Medicine, Technology, and Human Factors in Trauma Care: A Civilian and Military Perspective.

摘要

Medicine, Technology, and Human Factors in Trauma Care: A Civilian and Military Perspective. NA Baltimore, Maryland. November 15–16, 2001.This symposium was divided into three multidisciplinary sessions over 2 days in which innovations in organization, coordination, data capture, use of technology, and new approaches in emergency care of the injured were discussed. Military and civilian anesthesiologists and surgeons, field care providers, nurses, psychologists, computer scientists, technologists, and human factor engineers presented. *In the first session, Yan Xiao, Ph.D., of University of Maryland's Human Factors and Technology Group (http://hfrp.umm.edu), described studies carried by the Group on human and technology factors for coordination occurring along the event timeline of emergency medical care from the field to a dedicated trauma center. Dr. Xiao's presentation highlighted issues in remote decision making, preparation for incoming trauma patients, and coordination among care providers managing operating rooms.Next, Michael McNeese, Ph.D., of the Pennsylvania State University's School of Information Sciences and Technology, identified futuristic concepts for human factors in information systems (such as Living Lab) to illustrate the need for a variety of research methodologies in designing medical information systems. Colin Mackenzie, M.D., of the University of Maryland's National Study Center for Trauma and Emergency Medical Services, described development of best practices for brief, risky, beneficial procedures (e.g. , airway management, chest tube insertion) using video taping methodology. In comparison with traditional methods, videotaping allows detailed examination of performance, and practices that may be otherwise difficult to capture. Nancy Foster, M.S., of Agency for Healthcare Research and Quality, presented the Agency's initiatives in reduction of errors in medicine and described the funding of initiatives this year by the Agency on health system reporting, clinical informatics, working conditions, and centers of excellence for patient safety research.Stephen Schimpff, M.D., of the University of Maryland Medical Center, presented his view as Chief Executive Officer on patient safety in reducing medication errors, nosocomial infection, implementing best practices, 24/7 physician coverage of intensive care units, and improving resident supervision, as well as plans to adopt the recommendations from the Leapfrog Group. Harvey Magee, M.S., of the Army's Telemedicine and Advanced Technology Research Center (TATRC), presented the Center's strategy of building portfolios of projects on medical simulation technologies in PC-based multimedia simulation, digital mannequins, virtual workbenches, and total immersion virtual reality. John Holcomb, M.D., of the University of Texas, Houston Medical Center, described how his group developed measurements to quantitate the benefits of a 28-day surgical trauma training course using videotaping of simulated patient care. They showed the benefits of training included a shorter time of oxygen desaturation and hypotension during physiologically identical trauma patient management. Darin Via, M.D., of Uniformed Services University of Health Sciences (USUHS), described studies in collaboration with human factors specialists to evaluate performance during simulation. Critical incidents were developed as part of the simulation, and an eye-tracking device was used to capture visual scanning patterns. A performance evaluation tool kit was used to measure how simulation participants perform during trauma emergencies. General (Rtd.) Russ Zajtchuk discussed preparedness for bioterrorism attacks in the context of a video made 5 yr ago of a simulated attack on Wall Street, and the military role in relief operations after the hurricane disaster in Honduras.In his second presentation, Yan Xiao described the mobile digitally connected doctor (MobiDoc) project in which anytime, anywhere, aud