Use of Novel Information Technology in Military Medicine
& Mass Casualty Situation Training
Acta Universitatis Tamperensis No. 1507
By Jokela Jorma
Tampere University Press
Distributed By Coronet Books
$77.50 Paper original
In developed countries, novel information technologies have become an essential part of education in modern healthcare field. However, using these expensive and continuously developing technologies is often a challenge both for trainers and for students. In military medicine, as a part of national healthcare services, there are special needs for this kind of technology, especially when optimizing first aid and initial treatment in challenging field situations. The purpose of this thesis was to study the use of novel information mobile technologies in the training for military medicine and mass casualty situations. Methods chosen were short video clips, mobile medical information system (IS) and radio frequency identification technology (RFID).
Short video clips are potentially applicable as educational material in teaching advanced airway management and as the first means of introducing the use of a laryngeal tube (LT) or an intubating laryngeal mask (ILMA) to inexperienced military first-responder trainees with no prior hands-on experience. In a study, sixty medical non-commissioned officers were randomly assigned into one of two groups: the LT- and the ILMA-group. After viewing the video clips, the trainees were required to perform 10 consecutive, successful insertions of the given instrument into a manikin. The goal of 10 consecutive successful insertions was attained by all 30 subjects in the LT-group, and by 27 of 29 subjects in the ILMA-group with a maximum of 30 attempts. “Satisfactory” to “good” skill levels can be achieved with the applied video-clip demonstration method, even in inexperienced first-responder trainees lacking previous hands-on experience. Self-assessment measured by VAS score showed that the performance felt easy.
A mobile medical information system (IS) was compared between civilian medical students and physicians undergoing compulsory military service in Finland. Special emphasis was placed on differences in system usage and perceptions towards the mobile medical IS. Other points of interest were the important features of the mobile medical system, advantages and disadvantages of using the system in actual emergency situations and use of the device to search for general information. A questionnaire was handed to both sixth-year medical students at the University of Oulu, as well to medical students of similar academic level undergoing their military service. The two groups were found to have similar approaches towards the mobile system in different contexts. The results have helped to develop an understanding of how the two groups of users use a mobile medical information system while also providing insight into some behavioral differences between them. Not all of the differences were significant; indicating the possibility of developing a universal tool for both military and with some civilian application, but with supplemental content in military medicine for military medical officers (MO). When reporting on the possibility of the development of a universal tool for both military and civilian use, MO`s said that they would have liked to complement the mobile medical information system with military medical data.
The applicability of radio frequency identification (RFID) technology and commercial cellular networks designed to provide an online triage system for handling civilian mass casualty situations was tested during a military field exercise. The system proved to be usable. Compared to the current system in use, it dramatically improved the general view of mass casualty situations and enhances medical emergency readiness in this military medical setting. The system can be adapted without any difficulties by the civilian sector for the management of disasters. The feasibility and the direct benefits of the system were evaluated in two separate, simulated civilian mass-casualty situations; one in Finland involving a passenger ship accident and another at a major airport in Sweden with a plane crash scenario. Both simulations involved multiple authorities and functioned as a test setting for comparing the disaster management’s situational awareness using the RFID -based system, where triage was done using both a mobile phone system with information sent automatically to the situation command center and the hospital, alongside a traditional method using paper triage tags. The development of situational awareness could be measured directly by comparing the availability of up-to date information at different points in the care chain with both systems. The RFID system proved easy to use, quick and stabile, and improved the situational awareness for the disaster management significantly. Information about the numbers and status of casualties was available for the coordinating units over an hour earlier in comparison to the traditional method. Results surpassed the traditional systems in all respects. It also dramatically improved the general view of mass casualty situations and enhanced medical emergency readiness in a multi-organizational medical setting.
The novel information technologies addressed here are of great value both pedagogically and technically in medical training in military medicine and mass casualty situations.
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