Pulsara Blog

Mass casualty incidents present a number of unique challenges. They're unplanned, unpredictable, and come with a number of unknowns. Responders from multiple agencies may be working the same scene, providing mutual aid and trying to work together to stabilize patients and get them care as quickly as possible. 

In such a high-pressured environment, communication and coordination are critical. As lives hang in the balance, the ability to track patient movement, manage resources, and ensure that everyone involved in the response is working from the same playbook can mean the difference between life and death.

Over the past eight years, healthcare providers in Colorado have relentlessly pursued methods to improve communication between EMS and the hospital, and now between all parties who respond to mass casualty incidents.

Imagine: In the midst of a pandemic, you're managing patient load across a state that covers over 261,000 square miles and is home to over 30 million people. Some of your hospitals have beds, but not enough nurses; some hospitals have enough nurses but are running out of beds. You need to disperse patients to hospitals with resources across the state, and fast. 

How do you do it?

Now, imagine you're trying to find a way to track patients during a mass casualty incident and enable better communication between first responders and the hospital. 

Is it possible to do using the same tool you used to load balance during the pandemic? 

That's exactly what the state of Texas has accomplished. Between load-balancing patients during the COVID-19 pandemic and reimagining MCI response, they've been leveraging a statewide patient wristband system, paired with Pulsara, to help track patients and consolidate communication in a crisis.

Patient tracking during MCIs and pre-planned events is a complex operation with many moving parts. Every incident is different and requires different resources, making planning for and preparing for incidents challenging. To set ourselves up for success, we need to practice the same way we respond. That's why a panel of experts from California, Colorado, and Texas believe that the answer lies in using the same tools to manage and track patients during a crisis as you do for everyday response.

In the webinar Streamlining Crisis Response, field experts Eric Epley, Dr. Jeremy DeWall, and Dr. Troy Pennington discussed how they've simplified communication and collaboration around patient triage, tracking, and reunification during MCIs and large-scale events. They revealed new game-changing solutions around patient load-balancing—discovered and implemented in response to the many communication and logistics challenges experienced during the COVID-19 pandemic. All three experts and their healthcare systems have also been leveraging patient wristbands, paired with the Pulsara platform, to help track patients and consolidate communication in a crisis. 

Read on for the top 4 takeaways from this extraordinary discussion, and check out the full webinar recording below.

EDITOR'S NOTE: This article originally appeared on EMS1.com. Special thanks to our guest author, John Erich, for EMS1 BrandFocus Staff.

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Technologies require these four attributes to unite all the players in emergency response

In many ways, the response to the November 2022 Club Q shooting in Colorado Springs was textbook. Police received the first call from inside the club at 11:56 p.m., got there at midnight and had the shooter—who had been subdued by club patrons—in custody by 12:02 a.m. Firefighters arrived in seven minutes to a scene that was basically secured. Multiple responding EMS agencies – and even some officers in patrol cars – expeditiously transported casualties, helping limit the death toll to five. 

Leaders of the Colorado Springs Fire Department (CSFD), however, felt they could have done better. 

“One learning point we garnered from Club Q was that we didn’t [have] good communication with the hospital. We could have done a better job at that,” CSFD Lt. Jeremiah Heddings told a local news station that followed up with the department in late 2023. “They should be able to prepare and estimate how many patients they have [and] the severity.”

CSFD has long been proactive in striving to improve communication between first responders and the Emergency Department. In 2016, they were early adopters of Pulsara, a streamlined, HIPAA-compliant app designed to help unite and inform inter-organizational care teams throughout major incidents and beyond. For several years now, they have used Pulsara for all-day, everyday communication between EMS and the hospital. In the wake of the incident, Colorado Springs Fire Department evaluated ways to take their patient tracking practices to the next level. Now, they’re using Pulsara’s incident management functionality paired with patient wristbands to enhance their patient tracking capabilities.

Pulsara is not an ePCR, but a communication tool—one that can provide systems with the advanced levels of interoperability required at such complex events.

While no one wants to think about the probability of an impending disaster, emergency managers and healthcare professionals know that mass casualty incidents are an eventuality. It’s not if they’ll happen, but when. In order to prepare future healthcare professionals for that day, Texas A&M annually hosts the largest student-led disaster exercise in the world: Disaster Day. 

