Prehospital Data Collection and Analysis for Combat Algorithm Design and Remote Triage1

Few data warehousing systems provide a complete and continuous history of trauma patients from the outset of prehospital care to the point of hospital discharge. Typical prehospital database systems are limited to data recorded by emergency personnel during patient transport and contain a minimal number of data points. This incomplete information provides a snapshot of patient status during the course of treatment, but does not present a complete picture. Furthermore, the lack of patient outcome information in prehospital trauma data repositories severely limits meaningful correlation analyses. This lack of data has consequently led to the development of treatment algorithms based on anecdotal evidence rather than proven statistical methodologies. Therefore, in order to develop more accurate prehospital protocols and algorithms for remote triage, we created a robust system for recording patient injuries, vital signs, interventions, and outcome. This paper describes the Trauma Vitals warehousing system which was designed to provide researchers with a comprehensive database for the continuous capture, storage and analysis of trauma patient data during all phases of prehospital and hospital critical care. Patient prehospital vital signs are recorded automatically to ensure comprehensive data collection. Automatically collected prehospital data is combined with manually entered prehospital and emergency department (ED) hospital data. The system incorporates a web-based approach using a Java applet interface for handling user requests and data management commands to an underlying real time database.