Medical telematics in disaster response.
BACKGROUND
Every year many disasters cause thousands of injuries, deaths, refugees. Depending on the kind of disaster (train/plane accident, flood, earthquake) not only an acute emergency medicine treatment but also general and family medicine and hospital treatment have to be safeguarded over a longer time-period in the disaster area.


OBJECTIVE
Regarding to a lot of organizations, institutions and disaster teams taking part in the disaster assistance is there any lack of work or data flow in the medical treatment?


METHODS
From the ODRA flood 1997, the high speed train crash in ESCHEDE 1998, the DANUBE flood 1999 and the ELBE flood in 2002 experience reports were collected. They were analysed with emphasis on data and work flow in the medical treatment and its command system: Standardised command structure? Communication problems? Used communication lines? Language problems? Medical Intelligence distribution? Use of Patient Tracking System? Triage problems?


RESULTS
The use of spoken radio communication causes transmission mistakes or misunderstandings and radio-overload and need connection-set-up-time for each call. Manual distribution of same data for many receivers using different communication lines causes a time shift in the up-to-date-information. Language problems during the ODRA flood between German and Polish people led to longer reaction times. Up-to-date triage results as well as up-to-date transportation and hospital information are necessary for medical evacuation. Compared with other reports about these disasters the quality of disaster management depends on the quality of communication and information.


CONCLUSIONS
The use of health telematics in disaster response helps to cope with the scenario. Modern technologies provide support for building up medical aid although the normal infrastructure is destroyed. To cope with disaster scenarios there are some telematic tools which can be used:--Computer-based Command and Control System--Telemedical support --Data-ressources-network /Medical Intelligence. A further study is recommended to evaluate the real impact of using these telematic tools in a disaster.
Benner
Thomas
T
International Center for Telemedicine Regensburg, Regensburg Emergency Services Center at the University, Josef-Engert-Strasse 9, 93053 Regensburg, Germany. thomas.benner@stud.uni-regensburg.de
Schaechinger
Ulrich
U
Nerlich
Michael
M
D004189:Disaster Planning / Q000458:organization & administration*; D005858:Germany; D006801:Humans; D017216:Telemedicine