20
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Wireless local area network in a prehospital environment

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          Wireless local area networks (WLANs) are considered the next generation of clinical data network. They open the possibility for capturing clinical data in a prehospital setting (e.g., a patient's home) using various devices, such as personal digital assistants, laptops, digital electrocardiogram (EKG) machines, and even cellular phones, and transmitting the captured data to a physician or hospital. The transmission rate is crucial to the applicability of the technology in the prehospital setting.

          Methods

          We created two separate WLANs to simulate a virtual local are network environment such as in a patient's home or an emergency room (ER). The effects of different methods of data transmission, number of clients, and roaming among different access points on the file transfer rate were determined.

          Results

          The present results suggest that it is feasible to transfer small files such as patient demographics and EKG data from the patient's home to the ER at a reasonable speed. Encryption, user control, and access control were implemented and results discussed.

          Conclusions

          Implementing a WLAN in a centrally managed and multiple-layer-controlled access control server is the key to ensuring its security and accessibility. Future studies should focus on product capacity, speed, compatibility, interoperability, and security management.

          Related collections

          Most cited references24

          • Record: found
          • Abstract: found
          • Article: found

          Outcome of Myocardial Infarction in Patients Treated with Aspirin Is Enhanced by Pre-Hospital Administration

          Objective: Reducing time to reperfusion therapy is one of the goals in the management of acute myocardial infarction (AMI). We assessed the association between timing of aspirin administration and outcome of patients with AMI. Patients: We studied 922 consecutive AMI patients with ST-segment elevation in Killip class I–III on admission. Patients were divided into two groups based upon the timing of emergency aspirin administration: before (early aspirin users) or after (late aspirin users) hospital admission. Results: Early aspirin users (n = 338; 37%) were younger, less likely to be women, and more likely to smoke (p < 0.006) than late users (n = 584; 63%). Other baseline and clinical characteristics were similar. Early aspirin users were more likely to be treated with thrombolysis or primary percutaneous transluminal coronary angioplasty. Compared with late users, early aspirin users had significantly lower in-hospital complications and lower mortality rates at 7 (2.4 vs. 7.3%, p = 0.002) and 30 days (4.9 vs. 11.1%, p = 0.001). By multivariate adjustment, pre-hospital aspirin was an independent determinant of survival at 7 (odds ratio 0.43; 95% confidence interval 0.18–0.92) and at 30 days (odds ratio, 0.60; 95% confidence interval 0.32–1.08). Survival benefit associated with aspirin persisted for subgroups treated or not with reperfusion therapy. Conclusions: Outcome of AMI patients treated with aspirin is improved by pre-hospital administration. Our findings suggest that emergency pre-hospital aspirin might facilitate early reperfusion.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Hospital and emergency ambulance link: using IT to enhance emergency pre-hospital care.

            Emergency ambulances traditionally inform receiving hospitals of impending arrival of patients only in instances of load and go situations, which on average constitute less than 5% of ambulance runs. Information transmitted is usually sparse. For all other runs, information is made available only on arrival at the emergency department (ED). There have also been numerous limitations associated with voice transmissions.A comprehensive electronic ambulance case record was created as a pilot project in Singapore between three emergency ambulances and the busiest ED there. All information captured by the ambulance crew, including vital signs information and ECGs was entered or downloaded onto a ruggardised PC in the ambulance and this complete ambulance record was transmitted to the ED. Transmission was wireless via the public mobile data network. A 3-month analysis of this pilot run revealed the following. (1) It was possible to capture a complete ambulance case record electronically at a mean time of 94 s vs 7 min 7 s for the traditional written record. (2) Air transmission time for data was approximately 4 s unless ECG wave forms were also transmitted resulting in transmission times frequently exceeding 60 s. (3) At least 68% of data was transmissible in 75% of Hospital & Emergency Ambulance Link (HEAL) ambulances as opposed to only 25% in less than 5% of non-HEAL ambulances. (4) Paramedics' time in the ED decreased from 15 to 8 min as a result of HEAL. (5) The waiting time for critical care patients to be seen at the ED decreased from 35 to 17 min if brought by HEAL ambulances.(6) The HEAL system was able to effectively prompt paramedics in carrying out critical aspects of treatment in close to 100% of instances. (7) The pilot HEAL system was able to demonstrate a limited amount of automated audit of specific aspects of ambulance runs. Having demonstrated the feasibility of the HEAL system, it is a matter of time before enhanced features such as electronic data collection at patient site, voice activated data entry, transmission of data from site, automated ambulance audits and an enhanced level of professional care in the ambulances become common-place reality.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Feasibility of real-time echocardiographic evaluation during patient transport.

              Echocardiography is a key diagnostic tool in evaluating patients with cardiac emergencies and chest trauma. The lack of qualified real-time interpretation limits its use by emergency first responders. Early diagnosis of cardiac emergencies has the potential to facilitate triage and medical intervention to improve outcomes. We investigated the feasibility of remote, real-time interpretation of echocardiograms during patient transport. Echocardiograms using a hand-carried ultrasound device were transmitted from an ambulance in transit to a tertiary care facility using a distributed mobile local area network. Transmitted studies were reviewed by a cardiologist for ability to interpret predefined features. Transmission quality and reliability were assessed. Echocardiographic images were successfully transmitted greater than 88% of transport time. The evaluation of left-ventricular size and function, and presence of pericardial effusion were greater than 90% concordant, but only 66% of all echocardiographic features were concordant. Most transmission losses were brief (
                Bookmark

                Author and article information

                Journal
                BMC Med Inform Decis Mak
                BMC Medical Informatics and Decision Making
                BioMed Central (London )
                1472-6947
                2004
                31 August 2004
                : 4
                : 12
                Affiliations
                [1 ]Health Informatics Program, Department of Health Services Administration School of Health Related Professions. University of Alabama at Birmingham (UAB). Birmingham, Alabama, USA
                [2 ]Current Address: Biostatistics and Bioinformatics Unit, Comprehensive Cancer Center of UAB. Birmingham, Alabama, USA
                [3 ]Department of Electrical & Computer Engineering, Centre for Telecommunications of UAB. Birmingham, Alabama, USA
                Article
                1472-6947-4-12
                10.1186/1472-6947-4-12
                517505
                15339336
                3f986699-6b29-41f1-9896-9427b5671ebd
                Copyright © 2004 Chen et al; licensee BioMed Central Ltd.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 2 December 2003
                : 31 August 2004
                Categories
                Research Article

                Bioinformatics & Computational biology
                Bioinformatics & Computational biology

                Comments

                Comment on this article