WO2008146324A1

WO2008146324A1 - Apparatus for guiding assistance operations, process for guiding assistance operations and software which controls an apparatus for guiding assistance operations

Info

Publication number: WO2008146324A1
Application number: PCT/IT2008/000361
Authority: WO
Inventors: Sabrina Menghini; Stefano Badiali
Original assignee: Iex S.R.L.
Priority date: 2007-05-31
Filing date: 2008-05-30
Publication date: 2008-12-04
Also published as: ITMO20070186A1

Abstract

An apparatus for guiding an operator in an assistance operation comprises a pair of electronic devices (1, 2) suitably selected so that they communicate with each other. A process for guiding an operator in an assistance operation using the apparatus comprises at least the steps of: displaying (25) a plurality of questions (30, 30a, 31, 32, 33, 34, 35, 36) relating to a patient's health, entering (26) a plurality of data relating to said health in response to the questions, suggesting (27) a way of proceeding for working on said health based on said data; a program comprises a code for implementing the process for guiding an operator in an assistance operation using the apparatus when the program is run in a computer system.

Description

DESCRIPTION

APPARATUS FOR GUIDING ASSISTANCE OPERATIONS, PROCESS FOR GUIDING ASSISTANCE OPERATIONS AND SOFTWARE WHICH CONTROLS AN APPARATUS FOR GUIDING ASSISTANCE OPERATIONS

Technical Field

The invention relates to an apparatus for guiding an operator to correctly carry out assistance operations in medical emergency conditions, as well as a process for guiding and documenting medical assistance operations.

The invention also relates to a software which controls an apparatus for guiding and documenting medical assistance operations.

Said apparatus may be used to guide an operator when providing assistance to people who are the victims of an accident of limited or vast proportions, and to keep said people under control both from a medical and logistical viewpoint.

Moreover, said process may also be used to guide a medical operator when providing assistance to patients in a medical structure, for example a hospital or accident and emergency department.

Background Art

For a variety of reasons, catastrophes may occur due to extraordinary events such as floods, hurricanes, tsunamis, earthquakes, or terrorist acts, or even air, road, rail or industrial accidents.

Such events can cause damage to property, but above all may physically and/or mentally harm people.

The number of victims of such events may vary greatly from one event to another, and, above all the harm done to the people involved may differ greatly depending on the event itself or even the position of the individual people at the moment when the catastrophe struck, that is to say, when a bomb exploded, or there was an earthquake or an accident, etc.

After the event has taken place, a rescue team goes to work in the disaster zone.

Preliminarily, the rescue team makes the disaster zone safe, to prevent accidental collapses, and/or to prevent the people involved in the rescue operations, or the victims of the disaster, from getting injured, or further injured.

Members of the rescue team are usually the first to make contact with the victims, or in general with the people present at the scene of the disaster.

They locate the victims at the scene of the disaster.

Members of the rescue team also carry out the initial "triage", a French term meaning "sorting" to determine medical priority, that is to say, dividing the victims of the disaster according to classes of increasing urgency/emergency, based on the seriousness of their injuries, or their clinical picture.

When catastrophes occur, triage is usually carried out at four different points of the so-called "rescue chain", that is to say, at the scene of the disaster (and/or in the collecting area), upon entering the Advanced Medical Post, upon leaving the

Advanced Medical Post and upon entering hospital, as is explained in more detail below.

Since triage is a dynamic process, it must be repeated as the person's conditions change, and/or each time it is necessary to identify any changes in the person's conditions.

Triage consists of attempting to find, if possible, from documents, or directly from the people involved, the identity and details of the various people affected by the disaster, and examining said people to evaluate their physical conditions. At the end of such an evaluation, each person receives a tag whose colour depends on the seriousness of their physical conditions, on which the rescue team member has marked the person's identity and details, and the place where the person was assisted.

On the tag, the rescue team member must also indicate any symptoms and/or problems found, specifying any operations carried out and recommended treatment instructions.

The tag also allows the various levels of priority for evacuation and care for disaster victims to be indicated.

The use of colours to identify the seriousness of a patient's conditions should facilitate identification of the urgency of the need for treatment for each person. The colour of the tag given to disaster victims varies depending on the seriousness of the clinical picture as follows: Code Green (less urgent): the person has injuries which are not life-threatening, but which require care; Code Yellow (urgent): indicates partial compromise of the functions of the circulatory or respiratory systems, but without any immediate danger of death; Code Red (emergency): indicates a person in a state of shock, with at least one of his vital functions (consciousness, respiration, pulse) compromised, in danger of dying; Code Black: deceased patient.

In some countries (for example in the USA) there is also a Code Blue (absolute emergency). In the latter case, in addition to the rescuers, a person authorised to use a semi-automatic defibrillator is sent. A code blue is usually called in the absence of a doctor. A Code Blue is also used in the event of disasters to indicate the cases in which any care given to the injured person would be useless and giving said care would mean depriving of attention and treatment those who could still be saved. Obviously, this happens where resources are scarce and the number of rescuers is much lower than the number of persons injured, meaning that it is applied in extreme medical emergencies.

Within different aid protocols, aid procedures may vary, but the colour codes are standardised and, therefore, can be recognised by all medical operators, even those belonging to different rescue teams and/or of different nationalities.

The tag is applied to the various victims, for example put around their necks.

The disaster victims are then moved away from the disaster zone, by members of a second rescue team, or by operators whose job is to evacuate victims from the disaster zone.

Operators who carry out the evacuation evacuate the various victims according to the code indicating the seriousness of their conditions.

The disaster victims are therefore transported to a Collecting Area, or, if already set up, to an Advanced Medical Post, located in a suitable zone near the disaster zone.

In said places, the victims are subjected to another triage operation.

The victims are examined by the personnel present, if possible medical personnel or nurses, or in any case personnel with some first aid training.

The personnel examine the tag given to each person, to quickly evaluate their clinical conditions and, if necessary, provide the assistance required.

Usually, the victims' vital functions are stabilised and so-called life-saving treatment is administered.

At the Advanced Medical Post the medical personnel re-evaluate each victim to find potentially deadly conditions and operate on said people to maintain their vital functions, if necessary using advanced support techniques, to stabilise their vital functions so as to guarantee good transportation to hospital.

The tag given to each person is updated by writing the operations carried out and/or the current clinical picture on it.

If necessary, victims can be given another tag, indicating their current clinical situation after the treatment received.

Victims whose code indicating the seriousness of their conditions shows that vital functions are not compromised, "Green" or "Yellow", may be kept at the

Advanced Medical Post and/or moved to another Advanced Medical Post or another collecting station set up to receive them.

Then, the victims are transported to a hospital, giving priority to victims who are more seriously injured, with a "Red" colour code.

In hospital, the victims are triaged again, to evaluate their clinical conditions and decide what subsequent treatment is required.

In hospital, the medical personnel in charge use the victim's tag(s) to obtain information about his clinical conditions and the treatment he has received and carry out evaluations to decide what subsequent treatment is required.

In the case of a small incident, known as single emergencies, triage is carried out at the scene of the disaster and upon entering hospital, using techniques very similar to those described above.

Similar triage operations are also carried out upon being accepted to the

Accident and Emergency Department in a hospital, to sort the various patients to be sent to the different wards and, above all, to assign them a colour code indicating treatment priority. If triage is carried out in hospital, for example when patients are accepted to the accident and emergency department, there is also a Code White (no urgency), which indicates a person who does not need first aid and who can be sent to their family doctor.

