Challenges in handling medical emergency in
real time and developing intelligent sensor
based IOT detection and reporting mechanism
-Ashish Agrawal
Introduction Roads accidents are very common in busy city life. Whether it is due to carelessness of the driver or due
to bad traffic conditions, accurately detecting an emergency situation using vital health symptoms and
communicating the same to medical health centers for getting required immediate help, can go a long
way in saving lives and ensuring right treatment is available.
The first hour following an accident or injury is called the golden hour because that is when life-saving
techniques are the most effective. Reducing this time between injury and treatment has been the focus
of bio-medical researchers and medical authorities to provide the desired treatment to the patient.
This paper presents an approach in the direction of design of an emergency detector as a wearable gadget
on the person’s body and its network to the hospital to inform the emergency center to call an ambulance.
Car Manufacturer’s perspective:
Car manufacturers are always concerned on how they can make their car safer for drivers
Using mobility and wearable based solution how can we detect an accident and raise an
alarm
This alarm can be connected with nearby medical help center
Medical officer based on the criticality of the accident can provide required support which
can even include sending an ambulance to the accident spot
Measures of Evaluation: Key Challenges in handling medical emergency
For providing the best IOT based solution, it is very important to provide a robust, secure,
portable and low infrastructure based solution to make it practical and widely acceptable to the
target audience and system integrators.
Accuracy of detecting Vital signs correctly is one of the highest priority to prevent false alarm
and ensure that right diagnosis and treatment could be done. Below mentioned are key
measures and challenges deploying a workable model
• Detects critical condition
• Detects airway clarity
• Size
• Transmits data (Accuracy)
• Security
• Delay in transmission
• Ease of use
• Portability
• Battery / Power requirement
• False Alarms
Emergency Medical Services
Some of the products and works that facilitate better care in this period are ICU on wheels ambulance
and its wireless connectivity to hospitals. Also, medical protocols are defined to take care of such
situations in a systematic manner. Through this paper we are trying to come up with innovative ways to
deliver prehospital care in an accurate and cost effective manner.
Design Details
Immediate treatment within the golden period of an injury is the aim of this project. This section describes
the design of a mobile medical device that can automatically inform the appropriate nearest hospital (or
clinic) of a life-threatening emergency situation using a nearby mobile for its intermediate pathway.
Components of the proposed design
Person who has met with an accident
Mobile device having capability to detect accident
Wearable watch like device to detect human vital signs HR,RR and SPO2
Emergency medical center with ambulance having ICU like diagnosis and treatment facility
Person meeting Accident
Mobile acceleromet
er detects collision
Intelligent wearable
device measures vital signs
Mobile evaluates
emergency situatuaion
MES gets a emergency alarm with
vital signs and send help
The concept:
The aim is to make wearable device like a watch that would detect emergency and
call an ambulance in case of life-threatening emergency. By continuously measuring
vital signs of the person, the device will be able to detect an emergency situation.
The device uses the mobile for its propagation of signal to the hospital.
How it will work?
In the case of accident detection, wearable device would measure the Respiratory
Rate (RR) at regular intervals (Tc) in time after previous check. A voice message
would come “Are you Okay?”
If the person thinks that this is incorrect detection i.e. he is alright OR if the situation
according to him is not that severe, then he can immediately switch off the
measurements by just pressing a button. If the person does not respond then the
wearable concludes that the airway is blocked and automatically signals over a
Bluetooth connection to the nearest mobile and the GPS location of the mobile is
transmitted to the nearest hospital with medical emergency system. If the person
responds saying something clearly (may be Yes or No or anything else), this would
imply that his/her airway is clear and the emergency needs to be verified by
measuring oxygen saturation and heart rate.
The RR would be measured again and now the device signals the nearest mobile and
the procedure of communication repeats if the RR is in critical range. If the RR value
is in normal range, then next step would be to measure oxygen saturation. If the
oxygen saturation value is out of normal range, then the mobile app is signaled to
call the ambulance, otherwise the device is deactivated until a sound threshold is
reached OR time Tc completed after previous check OR button is pressed. In the first
case of measuring RR, if the value of RR was normal, then also the same procedure
is followed and so on.
