include short battery life, bulky size, difficulty of data input under disaster circumstances, and cost. Provider familiaritywith equipment and software is also an important consideration, and technology choices should focus on equipment already familiar and/or software that is easy to learn and, perhaps, already routinely used.
Figure 1 – Information technology/ information priorities, including secure local area networks and mobile devices, and transferrable patient data.