For the triage operations described above various types of tags are currently used, which may be very different from one another.

Said tags are made of paper material and normally comprise a first zone in which the operator writes the victims' identity and details and the place where action was taken, and at least a second zone in which the operator writes the assessments of the victim made and any operations performed on the victim.

To indicate the victim's conditions using triage colour codes, some types of tags also comprise coloured tear off sections, which if necessary may be detached from the tags and which have the colour of the various colour codes used.

The operator leaves attached to the tag the tear off section with the colour indicating the seriousness of the victim's condition, detaching the other coloured tear off sections from the tag.

One defect of the tags used for triage and/or assistance is that they can easily be damaged.

The tags, mostly made of paper, can easily be marked, for example with blood, or even get wet due to rain or water and, therefore, the information on them may become illegible.

Therefore, the information on the tags is not accessible and any subsequent operators are obliged to examine the victim again.

To overcome this disadvantage, plasticised tags could be used. However, this would further complicate the step of operators writing on the tags, and, moreover, a plasticised tag requires the use of suitable pens, which are not always available.

However, even in such a case, the information on the tags may be washed away by the rain and therefore lost.

Moreover, tags may easily be lost, because the victims remove them or leave them somewhere.

As a result, the victims would have to be examined again, wasting a considerable amount of time. In some cases, such wasted time could prove fatal for the victim or for other victims who are not reached in time by the rescuers.

Moreover, the loss of medical history information may compromise the correctness of the evaluations carried out, and/or of the subsequent treatments which the victim receives.

Also, this means that the victim may repeatedly undergo the same operations, for example the taking of samples or pressure measurements lost with the tag, causing considerable inconvenience, even for the victim.

Moreover, when using the prior art tags, evaluation of the conditions of the various victims largely involves subjective evaluations by different operators who examine the various victims, meaning that there is a considerable margin of uncertainty in the evaluations carried out.

In addition, said evaluations are carried out by operators in conditions which are not optimum, in which the individual operators, even if suitably trained, may lose their lucidity and objectivity.

Moreover, such evaluations must be carried out as rapidly as possible, which does not help the operators to maintain objectivity. Also, the prior art tags do not help operators to carry out their evaluations in limited time periods, because a considerable writing step is required and, above all a high degree of personal initiative in selecting parameters to be examined and/or the action to be taken on the victim.

Moreover, prior art tags only allow a limited amount of information to be recorded, meaning that there is the risk that a sufficient clinical picture for subsequent operators may not be recorded.

Alternatively, to increase the information which can be recorded, either the size of the writing must be reduced, with a significant loss of clarity and risking the production of information which cannot be used by subsequent operators who are unable to read it, or the surface area of the tags must be increased.

However, tags which are too big may easily be lost or ruined or may be a nuisance for the people who have to wear them.

Another defect of prior art tags is that they cannot be used for subsequent triage operations, carried out by other operators in the rescue chain.

Subsequent operators must draw up new tags to be attached to the victim, because it is not possible to record further information on the tags already given to the victims.

Therefore, at the end of the assistance operations a single victim will have three or even four different tags.

To avoid such a disadvantage, folding tags were invented, having a plurality of faces on which the various operators can record information about the victim.

However, this causes other problems, for example because the tags are damaged when folded, or there may be doubts about which is the valid part of the folded tag, that is to say, the part used to record information by the last operator in chronological order to examine the victim.

Moreover, with the prior art tags a compromise must be found between complete information and legibility and clarity of the information and the size of the tags.

In addition, with prior art tags it is complex or even impossible to trace the victims, that is to say, at the end of the day to count the number of people examined by the various operators, to calculate the total number of victims of the event, or even to check if some people found at the scene of the event never arrived at the advanced medical posts or in hospital, in the worst case scenario because they were never taken away from the scene of the event.

For this reason, prior art tags can have tear off sections which are taken by the operators and which must be counted at the end of the day.

However, this system does not allow satisfactory results to be achieved because the tear off sections may get lost, calculating errors may be made, etc.

Moreover, in the prior art tags the colour code may not be visible enough for the second rescue team whose job is to evacuate victims from the disaster zone.

Therefore, the operators waste time identifying the seriousness of the conditions of the various victims and organising evacuation based on this.

Another disadvantage is that, following successive triage operations, the colour code assigned to individuals may change, due to a change in a person's clinical picture. That possibility is not allowed for in prior art tags.

In prior art tags, the colour code is indicated by leaving attached to the tags the tear off section having only the colour relative to the colour code indicating the seriousness of the victim's condition identified following one triage operation. Should the victim's conditions change, this change cannot be indicated using a tag colour code. Therefore, the victim must be issued with another tag.

Disclosure of the Invention

One aim of the invention is to improve methods for working in places where accidents and/or disasters occur.

Another aim is to improve the apparatuses and guiding methods for guiding an operator working at the scene of a disaster.

Yet another aim is to improve the apparatuses and guiding methods for guiding an operator who must evaluate a person's clinical conditions and who must decide what treatment should be carried out on that person.

Another aim is to provide an apparatus for guiding an operator who must evaluate a person's clinical conditions, for example at the scene of a disaster, and who must decide what treatment should be carried out on that person.

Another aim is to provide an apparatus which allows any operations carried out on a person to be saved and also allows easy, fast retrieval of the information about said operations.

Still another aim is to provide a software for implementing a method for guiding operators during assistance operations.

Another aim of the invention is to improve the quality of work at the scenes of accidents and/or disasters, providing a real time guide for an operator working at the scene of a disaster and who must evaluate a person's clinical conditions and decide what treatment should be carried out on that person.

A first aspect of the invention covers an apparatus for guiding an operator in an assistance operation by means of a first electronic device comprising means for displaying a plurality of questions about the state of a patient's health, means for entering a plurality of data about said health in response to said questions, means for suggesting a way of proceeding for working on said health based on said data.

Thanks to the invention, assistance operations performed by an operator can be facilitated, making them faster and facilitating a diagnosis.

Moreover, thanks to said apparatus the operator can avoid forgetting any fundamental steps for arriving at a correct diagnosis, and/or can avoid omitting to check one or more parameters of the patient's health which are essential for a correct diagnosis.

In one version the method also comprises an identification procedure, for identifying the type of event, and/or the type of operator, and/or the type of site where the operator carries out his work.

Another version involves writing said data about the patient's health using said first electronic device to a second electronic device made in such a way that it is compatible with the first electronic device and prepared so that it can be attached to the patient.

In this way, it is possible to leave evidence on the second device attached to the patient of what was done by the operator who examined the patient.

This prevents a subsequent operator having to again acquire parameters that were already checked by the previous operator, and/or prevents the subsequent operator from carrying out the same operations on the patient as were performed by the previous operator.

In another version there are means for using the first device for reading information from the second device which is attached to the patient, to be used before the display means. This allows the information from the second device to be simply and rapidly sent to the first electronic device. The information comprises, for example, information for identifying the patient, for example a bar code attached to the second device.

One version also involves reading the data from the second device attached to the patient using another, different, first device, after said writing.

This allows a subsequent operator treating the patient to display and read the data from the second device, using a first device which is in the possession of the additional operator, to rapidly and effectively obtain the data about the patient's health and for information about what the previous operator already did to the patient.

This prevents the additional operator from having to repeat the same operations performed by the previous operator, and/or from again checking the parameters checked by the previous operator. This, therefore, avoids useless time wasting.

