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Hospital in the Ambulance, Chip in Your Hand

You have a chip in your hand

It is small, about the size of a grain of rice. It has a passive, radio frequency Identification (RFID chip inside it, protected from your body's interference by a thin shell. This chip, contains a single, long, unique number code shared by no one else on the planet. The ultimate embodiment of personal identification, they have become, or are becoming, standard.

The chip is in your palm, or maybe the back of your hand, nestled near the wrist. It is in the hand so anything you reach out to touch or grasp gets close enough to activate the tag. Currently this range is just twelve inches - one foot - but it may get longer as technology advances.

You are in the ambulance; they have lifted you in, on a gurney. The trolley slides under, and in a hulking piece of machinery that occupies much of the back of the vehicle, although parts of it are removed at different times, for the paramedic to access, and your head remains clear at the front.

The paramedic makes sure your body is as clear of metallic implements as possible. The machine has already searched for, found, and read your RFID chip in a broadcast scan, and has read the short pulsed reply. It is even now, connecting, via the ambulance's net connection, to the national health database, and locating your number on there. Using it as a primary key - for that is what it is - the number unlocks your medical information.

More advanced than a home unit, the ambulance unlocks your medical history, delivering relevant information to the paramedic via a flatscreen display. It pulls out your usual blood work records, your dietary requirement, allergies, brief details of any medical conditions you are known to have, warnings about incompatible medication, name of your GP, and any ongoing treatment. Complete list of current medications, and a short summary of your medical history.

A battery of tests is possible in the small space that is the back of the ambulance, with shoebox sized portable labs, and HMD systems to check for brain damage.

Biochip arrays will work happily on a pinprick of blood, no more than is necessary for a diabetes test. Modern-day biochips can test for hundreds of different conditions from a simple sample, limited only in scope by the complexity of circuit designs. A single lab, capable of hundreds of tests, will fit in a standard shoebox, so arrays of a dozen or more are perfectly possible in an ambulance. Near future chips will test for thousands, if not tens of thousands of chips, perhaps in a stackable array for easy removal and replacement, for sterility.

An example current-day Biochip lab, the above will happily screen 200 possible causes of arthritis, in two hours, from five different patients simultaneously.

Each biochip is disposed after testing.

Having your own bloodwork to hand, after identifying the right record from your chip, the machine quickly analyses your blood from a pinprick taken by the sampler. It checks for conditions you have a known genetic disposition to first, as the data it received shows. It then continues to a general health and fitness check, as it compares different levels of blood chemicals there and then, all from the same sample.

The machine doesn't have to stop there. Blood pressure can be taken easily, the lungs can be listened to via an automated system, to check for sounds that should not be present, and analyse them, stool and urine can be checked in much the same way as blood.

At the same time as all this, the medic can be talking to you, or maybe strapping the HMD on your head for a quick test of your mental state if you are conscious, reading the information and preparing drugs for injection if not.

If you have been hit on the head, you may be concussed. The simplest way is to hit you on the head again. If you have a concussion you will likely die. Whilst this is an obvious diagnosis, it is hardly acceptable. The second way usually involves several hours of lab testing, and in the mean time, neither the ambulance crew nor the medical staff know if you are or not, they only have the diagnosis "possible concussion".

In early 2005 the prototype for the sort of system ambulances are likely to have in short order, was developed. DETECT (Display Enhanced TEsting for Concussion and mild Traumatic brain injury) is able to detect signs of brain injury or dementia within minutes. It requires no formal training by the operator, and Non-medical personnel can utilise it to gauge the extent of brain damage, whilst the system works quite happily in noisy emergency rooms, whilst being portable enough to be used on the battlefield or at the side of a sports field.

The person who has suffered the blow wears a VR headset, plus headphones, and is given a device similar to a video game controller to operate. The system puts the wearer through an array of neuropsychological tests designed to pick up reduced reaction times and deficits in working memory, conditions that would indicate injuries to different parts of the brain.

The wearer sees groups of words, flashing white squares that change positions, and a series of shapes with different colours and patterns. At the same time, instructions are flashed up on the VR display while verbal commands are given through the headphones. The wearer responds to the commands by pressing one of two buttons on the controller.

By measuring reactions times in a battery of tests, the system is designed to detect even mild cognitive deficits associated with concussion or early dementia. DETECT completes its tests in about 7 minutes. Conventional cognitive tests require hours of testing and trained personnel to administer them, and score and interpret the results.

In addition to all this, MRI scanners are now small enough, and can likely be made light enough, if not already, then soon, to fit in the back of the ambulance, as part of the overall machinery your trolley was wheeled into. This can check for broken bones, lacerations, or internal trauma before the ambulance has even made it to the hospital. Thanks to DICOM, and the ambulance's internal net connection, arrives at the hospital before you do, all tagged to your personal chip's ID number so there is no chance of it being lost.

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