We have developed and retrospectively validated a decision-support system for the initial definitive management of multiple trauma (penetrating injuries of the chest and abdomen) in Emergency Centers [8,27]. TraumAID was designed to complement the coverage of ATLS procedures [1] and conform to the information needs of local, state and national trauma registries. Deployment in the Emergency Center at the Medical College of Pennsylvania for the purpose of prospective evaluation began in April 1995. An earlier version of the TraumAid system was adapted to use by medical corpsmen on submarines and extended to cover basic care of injuries to the extremities as well [7].
Information on the state of the patient (signs, symptoms) and the state
of patient management (procedures and their results) will be entered
by a member of the Trauma Team, designated as the ``Scribe Nurse''.
(Currently, this is being done by a medical student.)
[2]Eventually,
we see much of this data being gathered through a
Trauma Care Information Management Systems (TCIMS), whose goal is to apply
telecommunications, information and decision
support technologies to improving the speed and effectiveness of
pre-hospital trauma care. Information collected pre-hospitally via
TCIMS will reduce
TraumAID's in-hospital data collection needs and position it to provide
decision support for definitive management as soon as the patient
enters the Emergency Center. We have developed two formats for presenting
TraumAID's decision support: a graphic presentation of its recommended
plan and the goal(s) each action is intended to serve, and a restricted
critique of physician orders [17,19,18]. Since critiquing
can be used both during practice and for training, we are considering
adapting TraumAID's critiquing module, TraumaTIQ, to the MediSim context.