Brief Description of the Drawings

The invention can be better understood and implemented with reference to the accompanying drawings, which illustrate several non-limiting example embodiments, in which:

Figure 1 is a flow chart showing the steps of a guiding process in accordance with the invention;

Figure 2 illustrates an electronic device for implementing the process of Figure

1 in a non-operating configuration;

Figure 3 illustrates the electronic device of Figure 2 in a possible configuration of the reading step of the process of Figure 1 ;

Figure 4 illustrates the electronic device of Figure 2 in a possible configuration of the operator identification step; Figure 5 illustrates the electronic device of Figure 2 in a possible configuration of the site identification step;

Figure 6 illustrates the electronic device of Figure 2 in a possible configuration of the question step;

Figure 7 illustrates the electronic device of Figure 2 in another possible configuration of the question step;

Figure 8 illustrates the electronic device of Figure 2 in a possible configuration of the colour code assignment step;

Figure 9 is a flow chart showing the steps of an alternative version of the guiding process in accordance with the invention;

Figure 10 is a flow chart showing the steps of another alternative version of the guiding process in accordance with the invention;

Figure 11 illustrates the electronic device of Figure 2 in another possible operating configuration;

Figure 12 is a first table indicating the possible steps of the process 100 for a lay rescuer at the scene of an event;

Figure 13 is a second table indicating the possible steps of the process 100 for a lay rescuer in a Collecting Area;

Figure 14 is a second table indicating the possible steps of the process 100 for a lay rescuer in an AMP (Advanced Medical Post);

Figure 15 is a fourth table indicating the possible steps of the process 100 for a nurse at the scene of an event;

Figure 16 is a fifth table indicating the possible steps of the process 100 for a nurse in a Collecting Area; Figure 17 is a sixth table indicating the possible steps of the process 100 for a nurse in an AMP;

Figure 18 is a seventh table indicating the possible steps of the process 100 for a nurse in a hospital;

Figure 19 is an eighth table indicating the possible steps of the process 100 for a doctor at the scene of an event;

Figure 20 is a fifth table indicating the possible steps of the process 100 for a doctor in a Collecting Area;

Figure 21 is a sixth table indicating the possible steps of the process 100 for a doctor in an AMP;

Figure 22 is a seventh table indicating the possible steps of the process 100 for a doctor in a hospital;

Figure 23 is the operating diagram of the S.T.A.R.T. (Simple Triage And Rapid

Treatment) work protocol;

Figure 24 is a perspective view of a second electronic device for implementing the process of Figure 1.

Detailed description of the Preferred Embodiments of the Invention

With reference to Figure 1 , a flow chart is shown, indicating the steps of a process 100 for guiding an operator in an assistance operation. Said process may be implemented using various types of apparatuses.

There may be an apparatus comprising a pair of devices, in which a first device and a second device are suitably selected so as to communicate with each other.

For example, the first device is made in such a way that information can be entered and^' saved in it, and is such a way that it can communicate said information to the second device, so that said information can be recorded on the second device.

The first device may be entrusted to an operator. The second device may be attached to a patient, or to a victim.

The first device may be an electronic and/or digital device, a PDA (Personal

Digital Assistant) type device which communicates with the second device using electronic means of communication, for example using WiFi, Bluetooth, infrared, radio waves, radio frequency, or other means.

The first device may also comprise emitter means prepared in such a way that they can send information to a suitable data collection system.

The operator can use the emitter means to send the data collection system various types of information in real time, for example requests for specialists: cardiologists, orthopaedic surgeons, toxicologists, or requests for support, for example for bags of blood, or to send data about the victims for real time monitoring of the number of victims of the event.

If necessary, the first device may also have a video camera, or a camera for still images, for capturing images of the state of the patient, for example for promptly communicating his appearance above all in the case of fear of a chemical attack, or his position at the scene of the event, to facilitate the work of the transportation team, above all if the victim is not easy to see.

The first device may comprise a GPS receiver device so that the first device can be located. The location information is recorded on the second device so as to record the position of the patient and make it easier him to be identified by the rescue team whose job is to move victims away from the scene of the event. This makes operations for moving victims away from the scene of the event simpler and faster.

Moreover, by locating the various victims it is possible to optimise resources, for example sending specialised medical personnel and/or material requested, for example blood, to the place where the victims for whom the operator made the specific request are actually positioned.

For example, the first device may comprise a palmtop device 1 , illustrated in

Figure 2, which has a screen 2 and a push-button panel 3.

The push-button panel 3 comprises navigation keys 4 for navigating in the palmtop device 1 , entry keys 5 for entering information in the palmtop device 1 , accessory keys 6 for accessing palmtop device 1 functions. The palmtop device

1 also comprises an ON/OFF button 7 for switching the palmtop device 1 on/off, and a loudspeaker 8.

The screen 2 comprises a main display 2a for displaying various screen pages/information one after another, as is explained in more detail below, and a display bar zone 2b which is always visible even when the screen pages in the main display zone 2a change.

The display bar zone 2b may display information useful to the operator at all steps in his assistance work, for example the time, position, presence and/or strength of the signal, etc.

In the main display zone 2a of the screen 2 there may be a first zone 11 for displaying the current palmtop device 1 activity, or suitable selection zones are displayed, described in more detail below, and a navigation zone 12 for navigating between the various palmtop device display images, for example to go back or to go forward to the next screen page. In one version, the palmtop device 1 screen 2 may be configured in such a way that the navigation zone 12 is always visible in all of the different palmtop device 1 screen 2 display images, to allow the operator to rapidly proceed with the process 100 and/or go back to repeat a particular step of the process 100. If, instead, the palmtop device 1 screen 2 is configured in such a way that the navigation zone 12 is not always visible, it is possible to repeat any of the steps of the process 100, or to go back or to proceed to the next step of the process 100 using the push-button panel 3.

In this way, during any step of the process 100, by applying a predetermined pressure on a first portion of the navigation zone 12, and/or on a suitable key of the push-button panel 3, in particular the entry keys 5, it is possible to go to the next step of the process 100, whilst by applying a predetermined pressure on a second portion of the navigation zone 12, and/or on another suitable key of the entry keys 5, it is possible to repeat that specific step of the process and/or return to the previous step of the process 100.

The palmtop device 1 screen 2 may be of the "touch screen" type, so that information can be entered in the palmtop device 1 by applying suitable pressure on predetermined zones of the screen 2.

In this way, the information and/or data can be entered in the palmtop device 1 using the push-button panel 3, and/or using suitable portions of the screen 2. The second device, illustrated in Figure 24, comprises an electronic storage device 92 for storing the information written to it using the first device. The second device may comprise, for example, a microchip, or an RFID (Radio Frequency IDentification) tag. The second device may have a GPS receiver device 93 so that the second device can be located, allowing any patient movements to be recorded.

The second device may have the shape of a bracelet 9 to be applied to the various victims and/or patients.

The bracelets 9 have application devices 91 made in such a way as to allow simple, rapid application of the bracelets to the various victims.

The application devices 91 must also be made in such a way that they allow the bracelets to be applied in such a way that they can be removed from the various patients, but are stable to prevent the bracelets from being accidentally removed.

The bracelets are also made in such a way that they are easily visible for and distinguished by the various operators.

In addition to the palmtop device 1 , each operator may also be supplied with a predetermined number of bracelets 9, depending on the extent of the catastrophe, that is to say, the expected number of people affected.

The bracelets 9 may be made in various colours, corresponding to triage colour codes, that is to say, green, yellow, red, black and if necessary white, for hospital use, and/or blue for use in countries in which that colour code is required.

