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A CATASTROPHIC EVENT AT THE STADIUM PatientCentral Technologies, L.L.C. Copyright 2006, 2007 Slide 2 Katrina, Rita, Madrid and London demonstrate the need to have an effective plan in place so that a coordinated response can be made when a catastrophic event occurs. With 70,000 fans filling Reliant Stadium, it must be assumed that a disaster will cause chaos despite the pre-event planning that the team, the league, stadium management and first responders have put in place. Slide 3 Slide 4 Technological tools such as DisasterLink assist emergency medical providers, police, fire department, security agents and local area hospitals in managing casualties in large scale disasters. Our technology improves: --Patient safety --Efficiency and effectiveness of first responder medical assessment --Management and transport of casualties to local area hospitals --Coordination, communication and synchronization between first responders and hospitals --Efficiency and effectiveness of hospital emergency room management when multiple patients arrive almost simultaneously Slide 5 Slide 6 By adopting DisasterLink : NFL teams, including the Houston Texans, will be in a position to protect the health and safety of the fans, the team, its support staff, vendors and employees of Reliant Stadium. Slide 7 A proactive plan for implementing innovative first- response casualty management technologies and innovative technologies for local area hospitals to manage mass casualty disasters A proactive plan for implementing innovative first- response casualty management technologies and innovative technologies for local area hospitals to manage mass casualty disasters improves safety, reduces loss, inspires consumer loyalty and confidence. DisasterLink offers a value-added benefit for the Houston community as a whole, and sets an example for other teams across the nation to commit to the safety of their fans, teams, support staff, and communities. DisasterLink offers a value-added benefit for the Houston community as a whole, and sets an example for other teams across the nation to commit to the safety of their fans, teams, support staff, and communities. Slide 8 There are four parts to this presentation: 1.An imagined catastrophic event; 2.A description of how a disaster would be handled presently by first responders and by Medical Center hospital emergency rooms; 3.A description of the DisasterLink stadium infrastructure and first responder equipment; 4.A description of how the same events would be handled if DisasterLink were in place and active. Slide 9 PART ONE- THE SCENARIO: Per routine, special preparations were made in advance of gameday. NFL auditors performed a pre-game walkthrough and interview of facility operators to survey for potential security concerns. By gameday, NFL auditors, facility operators and security personnel were confident that proper measures had been taken to protect the team, support staff and the teams fans from any potential safety hazards or breaches in security. Slide 10 Security personnel performed their usual stringent screening procedures at the turnstiles. Security personnel performed their usual stringent screening procedures at the turnstiles. Patrons walked through metal detectors and security personnel used magnetometers to detect weapons. Patrons walked through metal detectors and security personnel used magnetometers to detect weapons. Ticket sales were skyrocketing. The Texans were heading straight for the playoffs and maybe all the way to the Super Bowl. Ticket sales were skyrocketing. The Texans were heading straight for the playoffs and maybe all the way to the Super Bowl. Slide 11 Slide 12 The crowd cheered the team as it left the field at half-time with the lead, but no one would have anticipated what was about to happen On this beautiful, sunny October day, Channel 99's chopper came in a little closer than is usual or permitted to get a better shot of the crowd scenes through the open roof. The crowd cheered the team as it left the field at half-time with the lead, but no one would have anticipated what was about to happen On this beautiful, sunny October day, Channel 99's chopper came in a little closer than is usual or permitted to get a better shot of the crowd scenes through the open roof. Slide 13 Slide 14 Without warning, flame and smoke could be seen as the helicopter spun out of control, striking the stadium roof and tumbling toward the stands. Without warning, flame and smoke could be seen as the helicopter spun out of control, striking the stadium roof and tumbling toward the stands. Slide 15 At impact, flames and shrapnel were scattered between the 30 yard lines in both the upper and lower bowls. There were hundreds of fans, cheerleaders, and team personnel suffering a range of injuries from minor to life-threatening. Slide 16 Immediately, there was pandemonium. Immediately, there was pandemonium. Those who were able either rushed to leave or rushed to help, making it extremely difficult for the lightly trained ushers and small number of EMS people on the scene to render aid or engage in crowd control. Those who were able either rushed to leave or rushed to help, making it extremely difficult for the lightly trained ushers and small number of EMS people on the scene to render aid or engage in crowd control. Slide 17 Immediately, there was pandemonium. Those who were able either rushed to leave or rushed to help, making it extremely difficult for the lightly trained ushers and small number of EMS people on the scene to render aid or engage in crowd control. Slide 18 PART TWO. THE RESPONSE WITHOUT DisasterLink: Current EMS response systems typically involve paper record-keeping during the process of triage (the process for sorting injured people into groups based on their need for or likely benefit from immediate medical treatment. Slide 19 Slide 20 Triage: First, EMS and Fire Department personnel placed a color-coded RFID tag on every patient. The colors corresponded to the severity of injury. Red tags were placed on patients who had the highest priority need for treatment. These included people with airway and breathing difficulties, severe bleeding, shock, and those with severe head injuries. Yellow tags were placed on patients who had non-life threatening injuries, such as fractures and soft tissue injuries without severe bleeding or those with first or second degree burns. Black tags, sadly, were placed on patients who, indisputably, had no hope of survival or were already dead. Triage: First, EMS and Fire Department personnel placed a color-coded RFID tag on every patient. The colors corresponded to the severity of injury. Red tags were placed on patients who had the highest priority need for treatment. These included people with airway and breathing difficulties, severe bleeding, shock, and those with severe head injuries. Yellow tags were placed on patients who had non-life threatening injuries, such as fractures and soft tissue injuries without severe bleeding or those