Development Of A New Handheld Trauma Scoring-care System

Objective Prehospital care, especially salvage at scene, greatly affects the cure of trauma and war wound. Today, with the rapid development of telemedicine technology, it has been a tendency that computer used in first aid. At the scene of first aid when the large scale trauma happens, EMT(emergency medical technician) not only needs the prehospital scoring system to make a quickly judge and classification, but also needs the trauma care expert system. So a kind of trauma scoring-care system used in first aid is expected. The system should be small and simple to operate. Also it should involve trauma scoring system and trauma care expert system. Especially, the system is necessary to our country which has no perfect EMSS(emergency medical service system). The system is specially needed in naval warfare because of the bad conditions and the long prehospital time. Combined wound appears commonly in modern war at sea, and fragment-burn combined wound and burn-blast combined wound are in the majority of combined wound. The seawater immersion often happens to aggravate the wound. The method to quickly judge the combined wound with seawater immersion is absence, so the trauma scoring system can not be setup and the classification and salvage are always badly delayed. This paper will bring forth a new computer aided care system----handheld trauma scoring-care system, which involves trauma scoring system, trauma care expert system and referring system. For the more, based on the animal experiment, the method to find a scoring scheme for the combined wound with seawater immersion will be discussed.Metheds and results Recently, the development of the HPC(handheld personal computer)has made itself perfect fore signal interface to the telemedicine system. In this paper, the embedded developing tool EVB3.0 is used to develop the system based on the Windows CE operating system (OS) of HPC.1. Development of the common trauma scoring-care system Firstly, the common trauma scoring subsystem was developed by integrating such classical trauma scoring scheme as the PHI, CRAMS, TS, RTS, etc. Secondly, with the thorough analysis of the embedded equipment and embedded mobile database, the traumacare expert subsystem was developed by integrating classical prehospital care schemes. Finally, as the Windows CE OS support the function of database, the embedded developing tool was used in HPC installed with Windows CE OS to develop trauma database and referring subsystem. So a common trauma scoring-care system include three subsystem above was setup and could be used in common trauma and war wound.2. The method to judge the combined wound with seawater immersionAnimal experiments were proceeded to find the method and the models were developed in local dogs as:① The models of burn-blast combined wound with seawater immersion were developed in local dogs combined with 10% Ⅱ°burn injury and light blast injury on their right lungs before immersed in seawater for 4 hours② The models of fragment-burn combined wound with seawater immersion were developed in local dogs combined with 10% Ⅱ°burn injury and gunshot injury on their right legs before immersed in seawater for 4 hours.The dogs with burn-blast combined wound and bullet-burn combined wound were randomly assigned to two groups: immersion and unimmersion. In immersion groups, the dogs were immersed in seawater for 4 hours, keeping the head and front limbs out of water, then were taken out from seawater and dried with warm wind. Changes of vital signs, hemorrheologic, acid-base balance electrolyt balance, blood-gas analysis and osmotic pressure were monitored before and 4h, 7h, 10h, 20h, 28h after wound. The morphologic changes in heart and lung tissue were observed after the experiment was finished. The treatments in unimmersion groups were the same as those immersion groups except unimmersion. This paper try to find a method to judge the wound. A Logistic regression model was set up to analysis the relation between the death of dog and the chang...