NOAH--a mobile emergency care system.

The German emergency care system is a very sophisticated one. However, negative headlines like "Emergency Patient Tourism" appearing from time to time, have provoked a thorough deficit analysis which revealed two weak points: communication and documentation. The communication system presently used is a rather outdated one employing analogue voice radio between the ambulance cars/helicopters and the dispatch center and telephone communication between the dispatch center and the emergency rooms. To document the emergency case the on-scene physician is required to fill out a form. A survey showed that many of these forms are filled out incompletely and/or inconsistently or are even missing completely. NOAH, which means "Emergency Organization and Administration Aid" ("Notfall Organisations- und Arbeits-Hilfe" in German) intends to address both of these communication and documentation deficits. The on-scene physician is equipped with a mobile ruggedised PC with an internal digital radio-modern. It provides a direct, digital communication channel from the on-scene physician to the emergency physician starting from the first minutes of the treatment of the emergency patient. It also provides an easy-to-fill-out variant of the paper form mentioned above with an on-line help function and visual aids. A typical course of events with the communication part of NOAH is as follows. The on-scene physician is alarmed via NOAH and can obtain details of the emergency during the approach. He can enter the status codes ("on the move","arrived at the emergency scene","arrived at the patient", etc.) with NOAH. During the first minutes of the treatment of the patient the physician enters a so called "First Message", which requires only 10 to 15 seconds. This message contains basic information like sex, age and the injuries of the patient. It helps the dispatch center (if the on-scene physician desires so) to make an informed recommendation where to bring the patient. This message is also forwarded to the emergency room of the destination hospital, where it can help to start appropriate preparations for the patient. When the on-scene physician has enough time, he can already bring up the documentation masks and give further information to the emergency room.