UCSD Engineers, Physicians
Test Wireless Technologies in Car Bomb Drill
New 'Intelligent' Triage Tag used to Manage Care of Victims

By Doug Ramsey I November 21, 2005

In Joni Mitchell's Big Yellow Taxi, "they paved paradise and put up a parking lot." In San Diego last week, the big yellow taxi was in the parking lot - until emergency officials detonated a car bomb that destroyed the taxi and sent plumes of charcoal-gray smoke billowing into the clear blue sky over the Del Mar Fairgrounds.

The explosion triggered a six-hour disaster drill simulating the aftermath of a car bomb attack and accidental release of lethal chemicals. The scenario assumed 25 fatalities and 125 injured.

Triage team leader, Dr. Colleen Buono, demonstrates how easy it is to use the electronic ID tag.

The drill brought together roughly 1,100 emergency officials, first responders, volunteer 'victims' and nearly two dozen researchers and staff from UCSD and the California Institute for Telecommunications and Information Technology (Calit2). The UCSD team is part of the Wireless Internet Information System for Response in Medical Disasters (WIISARD), a $4 million project funded by the National Institutes of Health's National Library of Medicine.

The Del Mar disaster drill was the latest and largest to be staged by San Diego's Metropolitan Medical Strike Team (MMST). For fire, police, hazardous materials, SWAT and other first responders, the goal of the joint exercise was to practice working together in a crisis environment in order to be better equipped to respond in case a real disaster strikes.

"This is the first time that WIISARD technologies have been integrated in every aspect of the medical response in a disaster drill," says MMST medical director Theodore Chan, a professor of clinical medicine at UCSD.

"The biggest lesson was probably that responders took very well to the new technology," says professor of medicine Leslie Lenert, principal investigator on the WIISARD project and associate director of Calit2's UCSD Division for biomedical informatics. "Now we need to work on ways for managers to react to that data and get the knowledge into the decision-making process."

MMST medical director Ted Chan (center, in blue) uses wireless PDA to scan victim data with WIISARD software.

"This was a big step for the project," agrees Jacobs School of Engineering computer science professor Bill Griswold, who is responsible for WIISARD's overall software architecture. "This was our first end-to-end test of the WIISARD concept."

Indeed, the drill marked the first full deployment of WIISARD's system software, which has been under development more than two years. It is optimized to allow the system to continue working even if a piece of the network fails or a device disappears out of range.

The Del Mar drill was also the first time that devices and applications developed by WIISARD researchers were deployed to run on the new software architecture. "One thing completely new was the iTAG, an 'intelligent' triage tag," notes Lenert. "It was successfully used to tag and track victims in the hot zone."

The iTAG is an advanced, active radio frequency (RF) identification tag designed by Calit2 principal development engineer Doug Palmer. Swathed in sand-colored Level C gear to protect them from toxic chemicals, a team of ten triage doctors and nurses checked out the wounded and put 38 of the electronic tags around the necks of victims. "It was amazing to watch the triage team, in bunny suits, pushing a couple of buttons on the tag to record the victim's triage status," recalls Palmer. "Immediately one of four colored lights started flashing, and then at the command post the tag and its location showed up on a screen, and soon after, there was a light on the screen for each victim, indicating the seriousness of their condition."

RealityFlythrough developer Neil McCurdy (right) tests it with fellow Computer Science and Engineering graduate student Barry Demchak.

The ID tags were a big hit with responders. "It took them only a few minutes to learn how to use the tags," says UCSD emergency physician Colleen Buono, who led the triage team. "And the geo-location data and wireless transmission represent a quantum leap over conventional paper triage tags. One day the devices could also carry a patient's medical history and other potentially life-saving data. So this is the future."

Other 'client' systems tested during the Del Mar drill included PDA hardware with a bar code scanner for triaging and treating patients; pulse-oximeters running on wireless-enabled PDAs to monitor pulse rate and blood-oxygen levels of victims; and supervisor software that runs on a tablet PC. One such application: Command Center. "It aggregates data from many different sources onto a single display, giving comprehensive and real-time situational awareness to incident commanders needing to make timely and accurate strategic decisions," says Barry Demchak, a first-year CSE graduate student who is developing the application.

The system is still in its infancy but a vital part of WIISARD's mission. "All the data needs to be collated and displayed on a large screen," says Steve Vandewalle, a technical specialist with the San Diego Fire Department's Hazardous Materials Response Team and part-time WIISARD advisor. "If the medical, tactical, bomb and security layers are displayed on a screen in real time over the venue map, the Command Center system would do much to provide a unification to joint command."

SWAT team in chemical-hazard suits secure area before medical teams can deploy to help the wounded.

The on-site wireless connectivity was provided by Calit2 and Ericsson researchers, who deployed a mesh network of ten WiFi access points. The network created a nearly one-kilometer-long corridor of WiFi connectivity linking the command post with emergency workers throughout the affected area. "The network was good at handling all of the data and services at the scene," says Rajesh Mishra, an Ericsson researcher who works at Calit2.

As the disaster drill drew to a close, organizers used another WIISARD technology called WiFi Bullhorn. The rugged, wireless notification system was developed by a team of four electrical engineering seniors in ECE 191 this quarter, funded by Calit2. "They built the loudspeaker-bullhorn system to be deployed in crisis situations to manage crowds and first responders," says Calit2's Doug Palmer, who is advising the ECE 191 students. "They set up the WiFi Bullhorn in a crowded area, and then remotely, through laptop computers, sent recorded or stock messages to the unit for broadcast." The first system was ready in time for the Del Mar drill, and the San Diego Fire Department's chief information officer used it to conclude the drill. [Listen] [Real player required]