The Boston Marathon Bombings Mass Casualty Incident: One Emergency Department's Information Systems Challenges and Opportunities
The Boston Marathon Bombings Mass Casualty Incident: One Emergency Department's Information Systems Challenges and Opportunities
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DOI：
10.1016/j.annemergmed.2014.06.009
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发表时间：
2015-07-01
影响因子：
6.2
通讯作者：
Goralnick, Eric
中科院分区：
文献类型：
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作者：
Landman, Adam;Teich, Jonathan M.;Goralnick, Eric
急诊科（艾德）信息系统旨在支持高效和安全的急诊护理。这些相同的系统在灾害中通常发挥关键作用，以促进实时情况感知，信息管理和通信。在这篇文章中，我们描述了一个艾德的经验与艾德信息系统在2013年4月波士顿马拉松爆炸案。在事件后的汇报中，工作人员分享说，我们的艾德信息系统和工作流程没有最佳地支持这一事件;我们发现，我们的未识别患者命名惯例、患者位置的实时态势感知以及评估、订单和程序的文档记录存在挑战。因此，在我们下一次大规模集会活动之前，我们改变了我们的身份不明患者命名惯例，以更清楚地区分多个同时发生的身份不明患者。我们还对灾害登记工作流程进行了修改，并加强了更新电子系统的角色和责任。卫生系统应使用其艾德信息系统进行灾难演习，以在实际事故发生前发现效率低下的问题。艾德信息系统可能需要增强，以更好地支持灾害。较新的技术，如射频识别，可以进一步改善灾害信息管理和通信，但需要仔细评估和实施到日常的艾德工作流程。
Emergency department (ED) information systems are designed to support efficient and safe emergency care. These same systems often play a critical role in disasters to facilitate real-time situation awareness, information management, and communication. In this article, we describe one ED's experiences with ED information systems during the April 2013 Boston Marathon bombings. During postevent debriefings, staff shared that our ED information systems and workflow did not optimally support this incident; we found challenges with our unidentified patient naming convention, real-time situational awareness of patient location, and documentation of assessments, orders, and procedures. As a result, before our next mass gathering event, we changed our unidentified patient naming convention to more clearly distinguish multiple, simultaneous, unidentified patients. We also made changes to the disaster registration workflow and enhanced roles and responsibilities for updating electronic systems. Health systems should conduct disaster drills using their ED information systems to identify inefficiencies before an actual incident. ED information systems may require enhancements to better support disasters. Newer technologies, such as radiofrequency identification, could further improve disaster information management and communication but require careful evaluation and implementation into daily ED workflow.