Or, the bracelets 9 may have connecting means 94, for stably connecting to the bracelets coloured bands 95a made in the colours of triage colour codes.

Each operator will be supplied with a predetermined number of bracelets 9 in the various colour code colours, or a predetermined number of bracelets 9 and a predetermined number of coloured bands 95a made in the various colours of triage colour codes. Or, the bracelets 9 may have a lighting device 95b made in such a way that it has a different colour depending on the colour code corresponding to the victim's conditions.

Use of the colour allows the various operators to rapidly identify the seriousness of the conditions of the various patients.

In one version, the bracelets 9 may have emitter means 96 for emitting a signal, for example using radio waves, which can be picked up and recorded by suitable detector systems.

This allows real time location and mapping of the various victims of the event.

This allows assistance operations to be optimised, without wasting time searching for victims at the scene of the event, and avoids the risk of some victims who are difficult to reach, and/or who have moved, not being reached by rescuers and provided with assistance.

The bracelets 9 are made of a material which is not altered by weather and which resists potentially damaging agents, for example corrosive substances, or other substances.

The guiding process 100 of Figure 1 comprises a reading step 10 in which the palmtop device 1 is brought close to a bracelet 9 to read an identification code belonging to the bracelet, followed by a guiding procedure 20, in which the operator is guided in assisting a patient.

The identification code is saved, if necessary together with other information, on the palmtop device 1. In this way, it is possible to link the identification code of the bracelet 9 attached to the patient to the information produced on the palmtop device 1 following the process 100. During the reading step 10 the palmtop device 1 screen 2 appears as illustrated in Figure 3. The first zone 11 of the main display zone 2a shows the operator the current palmtop device 1 activity, bracelet 9 data reading, that is to say, reading of the bracelet 9 identification code, and/or of the data previously stored in the bracelet 9.

At the end of the reading step 10, by applying a predetermined pressure on a first portion of the navigation zone 12, and/or on a suitable key of the pushbutton panel 3, it is possible to access the guiding procedure 20, whilst by applying a predetermined pressure on a second portion of the navigation zone 12, and/or on another suitable key of the push-button panel 3, it is possible to repeat the reading step 10, and/or switch off the palmtop device 1. The guiding procedure 20 comprises an identification procedure 50 comprising an event identification step 21, for identifying the type of event, for example disaster, maxi-emergency, NBCR (Nuclear, Biological, Chemical, Radioactive) emergency, single-emergency, hospital care, which the operator is dealing with. The event identification step 21 comprises an event displaying step 21a and an event selection step 21b.

During the event displaying step 21a, the first zone 11 of the screen 2 main display zone 2a displays a plurality of selection zones, each selection zone corresponding to a possible type of event.

During the event selection step 21b the operator selects the specific selection zone corresponding to the actual type of event he is dealing with. The specific selection zone can be selected using the push-button panel 3, that is to say, suitably using the navigation keys 4 to choose a particular selection zone and one or more entry keys 5 to select that selection zone. If necessary, the selection zones may be of the touch-screen type, and the selection can be made by applying suitable pressure on the portion of the screen 2 main display zone 2a relative to the specific selection zone to be selected.

Then the guiding procedure 20 identification procedure 50 involves an operator identification step 22.

The operator identification step 22 comprises an operator displaying step 22a in which the first zone 11 of the screen 2 main display zone 2a displays several possible alternative operators, and an operator selection step 22b, in which the operator identifies himself as a predetermined type of operator.

For example, if the operator previously selected the event type as emergency, single-emergency, or maxi-emergency, during this step he will probably be presented with three alternatives to choose from: doctor, nurse, lay rescuer, including fireman, emergency services operator, member of the civil defence force, of the forces of law and order, etc.

In the above-mentioned cases, during the operator displaying step 22a, the palmtop device 1 screen 2 may be configured as shown in Figure 4.

In such a configuration, the first zone 11 displays a plurality of operator selection zones 13, each corresponding to a possible type of operator: for example a doctor selection zone 14, a nurse selection zone 15, an other selection zone 16, including the various types of lay rescuers, rescue services volunteers, firemen, etc.

The operator selects the specific operator selection zone 14 - 16 amongst the plurality of operator selection zones 13 corresponding to the actual type of operator using the push-button panel 3 or the screen 2. As already seen, by suitably acting on specific zones of the navigation zone 12, the operator can repeat the selection of the specific operator selection zone amongst the plurality of operator selection zones 13, or return to the previous step of the process 100, or continue to the next step of the process 100. If, instead, during the event identification step 21 , the operator previously selected a hospital care event, during the operator identification step 22 he will probably be presented with the following alternatives from which to make a selection: doctor, nurse, clinic operator, for example from a diagnostic clinic or analysis laboratory.

Again, the operator will select the type of operator using the push-button panel 3 or the screen 2. Then, the guiding procedure 20 identification procedure 50 includes a work site identification step 23, with a site displaying step 23a in which the screen 2 main display zone 2a displays a plurality of site selection zones, each corresponding to a possible type of site, as explained below, and a site selection step 23b, in which the operator must select the type of site where he is working.

Figure 5 shows a possible palmtop device 1 screen 2 display image during the site displaying step 23a. The first zone 11 of the main display zone 2a displays a plurality of boxes 17, each corresponding to a possible site in which the operator finds himself.

During the site selection step 23b the operator selects the specific box 17 corresponding to the type of site where the operator actual finds himself. Again, the selection may be made using the push-button panel 3, and/or by applying suitable pressure on the relative zone of the screen 2. If the operator previously selected the event type as an emergency, during the site displaying step 23a the boxes 17 will probably suggest the following options from which to make a selection: scene of the disaster, Collecting Area,

Advanced Medical Post, P.E.I. M.A.F. (Internal Emergency Plan for Massive

Influx of Casualties), Hospital, or other.

If the operator previously selected the event type as single-emergency, the following will probably be suggested from which to make a selection: scene of the event, ambulance, Hospital.

If the selected event type was hospital care, the following will probably be suggested from which to make a selection: Accident and Emergency, ward, clinic, analysis laboratory, etc.

If necessary, by selecting ward and/or clinic, the operator can enter the particular ward and/or clinic in which he finds himself, either by typing in the type of ward and/or clinic, or by selecting the particular ward in which he finds himself from amongst a plurality of options which may then be displayed on the screen 2.

At the end of the identification procedure 50, the process 100 may comprise a location procedure, in which the operator records on the palmtop device 1 the

GPS co-ordinates where he finds himself at the time of the assistance operation in order to locate the patient, plus the current time and date.

The location procedure may also be carried out before starting the identification procedure 50, or at any other step of the process 100.

After the identification procedure 50, the process 100 guiding procedure 20 has an assistance procedure 24 in which the operator is supported and guided in taking action to provide assistance and/or aid. During the assistance procedure 24 the operator is presented with a plurality of questions designed to arrive at a diagnosis for the patient and operations to be carried out on the patient are suggested to the operator based on the supposed diagnoses, and/or to confirm or refute a supposed diagnosis.

The assistance procedure 24 and, therefore, the actions suggested to the operator vary depending on the selections previously made, that is to say, the type of event, the type of operator, the site where the operator is working.

The assistance procedure 24 comprises a question displaying step 25 in which the first zone 11 of the screen 2 main display zone 2a displays a plurality of questions relating to the patient's health, a data entry step 26 in which the operator enters a plurality of items of data relating to the patient's health in response to the questions of the question displaying step 25, a step of suggesting actions 27 in which a way of proceeding is suggested to the operator for working on the patient's health based on the data entered during the data entry step 26.

