Emergency Pre-Hospital Care
Communication System

Spring 2002 preliminary investigation

Background

Throughout America ambulances and, in many communities, fly cars respond to a variety of emergencies through 911 and other local emergency response systems. The Emergency Medical Technicians (EMTs) and Paramedics who respond in the field have levels of training that vary from 100-hour programs to a two-year course of study. These lifesavers work closely with other emergency providers, including police and fire departments. They provide care under the direction of local emergency departments and physicians skilled in emergency care.

Time is critical for many of the patients seen in the field. The emergency department, staffed with personnel best trained to care for the most critical patients may be a half hour away, or more, in some communities. With reliable, current information, emergency department physicians can direct care of the patient through the eyes and ears of other pre-hospital care providers. Care provided in this way assures the smoothest transition and best quality of care when the patient reaches the Emergency Department.

Problems

Two significant problems exist:
  1. Existing technology used in other industries is not harnessed to support the clinical activities of the rescuers. Such technology would provide higher quality care, reduce medical errors, ensure consistency, and provide the data to support improvement efforts.
  2. There is no consistent or direct mechanism to assure voice communications among all rescuers

Issues and Potential Enhancements

Enhanced Outcomes and Quality Improvement

ER Effectiveness: Early communication from the field can provide necessary data to alert the emergency department staff to prepare specialty medications and services and call in specialty staff to reduce the window of time that it takes to provide lifesaving therapies. Examples of this are: More care in the field: By providing additional and more reliable information to the emergency department the physician the role of the paramedic may be enhanced.

Communication

Many individuals and departments are involved in the pre-hospital care of a patient and the management of an emergency scene; these are dispatch, police and fire first responders, volunteer EMT ambulance crews, paramedics (providing advanced live support services), and hospital staff. A complex matrix and involvement of Municipal, State and County branches of police and fire/EMS responders and a complicated geography compounds these communication difficulties. Mobile telephone cell sites do not currently support service throughout all service areas. This technology permits limited availability for multiple communicators. Radio technology presents issues of confidentiality and shared bandwidth among multiple agencies.

As ambulance crews race to an emergency scene they prepare mentally for pending action.  They review protocols and consider options.  They anticipate the scene and prepare a plan to care for the emergency.  The more information they receive, en-route, the better this preparation.

Goal

The goal of this project is to use communication and information technology to save lives in emergency situations. The product will assure timely, complete communication among all emergency response providers. Care will be improved from the time of dispatch to the time the patient reaches the emergency department.