A real-time communication and information system for triage, positioning, and documentation (TriPoD) in mass-casualty incidents: a qualitative observational study.

Publisher: BioMed Central Country of Publication: England NLM ID: 100968543 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-227X (Electronic) Linking ISSN: 1471227X NLM ISO Abbreviation: BMC Emerg Med Subsets: MEDLINE

Original Publication: London : BioMed Central, [2001-

Triage*/methods ; Documentation*/methods ; Emergency Medical Services*/methods ; Mass Casualty Incidents*; Humans ; Qualitative Research ; Mobile Applications

Background: In mass-casualty incidents (MCIs), command centers often rely on oral or written reports, leading to communication gaps, misunderstandings, and inadequate logistics of available resources. This study developed a real-time communication and information system for Triage, Position, and Documentation (TriPoD) via action research in collaboration with end-users to ensure high usability. TriPoD integrates commercially available technology, utilizing a digital triage tag with a unique ID that attaches to each individual with an injury. Emergency medical service (EMS) providers scan the electronic triage tag (e-triage tag) via a mobile app, instantly sending data to command centers through a web portal. The developed TriPoD enables seamless sharing of patient information from the MCI scene during transport to and within hospitals.
Aim: This study aimed to explore the usability of TriPoD during a simulated MCI with figurants.
Methods: A qualitative observational design was employed, with non-participant observers stationed at the incident site, a regional command center, and a hospital command center. The observers compared TriPoD with standard procedures and management, and collected user perspectives on the system evaluated. A thematic analysis was used to guide the analysis.
Results: The results revealed that command centers receive real-time updates on patient count, triage status, and location faster and with more accurate numbers of injuries than traditional methods do. Data transmitted through the web portal was updated each time a new patient was scanned, enabling continuous real-time monitoring and informed decision-making. EMS providers and command center users observed TriPoD usability, with delays when EMS providers did not consistently scan injured individuals.
Conclusion: This study demonstrates that seamless information sharing from the scene of an MCI enhances reliable communication and management efforts. Although TriPoD shows strong potential for improving MCI response and management, further development, testing, and collaboration with intended end-users are essential for its continued improvement. The study was approved by the Swedish Ethical Review Authority (No: 2023-04615-01). International Registered Report Identifier (IRRID): PRR1- https://doi.org/10.2196/57819 .
Clinical Trial Number: Not applicable.
(© 2025. The Author(s).)

Declarations. Ethics approval and consent to participate: This study received ethical approval from the Swedish Ethical Review Authority (No: 2023-04615-01) and adhered to the Declaration of Helsinki. Before the observations began, the participants in the field exercise received written and oral information and provided their consent to participate. No consent for publication was obtained. Competing interests: The authors declare no competing interests.

Disaster Med Public Health Prep. 2019 Aug;13(4):700-703. (PMID: 30846024)
Prehosp Disaster Med. 2023 Oct;38(5):570-580. (PMID: 37675480)
AMIA Annu Symp Proc. 2022 Feb 21;2021:1254-1263. (PMID: 35308923)
Clin Pract. 2023 Oct 23;13(5):1266-1285. (PMID: 37887090)
Prehosp Disaster Med. 2022 Jun;37(3):321-326. (PMID: 35379369)
Emerg Med J. 2006 Sep;23(9):666. (PMID: 16921074)
Prehosp Disaster Med. 2015 Apr;30(2):205-15. (PMID: 25659266)
Interact J Med Res. 2024 Sep 11;13:e56729. (PMID: 39259967)
Eur J Trauma Emerg Surg. 2022 Aug;48(4):2613-2638. (PMID: 35024874)
Med Teach. 2020 Aug;42(8):846-854. (PMID: 32356468)
JMIR Res Protoc. 2024 Dec 19;13:e57819. (PMID: 39701586)
Acad Emerg Med. 2004 Nov;11(11):1229-36. (PMID: 15528589)
Prehosp Disaster Med. 2013 Oct;28(5):445-53. (PMID: 23663377)
Healthcare (Basel). 2021 Jul 13;9(7):. (PMID: 34356255)
Scand J Trauma Resusc Emerg Med. 2015 Jan 16;23:4. (PMID: 25591664)
Sensors (Basel). 2021 Apr 17;21(8):. (PMID: 33920744)
Am Psychol. 2003 Sep;58(9):697-720. (PMID: 14584987)
Int J Med Inform. 2009 Apr;78(4):259-69. (PMID: 18835211)
Disaster Med Public Health Prep. 2017 Apr;11(2):244-250. (PMID: 27618948)
Isr J Health Policy Res. 2012 Oct 25;1(1):40. (PMID: 23098065)
BMC Health Serv Res. 2024 Nov 1;24(1):1331. (PMID: 39487444)
Acad Med. 2014 Sep;89(9):1245-51. (PMID: 24979285)
Hum Factors. 2022 Feb;64(1):228-249. (PMID: 34275344)
Appl Ergon. 2024 Jan;114:104139. (PMID: 37748355)
Int J Environ Res Public Health. 2020 Apr 28;17(9):. (PMID: 32354076)
J Am Acad Orthop Surg. 2007 Jul;15(7):388-96. (PMID: 17602028)
J Med Syst. 2021 Aug 13;45(9):86. (PMID: 34387773)

Keywords: Command and control; Communication; Decision support techniques; Mass-causal incidents; Situational awareness; Triage

Date Created: 20250706 Date Completed: 20250706 Latest Revision: 20250729

20260130

PMC12232746

10.1186/s12873-025-01274-0

40619380