環境認知式行動緊急救護系統架構設計與應用探討之研究

近年來台灣地區各類型之天災人禍層出不窮，使得因意外而受傷之患者逐年在增加，而意外傷害發生時，緊急救護人員扮演著搶救患者的重要角色，尤其如何能在獲知意外發生的第一時間內到達意外現場，並對患者施予適當搶救措施是拯救患者生命的關鍵因素之一。但是往往受限於距離和空間的問題，救護人員有時無法給予患者即時或適當的急救處理，因此錯過了挽救許多寶貴生命的機會，同時也造成了社會人才的損失。此外當重大災難發生時，例如921大地震，當時緊急醫療資源調度與患者救護大多仰賴傳統且自立救助之方式進行，且相關醫療院所皆會出動大量的醫護人員與車輛前往災難現場，也因為缺乏即時而統一的緊急醫療資源調度，使得無法提供患者適當之急救設備，甚至造成緊急醫療資源分佈不均的情況發生，因此一套可以輔助與整合醫療救助的緊急救護資訊與通訊系統變得迫切而且必要。本論文提出並實作一個三階式(3-tier)之“環境認知式行動緊急救護系統(A Context-Aware Mobile Communication Framework for Emergency Remedy，CAME)”，希望將緊急救護結合GIS/GPS、多媒體視訊系統與個人行動通訊，讓救護人員能藉由GIS/GPS系統的導引，在第一時間內到達意外現場並對患者施予急救措施。此外在運送患者回醫院途中，為了把握搶救患者的黃金時間，醫護人員亦能利用最新的(the state-of-the-art)多媒體行動通訊(Mobile Multimedia Communications)技術來達到急救的機動性，並藉由多媒體視訊結合大哥大行動通訊系統，即時地傳送傷勢圖片，讓急救醫院醫生可透過患者的多媒體資訊先行判斷病情，並提供確切的救護指導，使在救護車上亦能持續地給予患者適當之搶救。CAME系統建置之目的在於期望能有效輔助緊急醫療資源之統一調度，並改善傳統救護車只能用無線電或手機以口頭告知患者傷勢之缺點，並藉由指揮控制中心的統籌調派與資訊之提供，來減少醫療資源的浪費與提高患者生還之機率，進而提升緊急救護醫療服務流程與品質之目的。最後我們設計問春，並依問卷結果分析現今多媒體行動通訊技術與設備應用於緊急醫之可行性與需求性，並依分析結果進行修正CAME系統的功能，以加強系統之實用性與有效性。

關鍵字

緊急救護；環境認知；行動多媒體通訊；普及式運算；遠距醫療

並列摘要

In Taiwan, all kinds of natural and man-made calamities increase significantly. When an accident occurred that emergency first-aid persons quickly arrive the accident location and treat the patient is the most important operations to save patients' lives. It means that suitable and quick medical treatment is the emergenciest issue for saving lives in serious accidents. However the emergency first-aid personnel can't arrive in time and rightly treat the patients usually due to the chaos dispatching by the emergency center and the absence of knowing the exact treatment procedure. In this paper, we designed and developed ”A Context-Aware Mobile Communication Framework for Emergency Remedy (CAME)”, which combines the emergency medical services with GIS/GPS, mobile multimedia communications, and context-aware technologies. The goal of the CAME system is to let emergency first-aid personnel could arrive the accident location in time and give the first aid for emergency patients by the proposed dispatching procedure. Based on the GPS/GIS location-aware service, the first-aid personnel of the ambulance obtains the suitable and dedicated emergency hospital. Furthermore, the first-aid personnel could delivery the patient's symptoms, including the data of the medical equipment, the image, and audio/video of the patient to the doctors in the hospital via the mobile communication network, e.g., GPRS. According to the real-time information, the doctor is capable of providing some suitable medical suggestions with the first-aid personnel to treat the patients on the way to hospital. The CAME system improves the efficiency and effectiveness of the traditional emergency medical services, by which the first-aid personnel merely tells doctors about patient's symptoms via the telephone. Based on the state-of-the-art information technologies, the CAME system is expected to promote the quality of emergency medical services.