with first or second degree burns. Black tags, sadly, were placed on patients who, indisputably, had no hope of survival or were already dead. Slide 21 Problems with mettags: EMS and Hospital personnel rely on paper records to accurately convey patient identification, and any history of prior treatment for injuries. EMS and Hospital personnel rely on paper records to accurately convey patient identification, and any history of prior treatment for injuries. Paper can be misplaced, damaged or lost in transport between field, ambulance, emergency room, and into the hospital. Paper can be misplaced, damaged or lost in transport between field, ambulance, emergency room, and into the hospital. Because of time constraints, or the physical properties of the tag have been compromised from bodily fluid, or other containments, rendering the tag unreadable. Because of time constraints, or the physical properties of the tag have been compromised from bodily fluid, or other containments, rendering the tag unreadable. Slide 22 Advantage of DisasterLink for Rapid Response: Radiofrequency technology eliminates reliance on paper and line of sight screening. Special encoded tags allow treatment to be recorded in held held devices. Critical data are recorded and can be transferred to hospitals. In any setting, data can be captured and managed in real-time to assess the scope and scale of a disaster. Interface capability between EMS first-responders and hospitals provides accurate information, reduces delays. Patient safety is improved. Slide 23 HOSPITALS WITHOUT DisasterLink Emergency rooms become stressed when multiple casualties present simultaneously. Doctors and nurses have to act quickly to both evaluate and treat patients in order to avoid further complications. Verbal communication and paper records provide the only link between first responders and hospital emergency rooms. Limited information and lost information from paper systems is inefficient and increases the potential for redundancy or omissions in treatment. Slide 24 Slide 25 PART THREE DisasterLinkS INFRASTRUCTURE AND EQUIPMENT FIRST RESPONDER EQUIPMENT : DisasterLink for first responders is composed of two modules: Module 1: Software link connecting radio frequency identification (RFID) reader devices, ID tags called mettags, and the database where information is being captured and managed. Module 2: The user interface, which allows access to recorded information via user friendly screens. Slide 26 Slide 27 STADIUM INFRASTRUCTURE RFID antennae are strategically placed throughout the stadium to capture data entered into the RFID readers/encoders. A central command computer is installed in Houston Fire Department vehicles to record individual and aggregate data captured by hand-held tag readers/encoders. Mettag boxes are placed at each entry site to facilitate rapid access by first responders. The mettags are used to identify each injured person. When information about a patient is entered into the reader/encoder, it can be readily retrieved by scanning the patients mettag. Slide 28 PART FOUR. ON THE SCENE AND ENROUTE TO HOSPITALS: Security, police, fire department, and EMS personnel who were equipped with DisasterLinks wireless handheld technology, immediately sprang into action, grabbing strategically placed mettag boxes on their way to respond to the casualties. Their supervisors were cued to call for reinforcements. The surrounding community of first responders had been equipped and trained to use DisasterLink. Facility managers were positioned to provide crowd control using their walkie-talkies which were wirelessly connected to the PA system. The first responder teams made their way past the exiting crowd toward the casualties, fans, support staff, cheerleaders, and members of the Channel 99 News Crew that had been injured by the crash. Slide 29 Slide 30 Treatment: Patients with yellow tags and red tags were moved by police, security and management personnel to a separate treatment area. There, EMS and Fire Department personnel and their supplements were able to record the name, age, medical history, allergies, and the injuries sustained as a result of the crash. Slide 31 Transport to Local Hospitals: Information about every patient was entered into a hand-held reader/recorder device and transmitted to the central database. There, at the command center, the EMS supervisor was able to prioritize patients for transport and notify local hospitals of the types of injuries they were soon to encounter so that each could begin to plan for the staff and equipment needed for evaluation and treatment. Patients were loaded into ambulances rapidly and in a coordinated fashion. The names of every patient, their next of kin, if known, nature of their injuries, treatment provided, and the name of the hospital each patient was to be transported to was readily available. Most survived, a few casualties died. The community was devastated. Slide 32 Because first responders were able to rapidly process and record information, the triage and treatment process was efficient and the information collected was reliable. Because inefficiencies were reduced, many patients had a better chance of survival once they were transported to local hospital emergency rooms. Each hospital emergency room had been notified of the impending arrival of casualties from Reliant Stadium. Area Medical Center hospitals had been equipped with DisasterLink and emergency room personnel were able to utilize the interface. Slide 33 DisasterLink IN ACTION IN HOSPITAL EMERGENCY ROOMS Real-time disaster management tools provided a seamless interface between first responders and hospital emergency rooms and from hospital emergency rooms through hospitalization and discharge. DisasterLinks hospital module provided a client interface tool which managed information collection and distribution about individual disaster victims. Slide 34 Slide 35 THE AFTERMATH: DisasterLink can be used as an analytical tool to assess disaster preparedness, in terms of the adequacy and availability of human resources, medical equipment, pharmaceuticals, blood products, beds, care by acuity level, and staples. DisasterLink also provides data for analysis of communication and coordination of care with first responders and external agencies. Data, including rapidity of response, distribution of care, costs and clinical outcomes are invaluable tools for performance improvement, root cause analysis, and prospective strategic planning. Slide 36 IN CONCLUSION: No one could have anticipated the disastrous crash of the Channel 99 News Team helicopter. Because the Houston Texans were in a position to protect the health and safety of its fans, the team, its support staff, vendors and employees of Reliant Stadium. The Houston Texans are in a position to protect the health and safety of its fans, the team, its support staff, vendors and employees of Reliant Stadium. A proactive plan can be implemented for innovative first- response casualty management technology. The result can save many lives.