The step of suggesting actions 27 comprises a step of displaying suggestions

27a in which the screen 2 displays possible operations suggested to the operator, and an action selection step 27b, in which the operator selects a particular operation to be carried out on the patient.

The step of suggesting actions 27 may also comprise a step of entering results

27c, in which the operator, after carrying out the particular operation selected during the action selection step 27b, enters in the palmtop device 1 the result of said operation on the patient.

The question step 25, the data entry step 26 and the step of suggesting actions

27 may be repeated a desired number of times, as indicated by the arrow 29, needed to arrive at a suitable diagnosis and for carrying out all possible and necessary operations on the patient.

During the question displaying step 25 and during the step of displaying suggestions 27a of the assistance procedure 24, the palmtop device 1 screen 2 may display various display images, based on the individual question posed during the question displaying step 25, and/or the value of the data entered during the data entry step 26, and/or the individual action suggested during the step of displaying suggestions 27a.

For each screen 2 display image, the entry or selection of the response(s) to the question of the question displaying step 25, and/or the selection respectively of the result(s) of the action(s) suggested, the action to be carried out, or carrying out one or more actions, can be done using the push-button panel 3, and/or by applying suitable pressure on the relative zone of the screen

2.

Figure 6 shows a possible palmtop device 1 screen 2 configuration during the question displaying step 25.

The first zone 11 of the screen 2 main display zone 2a displays the navigation zone 12 and a plurality of question zones 30, each question zone 30a of the plurality of question zones 30 relating to specific questions concerning specific patient vital parameters to be checked.

For example, the question zones 30 may comprise a first question zone 31 for questions relating to the conditions of the victim's respiratory system, a second question zone 32 for questions relating to other data linked to respiratory function, a third question zone 33 for questions relating to the victim's cardiovascular system, a fourth question zone 34 for questions relating to the victim's neurological state, a fifth question zone 35 for questions relating to topographic location of the injuries found, and a sixth question zone 36 relating to the victim's destination.

In an alternative version of the process 100, the number of question zones of the plurality of question zones 30 may be different, for example there may be four question zones respectively relating to: airways, indicated with "A" (Airway) in jargon, breathing, indicated with "B" (Breathing) in jargon, circulation, indicated with "C" (Circulation) in jargon, and neurological deficits or alterations in the state of consciousness, indicated with "D" (Disability).

The operator can select the specific question zone 30a using the push-button panel 3, or by applying a predetermined pressure on the portion of the screen 2 in which the specific question zone 30a is displayed.

When a specific question zone 30a is selected, the screen 2 of the palmtop device 1 displays an additional plurality of question zones relating specifically to the question zone 30a previously selected, which ask the operator detailed questions to allow a more detailed evaluation of the patient's health.

The actual questions in the additional plurality of question zones depend on the question zone 30a previously selected. That is to say, they depend on the particular patient parameters which require further investigation.

For example, if the operator selected the first question zone 31 for questions relating to the conditions of the patient's respiratory system, the additional question zones may comprise: Guedel, combitube/LMA, intubation, cricothyrotomy.

If the operator selected the second question zone 32 for questions relating to other data linked to respiratory function, the additional question zones may comprise: ambu/IPPV, PEEP, relieving PNX pressure, pleural drainage, oxygen, SaO₂, RR (respiratory rate).

If the operator selected the third question zone 33 for questions relating to the patient's cardiovascular system, the additional question zones may comprise: haemorrhage compression, medication of wounds/sutures, wounds, venous line, infusions, ECG monitor, HR (heart rate), BP (blood pressure), Defibrillator,

CPR/ROSC, Heating/protection, T⁰.

If the operator selected the fourth question zone 34 for questions relating to the victim's neurological state, the additional question zones may comprise: GCS

(Glasgow Coma Scale), pupils, analgesia.

If the operator selected the fifth question zone 35 for questions relating to the topographic location of the injuries found, the additional question zones may comprise: fractures/dislocations, splinting, fracture reduction, spinal board.

If the operator selected the sixth question zone 36 for questions relating to the victim's destination, the additional question zones may comprise: destination hospital, means of transport, position, AMP exit colour code, time of exit, accompanying operator.

The operator then examines one after another in the patient the various parameters as required by the additional questions and for each parameter checked the operator enters the relative data item, and performs one after another the actions required by the additional questions, thus arriving at the process 100 data entry step 26 and/or the step of suggesting actions 27.

In particular, for each question of the additional questions there may be a respective selection box which is activated by the operator who checks the parameter required by the respective question, and/or who performs the action required by the respective question.

If necessary, there may be an additional box designed for indicating the number of times the operator has performed the action and/or checked the parameter required by the relative question.

The additional questions relating to a specific question zone 30a may all be displayed simultaneously on the main display zone 2a of the screen 2, or they may be displayed on the screen 2 in several display images, one after another, for improved display image quality.

For example, if the operator selected the third question zone 33 for questions relating to the patient's cardiovascular system, a subsequent display image will show the additional question zones: haemorrhage compression, venous line, infusions.

For example, the operator will compress haemorrhages, indicating in the respective box that said action has been carried out.

If necessary, the operator may also perform a predetermined number of transfusions, indicating in the respective box that said action has been carried out, and, in another respective box, the number of transfusions performed.

Similar procedures can be used for the other question display images 25, or to indicate data entry 26, or to indicate that an action suggested during the step of displaying suggestions 27a has been carried out.

The questions of the plurality of question zones 30 and/or the additional questions change according to the previous selections made, that is to say, according to the type of operator providing assistance, the place where the operator is located, and the type of event the operator is dealing with. The operations which an operator can effectively carry out on a patient depend on the operator's medical training. A lay rescuer is not able to carry out actions which are required of a nurse and/or a doctor.

Moreover, the operations that an operator can effectively carry out on a patient depend on the place where they are located and therefore, for example, on the equipment available, etc.

In this way, the operator is guided when taking action to assist the patient, because the patient parameters to be checked are suggested to him, because actions to be carried out on the patient are suggested, and because the operator is able to indicate what he has done to the patient, leaving a record of his work.

The operator can carefully diagnose the patient's state of health, can select one after another two or more question zones 30a of the plurality of question zones

30, if necessary all of them, so as to investigate, one after another, all of the patient parameters which are considered vital and which if compromised would mean that the patient's life was in serious danger.

It may be possible to indicate that a particular question zone 30a has been selected, and therefore, the operator has checked the necessary parameters, and/or carried out the actions required in that question zone 30a and/or by the respective additional question zones.

Said indication may consist of colouring the question zone 30a selected with an indicator, for example an "X" or the like, or lighting the question zone 30a selected in a different way to the other question zones 30a which are still to be selected, that is to say relating to patient parameters which still need examining. During the question displaying step 25 and/or the data entry step 26 and/or the step of suggesting actions 27, in particular if the operator selected the fifth question zone 35, the operator can make use of a palmtop device 1 screen 2 configuration like that shown in Figure 7 to help locate any patient fractures and/or to indicate points which the patient says are painful. In said configuration, the screen 2 shows an outline of a person 37 seen from the front and another outline of a person 38 seen from the back. By applying pressure on the desired zones of the outline 37 and/or on the other outline 38, or by selecting desired zones of the outline 37 and/or of the other outline 38 using the navigation keys 4, the operator can indicate any parts of the patient which are painful or fractures.

At the end of the process 100 assistance procedure 24 there is a code assignment step 28.

