Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-23T20:20:29.087Z Has data issue: false hasContentIssue false
  • English
  • Français

Recent Advances in Medical Device Triage Technologies for Chemical, Biological, Radiological, and Nuclear Events

Published online by Cambridge University Press:  14 April 2015

Krystal Lansdowne Open the ORCID record for Krystal Lansdowne [Opens in a new window] ,
Christopher G. Scully ,
Loriano Galeotti ,
Suzanne Schwartz ,
David Marcozzi  and
David G. Strauss
Krystal Lansdowne
Affiliation:
Center for Devices and Radiological Health, US Food and Drug Administration, Silver Spring, Maryland, USA
Christopher G. Scully
Affiliation:
Center for Devices and Radiological Health, US Food and Drug Administration, Silver Spring, Maryland, USA
Loriano Galeotti
Affiliation:
Center for Devices and Radiological Health, US Food and Drug Administration, Silver Spring, Maryland, USA
Suzanne Schwartz
Affiliation:
Center for Devices and Radiological Health, US Food and Drug Administration, Silver Spring, Maryland, USA
David Marcozzi
Affiliation:
Office of the Assistant Secretary for Preparedness and Response, US Department of Health and Human Services, Washington DC, USA
David G. Strauss*
Affiliation:
Center for Devices and Radiological Health, US Food and Drug Administration, Silver Spring, Maryland, USA
*
Correspondence: David G. Strauss, MD, PhD 10903 New Hampshire Ave, WO62-1126 Silver Spring, Maryland 20993 USA E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

In 2010, the US Food and Drug Administration (Silver Spring, Maryland USA) created the Medical Countermeasures Initiative with the mission of development and promoting medical countermeasures that would be needed to protect the nation from identified, high‐priority chemical, biological, radiological, or nuclear (CBRN) threats and emerging infectious diseases. The aim of this review was to promote regulatory science research of medical devices and to analyze how the devices can be employed in different CBRN scenarios. Triage in CBRN scenarios presents unique challenges for first responders because the effects of CBRN agents and the clinical presentations of casualties at each triage stage can vary. The uniqueness of a CBRN event can render standard patient monitoring medical device and conventional triage algorithms ineffective. Despite the challenges, there have been recent advances in CBRN triage technology that include: novel technologies; mobile medical applications (“medical apps”) for CBRN disasters; electronic triage tags, such as eTriage; diagnostic field devices, such as the Joint Biological Agent Identification System; and decision support systems, such as the Chemical Hazards Emergency Medical Management Intelligent Syndromes Tool (CHEMM-IST). Further research and medical device validation can help to advance prehospital triage technology for CBRN events.

Lansdowne K, Scully CG, Galeotti L, Schwartz S, Marcozzi D, Strauss DG. Recent Advances in Medical Device Triage Technologies for Chemical, Biological, Radiological, and Nuclear Events. Prehosp Disaster Med. 2015;30(3):1-4

