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

Figure: Emergency detection and medical help

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.