The code assignment step 28 comprises a code displaying step 28a in which the screen 2 displays a plurality of code selection portions 18, each corresponding to a possible code indicating seriousness, for example as shown in Figure 8, and a code selection step 28b, in which, based on the findings and/or the operations carried out, the operator selects a colour code to be assigned to the patient, identifying the seriousness of the patient's conditions. The plurality of code selection portions 18 may comprise a first selection portion 18a for selecting the "Green" colour code, that is to say, less urgent, indicating a person who has injuries which are not life-threatening but which require care; a second selection portion 18b for selecting the "Yellow" colour code, that is to say, urgent, indicating a patient with partial compromise of the functions of the circulatory or respiratory systems, but without any immediate danger of death; a third selection portion 18c for selecting the "Red" colour code, that is to say, emergency, indicating a person with at least one of his vital functions

(consciousness, respiration, pulse) compromised, in danger of dying; a fourth selection portion 18d for selecting the "Black" colour code, indicating a deceased patient.

The operator selects the specific code selection portion 18a-d amongst the plurality of code selection portions 18 corresponding to the actual seriousness of the patient's conditions.

Again, the selection may be made using the push-button panel 3, and/or by applying suitable pressure on the relative zone of the screen 2.

If necessary, basically in hospital care procedures, there may be a selection zone for selecting the "White" colour code, that is to say, no urgency, which indicates a person who does not need first aid and who can be sent to their family doctor.

Moreover, if necessary there may also be a sixth selection portion for selecting the "Blue" colour code, that is to say "depassee" (beyond urgency) emergency, indicating a patient in particularly serious conditions, for whom even intervention could be useless.

In an alternative version of the process 100, whose flow chart is shown in

Figure 9, the code assignment step 28 may come before starting the assistance procedure 24.

In another version, the code assignment step 28 may be carried out in any of the stages of the question step 25, and/or the data entry step 26, and/or the step of suggesting actions 27. If the code assignment step 28 is carried out before the assistance procedure 24, or if it can be carried out in any step of the assistance procedure 24, in the various display images of the assistance procedure 24 the screen 2 main display zone 2a comprises the first zone 11 displaying the operator's operations, the navigation zone 12 and, a colour assignment portion 80, as illustrated in Figure 11.

In the colour assignment portion 80 there are the code selection portions 18a-d corresponding to the various degrees of seriousness of the patient's conditions, as already discussed.

The operator can select the code selection portion 18a-d corresponding to the actual seriousness of the patient's conditions, in the ways already described. To indicate that a particular code selection portion 18a-d has been selected, it may be provided with an indicator, for example an "X", or it may light up in such a way that it is distinguished from the other code selection portions 18a-d which have not been selected.

If necessary the three options described above may be used simultaneously, as shown in the flow chart in Figure 10. That is to say, the code assignment step 28 may be carried out before the assistance procedure 24, or in any of the stages of the question step 25, and/or of the data entry step 26, and/or of the step of suggesting actions 27, or at the end of the assistance procedure 24. The colour code assignment procedure 28 may be carried out with reference to the sequence of operations required by the S.T.A.R.T. (Simple Triage And Rapid Treatment) work protocol, an algorithm which defines a triage protocol which is used and can be used in emergencies and/or maxi-emergencies. The S.T.A.R.T. protocol comprises a set of questions which the operator must answer to rapidly check the patient's health so as to assign a colour code indicating the seriousness of the patient's conditions.

Figure 23 shows a block diagram representing the operating diagram for the

S.T.A.R.T. work protocol.

The operator checks if the patient can walk. If he can, the protocol ends with assignment of the "green" colour code. If he cannot, the operator checks if the patient is breathing.

If the patient is breathing at a rate of more than 30 breaths per minute, the protocol ends with assignment of the "red" colour code. If the patient is not breathing, the protocol ends with assignment of the "black" colour code. If the patient is breathing at a rate of less than 30 breaths per minute, the operator checks the radial pulse.

If there is no radial pulse, that is to say, systolic pressure is less than 80 mmHg, the protocol ends with assignment of the "red" colour code. If there is a radial pulse, that is to say, systolic pressure is greater than 80 mmHg, the operator checks if the patient responds to simple instructions.

If he does, the protocol ends with assignment of the "yellow" colour code. If he does not, the protocol ends with assignment of the "red" code.

The S.T.A.R.T. algorithm may be intended for rescue teams including medical and non-medical personnel and allows a death to be confirmed in the field.

If necessary, a work protocol can be used which has an algorithm different to that of the S.T.A.R.T. protocol and suitable for used by the medical emergency system. For example, another protocol, identified by the acronym C.E.S.I.R.A.,

(Coscienza, Emorragia, Shock, Insufficienza respiratoria, Rotture Ossee, Altro

- Consciousness, Haemorrhage, Shock, Respiratory failure, Broken Bones,

Other) may be used, which indicates the sequence of physiopathological conditions to be identified. The C.E.S.I.R.A. protocol is set out in the same way as the S.T.A.R.T. protocol, but is intended especially for rescue teams which do not include members who are medical professionals and so does not allow deaths to be confirmed in the field.

If necessary, other protocols may be used which are suitable for defining a code of seriousness indicating the patient's health conditions.

Figures 12 - 22 show tables indicating several possible options for operations provided by the process 100 for guiding the various types of rescuers in their activities as they provide assistance.

Figures 12 - 14 show tables relating to the assistance activities of a lay rescuer, for example a volunteer, a volunteer in the Italian Red Cross, from the 118 emergency services, a fireman, a member of the civil defence force, of the forces of law and order, etc., that is to say, a person who has no specific medical training. A lay rescuer can work at the scene of the event (Figure 12), in the Collecting Area (Figure 13), and in the AMP (Figure 14).

Figures 15 - 18 show tables relating to the assistance activities of a nurse respectively at the scene of the event (Figure 15), in the Collecting Area (Figure

16), in the AMP (Figure 17), in hospital, or PEIMAF, (Figure 18).

Figures 19 - 22 show tables relative to the assistance activities of a doctor respectively at the scene of the event (Figure 19), in the Collecting Area (Figure

20), in the AMP (Figure 21), in hospital, or PEIMAF (Figure 22). The tables relate to assistance activities for emergencies, or maxi-emergencies, or disasters, but similar tables may be drawn up with assistance procedures for hospitals, or other types of medical assistance activities. The tables in Figures 12 - 22 comprise a first column indicating questions relating to patient parameters to be checked and/or actions which are suggested to the operator, if necessary using the palmtop device 1 screen 2. The tables in Figure 12 - 22 comprise a second column indicating the expected results for the questions and/or actions in the first column. The second column corresponds to data which must be entered by the operator, for example in the data entry step 26 and/or after carrying out particular actions of the step of suggesting actions 27.

The questions and/or the actions indicated in the lines of the tables in Figures 12 - 22 may be displayed and/or carried out in a different order to that shown by the lines of the above-mentioned tables.

The first line of each of the tables in Figures 12 - 22 indicates that the operator must enter the details of the contact, i.e.: date, time, and GPS co-ordinates, that is to say, the location procedure referred to above.

The last line of the tables in Figures 14, 17, 18, 21, 22 indicates that it is necessary to enter data relating to the patient exiting respectively the AMP or the PEIMAF, or the hospital, that is to say, the date, time and GPS coordinates.

Indicated in the second line of each of the tables in Figures 12 - 22 is the colour code assignment procedure 28 for indicating the seriousness of the patient's conditions using a triage colour code. To assign a colour code indicating seriousness to the patient, the operator carries out a standardised procedure comprising a set of questions for checking several basic patient parameters, for example according to the S.T.A.R.T. protocol, as indicated in the tables in Figures 12 - 22, or another suitable protocol.