The Texas A&M School of Nursing started the event in 2008, and it has only grown from there. The event is held at Texas A&M Engineering Extension Service’s (TEEX) Disaster City in College Station. This year, over 700 students participated in the large-scale emergency drill — facing a myriad of disaster scenarios, all rolled into one: an earthquake, a shooting, and floodwaters caused by a tropical storm.

The drill allowed students to practice responding to the incidents from a wide range of angles, including triage, patient care, disaster management, and mental health support. “The scenario they created was absolutely insane—they’ll probably never see something that chaotic in real life,” said Brandon Means, Senior Vice President of Sales at Pulsara, and paramedic and flight nurse. “It went well and was a great sendoff for some of these students into the workforce.”

EDITOR'S NOTE: This article originally appeared on EMS1.com. Special thanks to our guest author, John Erich, for EMS1 BrandFocus Staff.

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No matter the incident’s size, scanning patient wristbands keeps all responders and clinicians united

Managing patients in the middle of a mass-casualty incident can feel like playing the game of telephone. Essential information is often passed from person to person, misheard, misunderstood, changed, lost, or even forgotten in the chaos.

Ideally, patient communication involves one continuous line of accurate, real-time information on each patient, flowing between EMS, hospital teams, public safety, public health, and emergency management personnel. A dedicated patient “channel” streamlines and improves care for routine cases and MCIs.

This is becoming a reality in several states. They’re implementing statewide patient wristband systems and pairing them with Pulsara, a health care communication and logistics platform, to simplify interoperability. Using Pulsara, responders scan patient wristbands to securely, quickly, and conveniently identify the injured, track what’s been done for whom, and provide the next caregiver a complete picture of the patient’s status – uniting all care teams and coordinators around each patient case in real time.

When William Rice, MBA, MLS, LP, market director of EMS and Air Med 12 at St. Joseph Health in Bryan, Texas, first implemented an effort to pair wristbands with Pulsara, he was met with skepticism.

“In the early days of the wristbands, I regularly had to remind folks in the region that they unanimously voted to support this project. People didn’t understand where the wristbands were going or how it would be helpful,” Rice said. “Once we added Pulsara, the value of the wristbands immediately sold itself because anybody who walks up to that wristband and scans it with Pulsara is now part of that patient care record.”

On March 1st, 2024, Pulsara was honored to participate in the largest student-led disaster drill in the world at Texas A&M’s Disaster Day in College Station, Texas. The team, comprised of students in various healthcare disciplines, used the Pulsara communication platform to manage the incident, including triaging and tracking around 300 patients, documenting treatments, and ordering and delivering meds from the field pharmacy.

The following is an excerpt from an article by the Texas A&M University Health Science Center, originally published on Texas A&M Today on March 1st, 2024. Check out the full article here. 

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Texas A&M University students sorted through the chaos of tropical storm-induced floodwaters, an earthquake and a shooting on Friday in a simulated disaster designed to prepare future health care professionals for large-scale emergencies.

The student-led exercise, held at Texas A&M Engineering Extension Service’s (TEEX) Disaster City in College Station, tested students in a variety of areas, including triage, patient care, mental health support and disaster management.

Started by the Texas A&M School of Nursing in 2008, the training has grown from a small event in the gym of a local church to a daylong disaster simulation involving more than 700 students, over 100 faculty and staff members, and numerous emergency response professionals. Students from Texas A&M schools of dentistry, medicine, nursing, pharmacy and public health, as well as athletic training, psychology and veterinary medicine students and the Corps of Cadets, participated in the drill.

Christine Kaunas, assistant vice president for Interprofessional Practice, Education & Research (IPER) at Texas A&M Health Science Center, said the annual Disaster Day exercise is an important component of preparing students to work together in emergency situations.

“Since 2020 alone, Texas has seen over 15 disasters and related declarations, including wildfires, tropical storms, hurricanes, winter storms, and of course COVID-19. Ensuring that our health professions students are prepared to respond effectively when, not if, a disaster strikes is crucial,” Kaunas said.

EDITOR'S NOTE: This article originally appeared on FireRescue1.com. Special thanks to our guest author, Courtney Levin, for FireRescue1 BrandFocus Staff.

