Division of Emergency and Transport Medicine, Children's Hospital Los Angeles, 4650 Sunset Blvd., Mail Stop 113, Los Angeles, CA 90027, United States of America; Department of Pediatrics, Keck School of Medicine, University of Southern California, 1975 Zonal Ave., Los Angeles, CA 90033, United States of America.
Division of Emergency and Transport Medicine, Children's Hospital Los Angeles, 4650 Sunset Blvd., Mail Stop 113, Los Angeles, CA 90027, United States of America; Department of Pediatrics, Keck School of Medicine, University of Southern California, 1975 Zonal Ave., Los Angeles, CA 90033, United States of America.
Am J Emerg Med. 2021 Oct;48:148-155. doi: 10.1016/j.ajem.2021.04.004. Epub 2021 Apr 5.
Communication failures secondary to damaged infrastructure have caused difficulties in coordinating disaster responses. Two-way radios commonly serve as backup communication for hospitals. However, text messaging has become widely adopted in daily life and new technologies such as wireless mesh network (WMN) devices allow for text messaging independent of cellular towers, Wi-Fi networks, and electrical grids.
To examine the accuracy of communication using text-based messaging transmitted over WMN devices (TEXT-WMN) compared to voice transmitted over two-way radios (VOICE-TWR) in disaster simulations. Secondary outcomes were patient triage accuracy, perceived workload, and device preference.
2 × 2 Latin square crossover design: 2 simulations (each involving 15 min of simulated hospital-wide disaster communication) by 2 modalities (TEXT-WMN and VOICE-TWR). Physicians were randomized to one of two sequences: VOICE-TWR first and TEXT-WMN second; or TEXT-WMN first and VOICE-TWR second. Analyses were conducted using linear mixed effects modeling.
On average, communication accuracy significantly improved with TEXT-WMN compared to VOICE-TWR. Communication accuracy also significantly improved, on average, during the second simulation compared to the first. There was no significant change in triage accuracy with either TEXT-WMN or VOICE-TWR; however, triage accuracy significantly improved, on average, during the second simulation compared to the first. On average, perceived workload was significantly lower with TEXT-WMN compared to VOICE-TWR, and was also significantly lower during the second simulation compared to the first. Most participants preferred TEXT-WMN to VOICE-TWR.
TEXT-WMN technology may be more effective and less burdensome than VOICE-TWR in facilitating accurate communication during disasters.
基础设施损坏导致的通信故障给灾害应对协调带来了困难。对讲机通常是医院备用通信的首选。然而，短信在日常生活中已被广泛采用，而无线网状网络 (WMN) 等新技术可使设备在无需依赖蜂窝塔、Wi-Fi 网络和电网的情况下进行短信传输。
在灾害模拟中，考察通过 WMN 设备传输的基于文本的消息（TEXT-WMN）与通过对讲机传输的语音（VOICE-TWR）在通信中的准确性。次要结局为患者分诊准确率、感知工作量和设备偏好。
2×2 拉丁方交叉设计：2 个模拟（每个模拟包括 15 分钟的全院范围灾害通信）和 2 种模式（TEXT-WMN 和 VOICE-TWR）。医师被随机分配到两种序列之一：VOICE-TWR 优先和 TEXT-WMN 其次；或 TEXT-WMN 优先和 VOICE-TWR 其次。使用线性混合效应模型进行分析。
平均而言，与 VOICE-TWR 相比，TEXT-WMN 的通信准确率显著提高。与第一个模拟相比，第二个模拟的通信准确率也平均显著提高。使用 TEXT-WMN 或 VOICE-TWR，分诊准确率均无显著变化；然而，与第一个模拟相比，第二个模拟的分诊准确率平均显著提高。平均而言，与 VOICE-TWR 相比，TEXT-WMN 的感知工作量显著更低，且第二个模拟的感知工作量也显著低于第一个模拟。大多数参与者更喜欢 TEXT-WMN 而非 VOICE-TWR。
在促进灾害期间准确通信方面，TEXT-WMN 技术可能比 VOICE-TWR 更有效且负担更小。