The other lines of the tables in Figures 12 - 22 indicate other possible operating options provided by the process 100 guiding procedure 24, for assisting the patient and designed to help the operator providing assistance to arrive at a diagnosis which is as accurate as possible in the shortest possible time.

The actions and/or parameters suggested in the various lines of the tables in

Figures 12 - 22 relate to the various question zones 30a or to the additional question zones referred to above.

The process 100 then involves a data recording step 40, in which the palmtop device 1 is moved close to the bracelet 9 to record on the bracelet 9, which is stably attached to the patient so that it remains with him, the data about the patient's health previously generated by the operator as he provided assistance.

During the data recording step 40, the palmtop device 1 screen 2 appears very similar to the configuration of the reading step 10.

During the data recording step 40, the first zone 11 of the screen 2 main display zone 2a indicates the current palmtop device 1 activity, that is to say, writing data to the bracelet 9.

By applying a predetermined pressure on a first portion of the navigation zone

12, and/or on a suitable key of the entry keys 5, it is possible to terminate the process 100, and/or switch off the palmtop device 1. By applying a predetermined pressure on a second portion of the navigation zone 12, and/or on another suitable key of the entry keys 5, it is possible to return to the guiding procedure 20, and/or to a particular step of the guiding procedure, and/or to repeat the data recording step 40. ^x

At this point the operator has finished providing assistance to the patient.

When an operator has finished providing assistance the patient is usually transported to another assistance site.

If the patient is a disaster victim, he is transported for example to a Collecting

Area or an Advanced Medical Post, or a hospital.

If the patient is in hospital he can be transported to a clinic, and/or an analysis laboratory and/or a ward.

At this additional assistance site, the patient is examined by another operator.

This additional operator is equipped with another palmtop device, made in such a way that it is similar to the previous operator's palmtop device 1.

The additional operator will repeat the process 100 in order to provide his own assistance to the victim.

The additional operator carries out the reading step 10, during which he brings the palmtop device close to the bracelet attached to the patient. In this way, the additional operator reads the identification code of the bracelet and the data about the patient's health generated by the previous operator and recorded on the bracelet.

Then the additional operator in turn begins the process 100 guiding procedure

20 in order to provide assistance to the patient. At the end of the procedure, the additional operator will carry out the data recording step 40 to record on the bracelet 9 additional data about the patient's health generated by the additional operator while he was providing assistance. Recording on the bracelet 9 of the additional data generated by the additional operator does not delete the data previously recorded on the bracelet 9 by the previous operator. Instead, the previous data and the additional data remain together in the bracelet 9 memory and may be retrieved by yet another operator who subsequently takes care of the patient.

This allows updated data about the patient to be recorded on the bracelet 9, therefore, references to improvements/worsening in his health, or the indication of new operations, treatments carried out on the patient, leaving a record and memory of everything done to the patient by the different operators who provided him with assistance.

By presenting the operator with a set of questions and suggesting a set of possible patient parameters to be checked, the process 100 allows the operator to be helped to reach a diagnosis quickly, and also allows an objective, unbiased diagnosis to be reached.

By also suggesting a set of possible actions to be carried out on the patient, the process 100 also allows the operator to be guided in carrying out operations on the patient, so that the operator does not forget any fundamental operations. Even if operators are well-trained and experienced, in some cases they may misinterpret some patient symptoms and make an incorrect diagnosis. This may occur above all in cases of disasters or in emergency situations and/or when the patient is in very critical conditions, when the operators must make decisions very rapidly and in conditions which do not favour an objective examination of the patient and his conditions.

The diagnoses arrived at by the operator, suitably guided by the process 100, are a valid support for a subsequent operator who takes over care of the patient.

The subsequent operator is not presented with a subjective diagnosis, based on non-standardised examinations, measurements, etc. but with a diagnosis based on the examination of predetermined parameters and predetermined features of the patient.

Therefore, it is a diagnosis which is an extremely valid starting point for additional evaluations and operations which the subsequent operator must in turn carry out on the patient.

In an alternative version, the process 100 may also comprise a language selection step, in which the operator selects the language for the display images on the screen 2 of the palmtop device 1.

Claims

1. An apparatus for guiding an operator in an assistance operation, characterised in that it comprises at least a first electronic device (1) which has at least means (2) for displaying a plurality of questions (30, 3Oa₁ 31, 32, 33, 34, 35, 36) relating to the health of a patient, means (2, 3) for entering a plurality of data relating to said health in response to the questions and means (2) for suggesting a way of proceeding for working on said health based on said data.

2. The apparatus according to claim 1 , characterised in that it comprises a second electronic device (9) with means (91) which allow it to be stably and removably applied to a patient.

3. The apparatus according to claim 2, characterised in that the first electronic device (1) comprises emitter means (61) designed to send data to the second electronic device (9) and/or to a collection centre.

4. The apparatus according to claim 2, characterised in that the first electronic device (1) comprises means (62) for reading the data from the second electronic device (9).

5. The apparatus according to claim 1, characterised in that the first electronic device (1) comprises location means (63) designed to identify the position of the patient.

6. The apparatus according to claim 3, characterised in that the second electronic device (9) comprises means (92) for recording data arriving from the first electronic device (1).

7. The apparatus according to claim 2, characterised in that the second electronic device comprises receiver means (93) designed to monitor patient movements.

8. The apparatus according to claim 2, characterised in that the second electronic device comprises connecting means (94) designed to connect coloured bands (95a) which identify the condition of a patient.

9. The apparatus according to claim 2, characterised in that the second electronic device comprises means (95a, 95b) for indicating the classification of a patient based on his condition.

10. The apparatus according to claim 2, characterised in that the second electronic device comprises signal emitter means (96) designed to instantly locate a victim.

11. A process for guiding an operator in an assistance operation using an electronic device (1) comprising at least the steps of: displaying (25) a plurality of questions (30, 30a, 31 , 32, 33, 34, 35, 36) relating to the health of a patient; entering (26) a plurality of data relating to said health in response to said questions; suggesting (27) a way of proceeding for working on said health based on said data.

12. The process according to claim 11 , wherein the questions of the plurality of questions are grouped in a system comprising a first group of questions (31) for questions relating to the patient's respiratory system, a second group of questions (32) for questions relating to the patient's respiratory function, a third group of questions (33) for questions relating to the patient's cardiovascular system, a fourth group of questions (34) for questions relating to the patient's neurological state, a fifth group of questions (35) for questions relating to locating the injuries found, a sixth group of questions (36) for questions relating to the patient's destination.

13. The process according to claim 12, wherein the questions of the first group of questions (31) may comprise questions selected in a group comprising: Guedel, combitube/LMA, intubation, cricothyrotomy.

14. The process according to claim 12 or 13, wherein the questions of the second group of questions (32) may comprise questions selected in a group comprising: ambu/IPPV, PEEP, relieving PNX pressure, pleural drainage, oxygen, SaO2, RR (respiratory rate).

15. The process according to any of the claims from 12 to 14, wherein the questions of the third group of questions (33) may comprise questions selected in a group comprising: haemorrhage compression, medication of wounds/sutures, wounds, venous line, infusions, ECG monitor, HR (heart rate), BP (blood pressure), Defibrillator, CPR/ROSC, Heating/protection, T⁰.

16. The process according to any of the claims from 12 to 15, wherein the questions of the fourth group of questions (34) may comprise questions selected in a group comprising: GCS (Glasgow Coma Scale), pupils, analgesia.

