於緊急醫療服務使用車用行動通訊網路之效益評估

Abstract

為了減少急重症病患死亡及失能之機會，緊急車輛能否盡快到達現場，施行急救處置是重要的關鍵。不幸的是，由於都市的快速發展，日漸劇增的車輛使得緊急車輛無法順利通過。許多學者嘗試利用車用行動通訊網路來解決上述問題，然而目前的研究多著重於通訊技術與協定的研發，尚未有人針對車用行動通訊網路應用對於緊急醫療的效益進行評估。因此本論文將重點擺在整理前人所提出的協助緊急車輛行駛之方法，並利用IEEE 802.11p/1609車用行動通訊網路通訊技術及全球定位系統等技術實作之。藉由模擬的結果與實證醫學的相關文獻相互參照，評估各方法對於急重症病患累進式存活率之增益。 根據結果顯示，交通號誌搶佔功能對於急重症病患累進式存活率（cumulative survival ratio, CSR）的提升是最明顯的，最高可以提高90.2%，最低也有32.4%。路徑嚮導的增益效果次之，可提高14.1%至57.8%，最後道路淨空為15.5%以內。為了使緊急車輛快速抵達現場，以現有的技術而言，路徑嚮導是一可實行且有效之方法。另外交通號誌搶佔雖然效果最佳，但是目前沒有可配合的硬體來支援。最後道路淨空獨自使用效果不彰，須配合其他方法同時使用。本論文可以提供交通管理和緊急救護相關人員參考。

Whether emergency vehicles can rapidly reach a scene and provide emergency treatment is crucial to reducing the chances of death and disability among acute and critically ill patients. Unfortunately, the rapid development of cities and sharp increases in vehicles prevent emergency vehicles easily reaching scenes. Numerous researches have attempted to use vehicular ad-hoc networks to resolve these problems. However, the majority of studies have focused on developing communication technologies and protocols. These studies have not assessed the benefits of vehicular ad-hoc networks as applied to emergency medical care. Therefore, this thesis collected the methods for assisting emergency vehicles in previous studies and implemented these methods using an IEEE 802.11p/1609 vehicular ad-hoc network technology and the global positioning system (GPS). Simulation results and evidence-based researches were cross-referenced to assess cumulative survival ratio (CSR) gains for acute and critically ill patients with each method. Simulation results indicate that the preemption of traffic lights increased CSRs for acute and critically ill patients most substantially. This method could increase CSRs to a maximum of 90.2% and a minimum of 32.4%. The next was path guidance, which could increase CSRs from 14.1% to 57.8%. The last was path clearing, which could increase CSRs fewer than 15.5%. With existing technologies, route guidance is a feasible and effective method to shorten travel time for emergency vehicle. Besides, traffic light preemption is the most effective method but there is no hardware support at present. Path clearing cannot gain much improvement if it is used alone. This thesis can provide traffic management authority and emergency medical technicians for reference.