When resources are lacking, these grant opportunities can help 

Operating a fire department requires an incredible amount of money, even for small or volunteer agencies. Certain budget line items cannot be sacrificed, while others may have a bit of wiggle room from year to year. Yet no matter how well-funded your department might be, you may feel like there’s never enough money to go around.

A sometimes-forgotten area of financial planning centers around preparation for incident management. While the basics like vehicles and radios may be accounted for, other facets could make a world of difference should a significant event occur.

Whether you’re looking for assistance with incident management training or want to upgrade your department’s communication tools, grant funding may be able to provide the necessary dollars to make your agency’s wishes a reality.

EDITOR'S NOTE: This article originally appeared on EMS1.com. Special thanks to our guest author, John Erich, for EMS1 BrandFocus Staff.

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Assistance is available from the U.S. government, but local systems have important responsibilities

When a major disaster strikes, Americans are used to seeing FEMA rush in. The Federal Emergency Management Agency is typically among the first nonlocal entities to get boots on the affected ground, with a mission of evaluating damages and needs, and then activating additional federal resources as appropriate.

But while your FEMA rep might be your best friend throughout the duration of response and recovery, they’re not the only one able to assist; nor is FEMA the only body. Other arms of the federal government can be involved and provide important assets, too – for both communication and victim management.

Here are five things to know about disaster response, keeping connected, and federal assistance if and when the big one surfaces in your area.

Looking to enhance your EMS team’s ability to coordinate care and communication during Mass Casualty Incidents (MCIs) and preplanned large events? Join our upcoming webinar where an expert panel of EMS leaders from TX, CO, and CA will share their insights and strategies on how to effectively streamline communication and improve patient outcomes.

Through case studies, discussion, and answering your real-time questions, learn how today’s leaders are tackling the distinctive challenges in crisis response to provide real-time connectivity among various teams, secure messaging, and shared patient view for improved situational awareness. We’ll discuss the new world of coordinating resources and triaging patients during MCIs, and how it has simplified communication and collaboration during large events, ultimately resulting in improved patient outcomes.

Don’t miss out on this opportunity to learn from the best and enhance your team’s ability to coordinate patient care, communicate with other EMS teams, and make critical decisions with confidence and ease. Register now and get ready to take your skills to the next level!

UPDATE: This live webinar has passed. Watch the on-demand recording here. 

EDITOR'S NOTE: This article originally appeared on FireRescue1.com. Special thanks to our guest author, Courtney Levin, for FireRescue1 BrandFocus Staff.

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Building muscle memory eases stress during critical emergencies

According to the U.S. Census, 29.15 million people lived in Texas in 2020. Estimates for 2022 show that figure has likely surpassed the 30 million mark as the Lone Star State continues to see a huge influx of new residents. Providing emergency medical care to that many people is an extraordinarily tall task, but one the state has worked to improve upon in recent years.

The tipping point came in 2020 as COVID-19 presented the United States with unprecedented medical challenges. Residents in Texas who needed specialized hospital care due to the virus were often caught in a tangle of delays, as medical teams weren’t always working from the same playbook.

“We heard stories across the state where multiple fixed-wing aircraft showed up at the wrong airport to pick up the wrong patient,” said Joey Branton, senior vice president of strategic initiatives at Pulsara. “They were making a minimum of 30 phone calls per patient transfer.”

While the pandemic put immense pressure on first responders and the health care system, mass casualty incidents like active shooters and natural disasters didn’t stop. It quickly became clear that those in Texas needed a better way to manage patients from start to finish.

A statewide wristband system was put in place to give every patient a unique ID that could be used across organizations. But it was the coupling of that initiative with the Pulsara platform which enabled fire and EMS providers to significantly improve their level of care.

Pulsara helps streamline communication between first responders during single-patient events and mass casualty incidents. As with any skill, confidence in using this tool comes through the muscle memory built up through regular use. “First responders in Texas realized to be truly proficient at using the efficiencies provided by the Pulsara platform, they needed to use it every day,” said Branton.

EDITOR'S NOTE: This article originally appeared on firechief.com. Special thanks to our guest author, John Erich, for FireRescue1 BrandFocus Staff.

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Triage at major events can be slow, and tracking patients can be difficult – Pulsara’s new functionality is aimed at improving both experiences

As it prepared for takeoff, the 737 couldn’t avoid the speeding rental truck that came crashing toward it through the fence beyond the airport tarmac. The resulting collision killed 14 of its passengers and crew, as well as the driver of the truck, and left 56 more injured.