17. The process according to any of the claims from 12 to 16, wherein the questions of the fifth group of questions (35) may comprise questions selected in a group comprising: fractures/dislocations, splinting, fracture reduction, spinal board.

18. The process according to any of the claims from 12 to 17, wherein the questions of the sixth group of questions (36) may comprise questions selected in a group comprising: destination hospital, means of transport, position, AMP exit colour code, time of exit, accompanying operator.

19. The process according to claim 11 , wherein the questions of the plurality of questions are grouped in a system comprising a first set of questions for questions relating to the patient's airways, a second set of questions for questions relating to the patient's breathing, a third set of questions for questions relating to the patient's circulation, a fourth set of questions for questions relating neurological deficits or alterations in the state of the patient's consciousness.

20. The process according to any of the claims from 11 to 19, and also comprising identifying the assistance operation (21).

21. The process according to claim 20, wherein identifying the operation (21) comprises displaying (21a) a plurality of operation options relating to possible assistance operations.

22. The process according to claim 21 , wherein said plurality of operation options are selected in a group comprising: emergency, NBCR (Nuclear, Biological, Chemical, Radioactive) emergency, single-emergency, maxi- emergency, hospital care.

23. The process according to claim 21 or 22, wherein identifying the operation comprises selecting (21 b) an assistance operation from the plurality of operation options.

24. The process according to any of the claims from 20 to 23, wherein identifying the operation (21) comes before the guiding (24).

25. The process according to any of the claims from 20 to 24, and also comprising identifying the operator (22).

26. The process according to claim 25, wherein identifying the operator (22) comes before the guiding (24).

27. The process according to claim 26, wherein identifying the operator (22) comes after identifying the operation (21).

28. The process according to any of the claims from 25 to 27, wherein identifying the operator (22) comprises displaying (22a) a plurality of operator options (13, 14, 15, 16) relating to possible operators.

29. The process according to claim 28, wherein the operator may be selected in a group comprising: doctor (14), nurse (15), lay (16) for example rescue services volunteer, fireman, clinic operator, analysis laboratory operator.

30. The process according to claim 28 or 29, wherein identifying the operator comprises selecting (22b) an operator option from the plurality of operator options (13, 14, 15, 16).

31. The process according to any of the claims from 25 to 30, and also comprising identifying a site where the operator is working (23).

32. The process according to claim 31 , wherein identifying the site where the operator is working (23) comes before the guiding (24).

33. The process according to claim 31 or 32, wherein identifying the site where the operator is working (23) comes after identifying the operator (22).

34. The process according to any of the claims from 31 to 33, wherein identifying the site where the operator is working (23) comprises displaying (23a) a plurality of operator work site options.

35. The process according to claim 34, wherein said plurality of site options may be selected in a group comprising: scene of the event, Collecting Area, Advanced Medical Post, Hospital, PEIMAF (Internal Emergency Plan for Massive Influx of Casualties), ambulance, Accident and Emergency Department, Ward, Clinic, analysis laboratory.

36. The process according to claim 34 or 35, wherein identifying the site where the operator is working (23) comprises selecting (23b) a work site from said plurality of operator work site options.

37. The process according to any of the claims from 11 to 36, and also comprising assigning a colour code (28) relating to the seriousness of the patient's condition.

38. The process according to claim 37, wherein the assigning (28) comes before the guiding (24).

39. The process according to claim 37, wherein the assigning (28) comes after the guiding (24).

40. The process according to claim 37, wherein the assigning (28) comes during the guiding (24).

41. The process according to any of the claims from 37 to 40, wherein the assigning (28) comprises displaying a plurality of colour code options (80, 18a, 18b, 18c, 18d).

42. The process according to claim 41, wherein the assigning (28) comprises selecting a colour code option (80, 18a, 18b, 18c, 18d) from the plurality of colour code options (80, 18a, 18b, 18c, 18d).

43. The process according to claim 41 or 42, wherein the plurality of colour code options may be selected in a group comprising a first colour option for a "Green" code, less urgent; a second colour option for a "Yellow" colour code, urgent; a third colour option for a "Red" colour code, emergency; a fourth colour option for a "Black" colour code, deceased patient; another colour option for a "White" colour code, no urgency; and yet another colour option for selecting a "Blue" colour code, "depassee" (beyond urgency) emergency.

44. The process according to any of the claims from 11 to 43 and also comprising location of the patient using GPS co-ordinates.

45. The process according to any of the claims from 11 to 44 and also comprising using the first device (1) to read (10) information from a second electronic device made in such a way that it is compatible with the first electronic device.

46. The process according to claim 45, wherein the reading comes before the guiding (24).

47. The process according to any of the claims from 11 to 46 and also comprising using the first electronic device to write (40) the health data to a second electronic device made in such a way that it is compatible with the first electronic device.

48. The process according to claim 47, and also comprising using the first device (1) to again read said health data from the second electronic device.

49. The process according to any of the claims from 11 to 48 and also comprising assigning the first electronic device to the operator and attaching to the patient a second electronic device which is compatible with the first electronic device.

50. The process according to claim 49, wherein the first device comprises a PDA-type device, and/or a palmtop device.

51. The process according to claim 50, and also comprising sending information to a suitable data collection system.

52. The process according to claim 51, wherein the information is selected in a group comprising requests for specialists: cardiologists, orthopaedic surgeons, toxicologists, requests for support, for example for bags of blood, or data about the victims for real time monitoring of the number of victims of the event.

53. The process according to any of the claims from 47 to 52, wherein the second device is selected in a group comprising: an electronic storage device for storing the information written using the first device, a microchip, an RFID (Radio Frequency IDentification) tag.

54. The process according to any of the claims from 47 to 53, wherein the second device comprises a GPS receiver device to allow the second device to be located.

55. The process according to any of the claims from 11 to 54, and also comprising capturing images of the victim, for example with a video camera or a camera for still images.

56. The process according to any of the claims from 11 to 55, and also comprising receiving GPS data with the first device, comprising GPS coordinates for locating the first device (1).

57. A program comprising code for implementing the method according to claims 11 to 56, when the program is run in a computer system.

58. A medium which can be read by a computer and on which there is a program (64) according to claim 57.

59. An electronic device on which the program (64) according to claim 57 is stored.

60. The apparatus according to claim 1 , characterised in that the first electronic device (1) comprises the program (64) according to claim 57.

61. A kit comprising an electronic device according to claim 59 or 60, and a second electronic device (9) made in such a way that it operates in conjunction with the first electronic device.

62. The kit according to claim 61, wherein the first electronic device (1) comprises reading means (62) for reading data stored in the second electronic device.

63. The kit according to claim 61 or 62, wherein the first electronic device comprises writing means (61) for writing data to the second electronic device.

64. The kit according to any of the claims from 61 to 63, wherein the second electronic device comprises an RFID bracelet which can be attached to part of a user's body.

65. The kit according to any of the claims from 61 to 64, wherein the second electronic device comprises coupling means (91) for coupling the second device to the user.

66. The kit according to any of the claims from 61 to 65, wherein the second electronic device comprises additional coupling means (94) for coupling colour indicator means to the second device.

67. The kit according to any of the claims from 61 to 66, wherein the second electronic device comprises emitter means (96) for emitting a location signal.

68. The kit according to any of the claims from 61 to 67, wherein the second electronic device comprises emitter means (95b) for emitting a coloured signal, making a colour code which indicates the seriousness of the user's condition visible.