By Maureen C. Curran
San Diego, CA, Feb. 14, 2008 -- A loud flash-bang, followed by billowing green smoke, cued the several hundred first responders and more than two dozen Calit2 researchers that the San Diego Metropolitan Medical Strike Team's (MMST) simulated attack in South Bay, choreographed for practicing emergency response, had begun.
About an hour later, the darkened skies opened up with a pouring rain, which lasted a half hour or so, but did not stop the drill, nor dampen Calit2's opportunity to showcase and field-test its developing emergency preparedness technologies. The short-lived rainstorm just added another dimension to the planned scenario, which involved two large-scale incidents close in time, but at separate locations, a first for these exercises.
The MMST full-scale drill, dubbed Operation Silver Bullet, took place at Coors Amphitheater and the neighboring Knott's Soak City waterpark in Chula Vista, CA on January 24, 2008. The first incident - a simulated bomb going off inside the amphitheater during an event full of people, was followed a while later by a second incident at the water park.
The key objective for the drill was to practice and evaluate readiness to rapidly adapt and manage a multiple site attack in the greater San Diego area. The two venues are neighboring, but distinct areas, so provided a practical simulation area for the exercise. The focus was on inter-agency communication and agility to adapt resources to a new situation.
In support of the law enforcement and public health first responders, Calit2 researchers were key participants, testing and evaluating the design and performance of their tools, devices and systems for the management of disaster and mass-casualty situations.
"The feedback from the first responders' community was overall very positive," said Per Johansson, "The fact that they were able to see the potential use of systems of this sort in a realistic incident setting made an even more compelling case than a demo in the lab." Johansson is a principal development engineer in wireless networking at Calit2.
Calit2's mass-casualty tracking, triage and medical information management system - WIISARD (Wireless Internet Information System for Medical Response in Disasters) - was used, as it has been at numerous MMST exercises beginning early in its development.
"We had worked with some of the fire stations at previous drills," said WIISARD researcher Ricky Huang, "so, their providers simply picked up the WIISARD system and started working smoothly. One of the supervisors even dropped the traditional paper system altogether."
WIISARD is an integrated system combining state-of-the-art data collection and display devices, database services (publish/subscribe functionality) and 802.11 wireless communications to produce a consistent, real-time medical view at a disaster scene.
"Two-incident capability was one of two new functionalities that we tested," explained Bill Griswold of WIISARD, "tracking events at two concurrent incidents, providing displays that allow you to see events from just one venue or both simultaneously." The purpose is to help incident commanders at the individual sites, as well as aid the overall area command. Griswold continued: "We had two servers connected by a point-to-point link provided by CalMesh. Each not only kept track of its own data, but shared a read-only image of the other site's data." Griswold is a professor in UCSD's Computer Science and Engineering (CSE) department.
"We were able to display data from both venues at Area Command, so they could truly get a bird's eye view of the entire situation," added Colleen Buono, also of WIISARD. Buono is an assistant clinical professor of emergency medicine at UCSD's School of Medicine and medical director at Palomar Paramedic College.
"We also tried accountability with bar-coded ID badges for the providers," Buono continued, "keeping track of which providers are on site and which are in the hot zone and learned some lessons with work flow." The key design element of this was the streamlined user interface, which put the triage PDA or supervisor tablet notebook in a "scanning mode" for recording people either on-site, in hot zone, out hot zone, or off-site. Hence, all the accountability officer had to do was stand at the appropriate entry or exit point and then scan everyone going by. This new capability was actually used to definitively record who was on-site for the purpose of paying the providers for their time.
Both new functionalities (dual incident and accountability) worked quite well. When one of the MMST Task Force leaders was shown the filterable displays of patient status, he said "That's huge!" Even with some initial reluctance by those new to the system and just-in-time training, the overall WIISARD concept was well-accepted.
Tablet PCs, PDAs and sensor devices (such as patient tags/pulse oximeters) have been developed for the WIISARD application, all running on top of CalMesh, an ad hoc wireless network infrastructure (small, lightweight and easily reconfigurable nodes) that allows for seamless connectivity in a changing environment. Several of the WIISARD researchers felt that this drill had the best coverage they have ever seen.
CalMesh played a key, central role for all the applications demonstrated; issues that arose were immediately addressed and resolved thanks mostly to the designed self-healing ability. New Calit2 postdoc Anders Nilsson Plymoth enjoyed his first drill and seeing CalMesh first-hand, he said, "I was impressed by the performance of the mesh network, and how smooth everything went when we put it up. We basically just put out the boxes, turned them on and we had a running WiFi mesh network."
Nilsson Plymoth also noted: "All mesh nodes including Gizmo were built with off-the-shelf components. To achieve this kind of performance in a mesh network at such a low cost is very impressive."
Gizmo is a remote-controlled rover, just 20"x14"x11" in size. It carries an onboard, embedded Linux computer that provides the computational power necessary for communication, control, GPS information, and video streaming. Gizmo connects to the CalMesh network and can seamlessly roam around within the coverage provided by the network.
The video stream from the webcam on Gizmo is also fed to the computer to aid the control of the truck. The same video feed can be observed at several locations in the CalMesh network through a regular web browser. During Operation Silver Bullet, Gizmo was sent into the disaster hot zone and provided mobile video surveillance back to the Incident Command and Area Command.
Unedited clips from the streaming video from Gizmo roaming inside the hot zone are available for viewing. All files are four minutes or less, except video 2a, which is 17 minutes in length. Files play on Windows Media Player. [Gizmo MMST Drill Video Clips]
GIZMO's video stream was integrated into another Calit2 emerging technology: Rich Feeds, which received and displayed it in real-time. The real-time data integration and display was successful in improving situational awareness at the disaster site. This drill was the official debut of the fully integrated Rich Feeds.
Rich Feeds aggregates data from multiple sources, including live research data. Based on user selections and filters, the Rich Feeds web site (http://rescue.calit2.net) enables users to view and juxtapose research data along with generally available information in order to draw novel conclusions that would otherwise be hard to reach.
During the drill useful feeds also included Calit2's Traffic Information System (http://traffic.calit2.net) and the asset tracking system, which registered the location of both Gizmos and the research truck.
Rich Feeds was displayed on a Non-Uniform Tile System OptIPortal (NUTSO); it was set-up next to the area command post, which oversaw both incidents. NUTSO is a command-and-control display wall of twelve tiled standard-size laptop monitors and two large television displays; each monitor can be used independently or in concert with any number of the others.
Researchers from three Calit2 projects participated in the exercise: the Responding to Crises and Unexpected Events (RESCUE), the ResponSphere and the Wireless Internet Information System for Medical Response in Disasters (WIISARD) projects.
San Diego MMST is a team of local responders who work together to develop and implement response plans for major urban crises and disasters. It includes all of the local San Diego city and county resources: fire, police, sheriff, bomb squads (police and sheriff), SWAT, harbor patrol, HazMat, FBI, paramedics from multiple agencies, county medical emergency services (EMS) and the Metropolitan Medical Response Service. The Chula Vista and National City fire and police departments were prominent in this drill.
About 100 volunteers played "victims/patients." Each was given instructions on their mock injuries and appropriate makeup. Despite the cold and wet and spending hours on concrete, most said they found it interesting and even fun. Also in attendance were representatives of various government research funding sources, who were very interested in the technologies demonstrated.
MMST conducts a major full-scale exercise approximately once a year. Calit2 researchers have a close working relationship with them and have been key participants in their drills both in San Diego and northern California. In fact, Atkinson Hall, home of Calit2 on the UCSD campus served as the venue for the last San Diego MMST drill.
Practicing the Art and Science of Emergency Response