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"  Onboard the amphibious assault ship USS Bataan, HM1 Ingrid Cortez monitors a real-time chatroom dedicated to streamlining patient transport by allowing the Navy hospital ships to communicate with medics on the ground in real-time. (Photograph by Benjamin Chertoff) USS BATAAN, Haiti--With an armada of more than 20 ships, a vast network of medical-response teams on the ground and helicopters buzzing patients between the ships and the island, the immediate medical response to the earthquake in Haiti suffered from a massive logistical problem: How to get the right patients to the right care as quickly as possible.  When the disaster-response teams began coordinating with the three major hospital ships (the aircraft carrier USS Carl Vinson, the amphibious assault ship USS Bataan and the floating hospital USNS Comfort), the medevac process was reactive, according to Navy Lt. Roger Caron. Medevac helicopters landed where there was deck space, and often the medical crews on the ships had only a faint idea of what sort of injury was inbound. &amp;quot;It looked like a plate of spaghetti,&amp;quot; Caron says, &amp;quot;and was about as effective.&amp;quot;  The solution: An online chatroom, allowing Navy medics onboard different ships to talk to each other and coordinate with crews on the ground in real time. The result, Caron says, has cut the time it takes a patient to receive the appropriate care from over an hour to less than 15 minutes, not counting flight times.  When Operation Unified Response began just hours after news of the 7.0 magnitude earthquake in Haiti reached the Pentagon, there was no effective way for medical personnel aboard the ships to communicate with disaster-response teams on the ground. As a result, medics performed triage--the critical step in emergency medicine for assessing the severity of the patient&amp;#039;s condition, and how best to treat it--on the flight decks of the Vinson, the Bataan and the Comfort.  All three ships are equipped with a flight-deck triage unit and an elevator that leads directly to the ships&amp;#039; sick bays. However, without accurate information about a patient&amp;#039;s condition, people often ended up in the wrong place. For instance, the Bataan is set up to handle trauma cases--mainly orthopedic injuries such as broken bones and crush injuries. &amp;quot;We&amp;#039;d get a spinal or head injury,&amp;quot; Caron says, &amp;quot;and we&amp;#039;d have to send it over to the Comfort where he&amp;#039;d be re-triaged. It wasted critical time.&amp;quot; In emergency medicine, time is everything: the first hour after an injury is referred to as the &amp;quot;golden hour;&amp;quot; it&amp;#039;s a narrow window when the probability of survival is the greatest. &amp;quot;In those early days, it could take well over an hour just to get a patient to the right place, let alone cared for.&amp;quot;  Sometime between Jan. 24th and 25th, a little ingenuity greatly streamlined the process. The Army, which has been handling operations in the urban areas of Port-au-Prince, already had a system of real-time chatrooms operating over Department of Defense satellite networks. Their medics realized the logistical nightmare of patient transport and created a chatroom dedicated to medevac operations, and invited the Navy into the conversation. The improvement was almost instantaneous. &amp;quot;It was like flipping a switch,&amp;quot; Caron says.  Administrated by medical personnel located in the Joint Task Force headquarters in the Embassy, The Chat, as the medics call it, allowed medics on all the Naval ships to communicate with each other and with personnel on the ground in real time. Now medical units on the ground could perform triage in the field, radioing that information to the Embassy, where a medic would post the case. Onboard the ships&amp;#039; medical units, doctors and corpsmen monitor The Chat around the clock, and can instantly respond with each ship&amp;#039;s medical capabilities and vector medevac sorties to the appropriate ship. &amp;quot;It&amp;#039;s like a dispatch system for ambulances in a large city,&amp;quot; Caron says. &amp;quot;It&amp;#039;s much faster and more reliable than phoning or e-mail, and triage is now in the field. We don&amp;#039;t have to put a patient back on a bird to go to another ship, wasting that golden hour.&amp;quot;  Onboard the Bataan, a ship roughly the size of a World War II aircraft carrier and designed to send Marines to beachheads via helicopter and hovercraft, hospital corpsman 1st Class Ingrid Cortez monitors what looks like any civilian Internet chatroom. A message pops up:  &amp;quot;HMC BLAKE: The Mesa Verde has a 9 y/o w/femur fx left leg hit by motorcycle x2 days. Can you accept pt from MV today or tomorrow?&amp;quot;  The Bataan has a relatively large medical ward with 15 ICU beds and 25 ward beds, and the sick bay specializes in orthopedic injuries such as the 9-year-old with a broken femur. The USS Mesa Verde, on the other hand, can&amp;#039;t handle major trauma cases, so soon the patient will be choppered over to the Bataan in an MH-60, the Navy variant of the Black Hawk helicopter.  &amp;quot;We&amp;#039;re maximizing our assets,&amp;quot; Caron says. &amp;quot;[The Chat] wasn&amp;#039;t planned ahead of time. This is really the first time all three branches [Navy, Army and Air Force] have coordinated so quickly.&amp;quot; Word of The Chat has spread among the doctors onboard each ship. &amp;quot;Physicians are using it for consults with doctors on other ships,&amp;quot; Caron says. &amp;quot;Soon we&amp;#039;re going to have to flip the switch on a second chatroom dedicated to doctors so that they don&amp;#039;t interfere with patient movement.&amp;quot;  For a fighting military retasked to save lives in a devastated country with a devastated infrastructure, communications are critical, and the more efficient, the better. In the red-lit corridors of the Bataan during the night watch, a Navy medic neatly sums up the system&amp;#039;s almost brilliant simplicity. &amp;quot;Everyone can see who has what,&amp;quot; she says with a smile, despite having pulled the 1900 to 0700 shift for a week. &amp;quot;It&amp;#039;s like any other Internet chatroom, except without emoticons.&amp;quot; "^^<http://www.w3.org/2001/XMLSchema#string>
<http://www.popularmechanics.com/military/a5297/4344622/>