Person is driving a car and encounters an
accident
Car parameters (acceleration, speed,
break speed) are evaluated by mobile
app to detect accident
If accident
detected
with high
impact
No action
needed
Initiate
measurement of
vital signs
If vital
signals are
above
threshold
Ash the user if
he is OK
If user is
ok? EMS is notified
for medical help
No
Yes
No
Yes
No Yes
Predictive treatment As mobile device or watch is a very personalized gadget and the proposed system is based on
the assumption that the device detecting the accident and identifying the human vital signs can
also correctly identity the person and along with accident location, vital signs numbers,
precious medical history of the person can also be send to EMS so that they can analyze
medical history and appropriate treatment can be given to the patient.
Medical history could include:
Blood group
Allergies
Any ongoing medication
Previous injury or treatment undertaken
IOT reporting mechanism
The EMS (Emergency Medical) system can be presented with below kind of
dashboard to monitor the accidents happening in there locality and accordingly
delegate medical help to desired site.
Accident
Time
Accident
location
Criticality
of
accident
Identification
of driver
Measurement
of vital signs
Medical
history
of
reported
patient
Nearest
ambulance
availability
with ICU
Doctor
required
Current capabilities of wearable device to detect human
vital signs
Following are the research publications talking about how human vital sign can be measures
and evaluated to detect emergency health situation
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3231103/
http://news.mit.edu/2015/ingestible-sensor-measures-heart-breathing-rates-1118
http://venturebeat.com/2015/03/31/vital-connect-uses-band-aid-like-strip-to-monitor-your-
vital-signs/
Challenges in meeting the expectation Size and user friendly ness of the device
In-order to have mass acceptance of the idea, it is very important to assemble this
idea into a user friendly systems which could be a combination of mobile and watch
on user side.
Accuracy of detecting an accident
For the entire process to work, it is very critical to have the capability of mobile device
to accurately detect the accident scenario by using the combination of available car
parameters.
Time taken for measuring RR, HR, SpO2.
The time involved in sensing, processing, comparing one parameter and then the
other to conclude the health condition of the driver
Sensor
The technology of sensors is advancing and there are possibilities of better, more
accurate and smaller sensors that consume negligible power. Human vital signs
need to be evaluated correctly to raise correct alarm.
Cost reduction
Since the device is supposed to be an emergency detector, it should have an
affordable cost and easy deployment with minimal infrastructure cost.
Detecting the site of injury
The nearest hospital with appropriate facilities should be contacted depending on
the site of injury. The accident coordinates should be captured using mobile phone
GPS capability and system should be intelligent enough to reach the closest EMS
system.
The critical values of the vital signs
The range of normal values of vitals is quite different for athletes and normal
people. Also, the vitals may suddenly go out of normal range during exercise etc.
Different guidelines need to be set up for different cultures/professions regarding
usage of device or even the critical values need to be changed i.e. different devices
for athletes.
Mobile device capability
The smartphone device under discussion should have capabilities like
accelerometers, GPS, internet and Bluetooth to be able to carry out the required
functionalities.
Alternative approaches
In-case of an accident, there is a possibility that the wearable or mobile device might get
damaged and that would break the system link.
Also in-order to tackle harm to sensor device or unavailability of senor following alternative
approaches can be used for implementation
1. Accident detection and communication with EMS can be in-build into the car
system.
- To make the whole solution more cost effective this solution can also be
in-build in to the car system. This could be given as an offering by the car
manufacturer. Based on the detection of accident, the car radio system
can communicate with EMS for urgent medical help by sending the
coordinated of accident.
2. Speech recognition based approach for triggering medical help
- Personal speech recognition can also be used to detect the urgency of
medical help required. In-case of accident detection, the device can
trigger an alarm which will ask the user if he is ok, if the device gets a
legitimate response within a given time internal it can assume that user is
in stable condition or either with user discretion or due to lack of
response, the system can notify the EMS with location co-ordinates for
get required medical help.
3. Traffic police with sensor device availability can help in doing initial
evaluation of the criticality and initiating medical help
- During the case of accident, traffic police are generally rushed to the
accident site to access the situation and help in getting the required
medical help. If the traffic police can be given the sensor device which
can measure the critical signs of the person and share with the same with
nearby EMS which can plan and provide the requirement treatment.