Keywords

mass-casualty incidentspatient monitoringtriageweapons of mass destruction
Type
Special Report
Information
Prehospital and Disaster Medicine , Volume 30 , Issue 3 , June 2015 , pp. 320 - 323
Copyright
© World Association for Disaster and Emergency Medicine 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Cone, D, Koenig, K. Mass-casualty triage in the chemical, biological, radiological, or nuclear environment. Eur J Emerg Med. 2005;12(6):287-302.Google Scholar
2. US Department of Health and Human Services. Agency for Healthcare Research and Quality. “Chapter 2: Health and Medical Care Delivery in a Mass Casualty Event.” In: Altered Standards of Care in Mass Casualty Events. http://archive.ahrq.gov/research/altstand/altstand2.htm. Accessed December 16, 2013.Google Scholar
3. Ramesh, A, Kumar, S. Triage, monitoring, and treatment of mass-casualty events involving chemical, biological, radiological, or nuclear agents. J Pharm Bioallied Sci. 2010;2(3):239-247.Google Scholar
4. Hogan, D, Burstein, J. Disaster Medicine. 2nd ed. Philadelphia, Pennsylvania USA: Lippincott Williams & Wilkins; 2007.Google Scholar
5. Jahns, Ralf-Gordon. “500m people will be using healthcare mobile applications in 2015.” Research2Guidence Web site. http://www.research2guidance.com/500m-people-will-be-using-healthcare-mobile-applications-in-2015. Published November 10, 2010. Accessed October 16, 2013.Google Scholar
6. Case, T, Morrison, C, Vuylsteke, A. The clinical application of mobile technology to disaster medicine. Prehosp Disaster Med. 2012;27(5):473-480.Google Scholar
7. US National Library of Medicine. “Wireless Information System for Emergency Responders.” WISER Web site. http://wiser.nlm.nih.gov/. Accessed December 16, 2013.Google Scholar
8. US Department of Health and Human Services. “Radiation Emergency Medical Management.” REMM Web site. http://www.remm.nlm.gov/. Accessed December 16, 2013.Google Scholar
9. US Department of Health and Human Services. Chemical Hazards Emergency Medical Management Web site. http://www.chemm.nlm.nih.gov/. Accessed December 16, 2013.Google Scholar
10. Phoenix Hazard Training Ltd CBRN App. Phoenix Hazard Training Ltd Web site. http://www.phoenixcbrn.com/app.php. Accessed December 16, 2013.Google Scholar
11. Marx, J, Hockberger, R, Walls, R, Adams, J, Rosen, P. Rosen’s Emergency Medicine - Concepts and Clinical Practice. 7th ed. Philadelphia, Pennsylvania USA: Mosby/Elsevier; 2010.Google Scholar
12. Apple iTunes. “CBRN Survival Guide.” https://itunes.apple.com/gb/app/cbrn-survival-guide/id438434171?mt=8. Published April 26, 2012. Accessed December 16, 2013.Google Scholar
13. Williamson, HM. Disaster management mobile protocols: a technology that will save lives. Am J Disaster Med. 2011;6(1):55-64.Google Scholar
14. US Food and Drug Administration. 510k Summary of Idaho Technology Inc. JBAIDS Tularemia Detection Kit. http://www.accessdata.fda.gov/cdrh_docs/pdf7/K072547.pdf. Published 2007. Accessed September 15, 2014.Google Scholar
15. Garty, G, Chen, Y, Turner, HC, et al. The RABiT: a rapid automated biodosimetry tool for radiological triage. II. Technological developments. Int J Radiat Biol. 2011;87(8):776-790.Google Scholar
16. Sullivan, J, Prasanna, P, Grace, M, et al. Assessment of biodosimetry methods for a mass-casualty radiological incident: medical response and management considerations. Health Phys. 2013;105(6):540-554.Google Scholar
17. Chu, Y, Ganz, A. WISTA: a wireless telemedicine system for disaster patient care. Mobile Netw Appl. 2007;12(2-3):201-214.Google Scholar
18. Curtis, DW, Pino, EJ, Bailey, JM, et al. SMART—an integrated wireless system for monitoring unattended patients. J Am Med Inform Assoc. 2008;15(1):44-53.Google Scholar
19. Massey, T, Gao, T, Welsh, M, Sharp, JH, Sarrafzadeh, M. The design of a decentralized electronic triage system. AMIA Annu Symp Proc. 2006;544-548.Google ScholarPubMed
20. Martí, R, Robles, S, Martín-Campillo, A, et al. Providing early resource allocation during emergencies: the mobile triage tag. J Netw Comput Appl. 2009;32(6):1167-1182.Google Scholar
21. Higashino, T, Uchiyama, A, Yasumoto, K. eTriage: a wireless communication service platform for advanced rescue operations. SIGCOMM Conference (Special Interest Group on Data Communication). 2011.Google Scholar
22. US Department of Health and Human Services. “White Cell Growth Factors/Cytokines-Radiation Emergency Medical Management.” REMM Web site. http://www.remm.nlm.gov/cytokines.htm. Accessed January 21, 2015.Google Scholar
23. National Security Staff Interagency Policy Coordination Subcommittee for Preparedness and Response to Radiological and Nuclear Threats. “Planning guidance for response to nuclear detonation, 2010.” http://www.epa.gov/radiation/docs/er/planning-guidance-for-response-to-nuclear-detonation-2-edition-final.pdf. Accessed June 5, 2014.Google Scholar
24. Salinas, J, Nguyen, R, Darrah, MI, et al. Advanced monitoring and decision support for battlefield critical care environment. US Army Med Dep J. 2011: 73-81.Google Scholar
25. Scully, CG, Forrest, S, Galeotti, L, Schwartz, SB, Strauss, DG. Advancing regulatory science to bring novel medical devices for use in emergency care to market: the role of the FDA. Ann Emerg Med. 2015;65(4):400-403.Google Scholar