Project Ripple consists of internet-enabled mobile medical sensor network, messaging middleware, and user applications that improve situational awareness and patient monitoring in a disaster response.

The Problem

Here's a scenario...

A large-scale disaster event has occurred and emergency responders are deployed to rescue and evacuate injured victims. These scenarios currently present many problems. The environment is noisy and chaotic making it difficult for responders to efficiently and accurately share information on victims condition. Due to the time critical nature, documentation of patient condition and treatments is mishandled and mistakes are made in prioritizing the treatment and transport of patients.

Being task saturated, the team on site delays communication with remote teams that are responsible for managing the disposition of additional resources and this degraded situation awareness cascades throughout the care chain, causing transports to be delayed and medical facilities to be ill prepared for the influx of patients.

The Vision

Ripple proposes to improve emergency response through the incorporation of Internet of Things technologies, mobile applications, and technologies designed to improve the situation awareness of highly trained response teams.

Portable, low-cost sensors are needed that communicate wirelessly via open and standardized protocols. Monitoring of these sensors needs to be performed across a mobile adhoc network, enabling all patients to be monitored by any and all responders as needed. The devices need to be quickly deployed and configured and the network cannot rely on bulky infrastructure and computing devices.

Mobile applications need to facilitate collaboration and patient handoff. When patient information is measured and recorded, it should immediately be available to other members of the team, patient information should not be transmitted verbally over the radio where it can be misinterpreted or recorded incorrectly.

Patient data should be seamlessly be made available to remote stakeholders over available networks, relieving responders of the need to manually provide this information while trying to care for the injured.

The Implementation

Project Ripple builds technologies in three main categories:

• Sensors

A low power sensor records multiple vital signs. It uses an 802.15.4 radio to form a 6LoWPAN network . These sensors monitor and report patient health data to the mobile broker.

• Middleware

Ripple uses lighweight messaging middleware built around MQTT. The system incorporates one broker designed to run on a mobile device and share data amongst a team of responders. This is called the "Cloudlet" and is bridged to another broker that runs remotely. When a data link to the remote broker is inoperable, the cloudlet continues to provide service locally, ensuring that the team of responders is able to maintain situation awareness. When the data link is operable, the data is sent to the remote broker where information from the emergency response can be seamlessly shared with the remote stakeholders.

• Applications

Responders will be equipped with Android Tablets to visualize their patients' vital statistics and record their observations. NFC triage tags are implemented to replace the existing triage system. A Google Glass Heads-up Display (HUD) is being developed which will give responders a concise view of patient status without the need to give up their hands to check. Finally, geospatial and web applications are being built to enable other stakeholders to benefit from the information that is being collected at the disaster site.

A reflectance sensor connects to the D-Sub connector on the Pulse-Ox modules which emits two different wavelengths of light into the patient’s skin which are then picked up by a photodetector on the sensor.

Pulse Oximeter

The ADS1292R is an integrated circuit provided by Texas Instruments which provides the function of a low-power, two-channel, 24-Bit Analog Front End for Biopotential Measurements like ECG and respiration.

ECG Shield with TI ADS1292R

The Redbee Econotag is a 802.15.4 wireless mote utilizing the MC1322X microcontroller. Econotag modules in Project Ripple run the Contiki OS and IETF 6LoWPAN, allowing them to connect over IPv6.

Econotag with attached sensors

The Raspberry Pi is a low-power computer that this project employs as a dual-functioning information broker and border router. The Pi exchanges data with Econotag motes and clients over IP.

Raspberry Pi

The network architecture of Project Ripple begins with the MBAN and extends upward; to the cloudlet, the cloud, and beyond.

Mote Network

Sensors, Shields, Microcontrollers

• A network of low-power medical sensors with IEEE 802.15.4 radios.
• Network communicates using IPv6 via 6LoWPAN and RPL.
• Sensor data is pushed to a combined border router and information broker (the cloudlet), then forwarded to the responders' local smart phones and tablets.

Cloudlet

Know the surroundings

• Hosted on the low-profile Raspberry Pi
• Serves as a miniature cloud for on-scene responders.
• Program that acts as a bridge/buffer between the mote network and the responder network because of hardware incompatibilities
• Handles local data management(archiving) and forwarding of latest sensor readings to responder devices
• Utilizes MQTT protocol to transmit data to end clients (Android, PC, etc)
• Maintains list of devices and patients and makes available to end clients

The Cloud

Global Awareness

• Enables the Ripple Command Center view
• Maintains master list of devices and patients
• Asynchronously aggregates all sensory directory lists from cloudlets
• Allows NASA World Wind to provide location data to cloudlet devices
• Disseminates all data to any client under subscription

• Built on the Android framework
• Enables team of responders to collaboratively collect and share data on patients with minimal loss of time.
• Intuitive interface gives mobility to responders when viewing and interacting with patients' health data
• Top banner provides a vital overview for multiple patients simultaneously
• Patient health information is queried from the information broker
• Graphic representation of health data plotted in real time

• Implemented as a substitute for triage tags during mass casualty incident.
• Responders will be equipped with Ripple NFC app for Android tablets.
• Ripple NFC app provides a user interface similar to existing triage tags
• Supports read/write/re-write functions
• Patients will have NFC tag attached to them, similar to existing triage tag protocol
• NFC tags allow for fast and efficient data transfer without the need to pair devices