Strapped to a gurney in an ambulance headed for the emergency room, a pre-hospital patient isn’t thinking about the ambulance’s radio communications.
He isn’t thinking about how radio communications facilitated a quick response to a call for help, how it may have relayed vital signs and medical advice between the ambulance’s medical responders and an emergency room physician, or how it protected the privacy of his medical condition and records.
Emergency medical service demands the obvious: high levels of first responder training, modern ambulances and medical equipment.
But, in addition, it requires mobile communications that supports service delivery and complies with patient information confidentiality required by the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
Huron Valley Ambulance, Ann Arbor, Mich., is about to upgrade its mobile communications by using mobile data on a public wireless network to augment its voice radio communications.
HVA is a nationally accredited, nonprofit regional ambulance service covering all or part of eight southeast and south central Michigan counties with a fleet of 70 vehicles.
For example, in Jackson County, HVA acts as a secondary public safety answering point, with call center staff providing screening and pre-arrival medical instructions to 911 callers.
“The benefits are tremendous. Jackson City-County residents receive medical information from the highly skilled and trained staff from Huron Valley at no cost to Jackson taxpayers,” a statement on the Jackson County Emergency Dispatch Division Web page reads.
Jerry Zapolnik, HVA’s vice president of support operations, said that the new mobile data system would use mobile computers connected via the Nextel Communications IDEN radio communications network.
“It is my expectation that we will be able to reduce the voice traffic by 25 percent to 40 percent. At this time, we have no intention of discarding our current voice network and relying on the Nextel network for voice communications,” Zapolnik said.
For voice communications, HVA uses several private radio networks on various frequencies.
Most of the company’s ambulances and other transport units are dispatched via an 800 MHz systems operated by county governments.
In some outlying areas, HVA uses a VHF channel, and in some other parts of its service area, HVA uses a conventional 800 MHz channel for communications.
“With all of the various options, we are very well covered for both mobile and portable coverage. As with any coverage though, it could always be better,” Zapolnik said.
HVA uses voice for most of its communications.
The company uses alphanumeric pagers to send call information to the emergency medical service crews stationed with their vehicles at locations chosen to reduce response time.
Zapolnik explained that the pagers do not provide an acknowledgement of receipt of the information by the crews and presents some coverage problems outside the metropolitan area.
Along with the mobile data upgrade, Zapolnik said that HVA hopes to use a GPS functionality to improve mapping and routing information for the emergency medical service crews.
Digital Dispatch Systems, Richmond, British Columbia, Canada, is supplying HVA with MC1700 mobile computers for the company’s bus transportation vehicles and ambulances, and is handling the system integration with the Nextel network.
The mobile computer includes a GPS receiver and touch screen, and runs the Windows CE operating system.
It also is equipped with Personal Java, which allows developers to build cross-platform applications more easily.
The computer’s open architecture allows it to be integrated with HVA’s computer-aided dispatch.
Digital Dispatch has been known for its taxi dispatch systems, and it also provides systems for the courier, road assistance, airport shuttle, paratransit and transit.
It is making a transition to also providing overall systems integration, project management, technical consultation, system installation, training and customer support for public safety dispatching.
Emergency medical technicians and paramedics work indoors and outdoors, in all types of weather. They do considerable kneeling, bending and heavy lifting. They risk noise-induced hearing loss from sirens and back injuries from lifting patients.
EMTs and paramedics may be exposed to diseases such as Hepatitis-B and AIDS, and violence from drug overdose victims or mentally unstable patients. The work is physically strenuous and stressful, involving life-or-death situations and suffering patients. Nonetheless, many people find the work exciting and challenging, and enjoy the opportunity to help others.
EMTs and paramedics employed by fire departments work about 50 hours a week. Those employed by hospitals frequently work between 45 and 60 hours a week, and those in private ambulance services, between 45 and 50 hours. Some of these workers, especially in police and fire departments, are on call for extended periods. Because emergency services function 24 hours a day, EMTs and paramedics have irregular working hours that add to job stress.