First responders from multiple agencies rushed to the scene that morning last October at Preston Smith International Airport in Lubbock, Texas, to respond to the full-scale mass-casualty exercise. Medical personnel triaged the wounded and gave them special armbands the state now uses for patients experiencing time-sensitive emergencies, including victims of mass-casualty incidents. The bands contained individual barcodes that, with a quick scan, would take any responder at the scene to a dedicated care channel for that patient, where the provider could then enter the patient’s identifying and treatment information.

The testing of that technology – new functionality from Pulsara designed to help responders triage and track patients in major incidents – was one of the goals of the exercise, which simulated the kind of MCI that often overwhelms unprepared systems.

“We were looking for ways to improve patient tracking and incident awareness for all command staff on scene,” said Logistics Chief and Emergency Preparedness Specialist Brent Fox, NREMT-P, of University Medical Center EMS in Lubbock. “Pulsara allowed everyone on scene to have full visibility from any location once they joined the incident.”

That quick, easy shared awareness – with everyone who’s part of the response having access to the same information – is among several important benefits of the new tool responders to the Lubbock exercise got to experience firsthand.

New feature assists with triage and tracking of patients during a crisis

Bozeman, Mont., November 29, 2022 — Pulsara, the leading telehealth, communication, and logistics platform that unites teams and technologies across organizations during dynamic events, announced today the official release of new functionality designed for incident management. The new platform capabilities are designed to help triage and track patients during mass casualty incidents (MCIs), multiple patient incidents (MPIs), floods, evacuations, and other disasters, as well as major planned events (e.g., concerts, sporting events, etc.). The platform provides responders with a clear line of communication around every patient on a familiar platform they use every day for patient care. When a stress event occurs, no additional preparation or training is required; everyone can continue using the same platform to respond confidently and efficiently in a crisis.

The first major test of the new functionality occurred in October in Lubbock, Texas, as the FAA conducted a full-scale crisis exercise at Lubbock Preston Smith International Airport. First responders from multiple agencies assembled to respond to a drill scenario that involved a rental truck crashing through tarmac fencing and colliding with a plane that was preparing to take off, injuring 56 passengers. During the simulation, first responders and city agencies used Pulsara's Incident Management functionality to enter patient information, communicate, and coordinate care. 

Custom patient IDs and wristband scanning will enable seamless response across organizations during stress events.

Bozeman, Mont., April 27, 2022 — Pulsara, the leading mobile telehealth, communication, and logistics platform that unites healthcare teams and technologies across organizations during dynamic events, announced today that they are releasing new incident management functionality that will help quickly scale emergency response during mass casualty incidents (MCIs), multiple patient incidents (MPIs), floods, evacuations, and disasters. 

The product’s new incident management capabilities will allow first responders and EMS providers to quickly create or join an existing patient channel by scanning custom armbands (such as public safety-issued bands or traditional triage tags used during a crisis), add patient condition (red, yellow, green, and black) within the app, and give incident command the ability to monitor the number, status, and severity of patients through a patient dashboard.

When responding to mass casualty and multiple patient incidents, emergency responders often use wristbands and/or triage tags to triage patients and visibly denote their condition. Pulsara’s new incident management functionality will allow first responders to scan these wristbands/triage tags and instantly start a new patient channel in Pulsara. Responders — from any organization — who subsequently treat the patient will be able to simply scan the wristband and will instantly be added to the patient’s channel. They will then be able to see all information that has previously been added to the case, including any known demographic information, vitals, any treatments provided, and all communications around the patient. Emergency responders will also be able to add, track, and modify the patient’s triage status in Pulsara, with the appropriate green, yellow, red, and black statuses that match traditional triage tags. 

EDITOR'S NOTE:This article originally appeared on EMS1.com. Special thanks to our guest author, Michael Fraley of EMS1 BrandFocus. 

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Take control of the situation and establish command as soon as possible to start triaging and transporting patients

Much has been written over the years about responding to and managing “The Big One.” The list of all the articles and books about mass casualty incident management is a long one.

Every year, we conduct tabletop drills and full-scale exercises, tearing apart retired school buses and carrying high school drama students from the “scene” and around the block to the EMS station, where they are thanked with a free lunch.