Time is Tissue

While the wireless voice and data technologies supporting EMS improve, research assesses use of wireless networks to trigger response at the moment of collision.

“Time is tissue” is a battle cry in the emergency medical services (EMS) community. Forced by definition to be reactive, EMS providers constantly seek ways wireless communications can reduce their response time.

Current advances include more efficient and useful radio communications and telemetry. Meanwhile, activity in Congress, supported by the EMS community, foreshadows a vast expansion of wireless systems to instantly notify ambulance and rescue units of automobile accidents.

En route preparation for the emergency scene is being enhanced by real-time messaging via wireless mobile information software. For example, the Packetcluster Rescue system from Cerulean Technology, Marlborough, MA, designed for fire and rescue response, has features applicable for EMS and for agencies with dual duties. Once an agency’s computer-aided dispatch (CAD) or records management system (RMS) is tied into the server, responders can access details about the emergency scene from their vehicle. In addition to route displays, responders can view hazmat databases and identify any individuals at the site who have special requirements or medical conditions.

Coordination of shared communications among different ambulance providers is also a critical area. Several ambulance companies in Lansing, MI, using Motorola MTR2000 radios, had difficulty using an area hospital’s repeater because the radios would not accommodate multiple use of the Private Line feature. State Electronics, Lansing, and Zetron, Redmond, WA, worked together to create a new interface assembly combined with a tone panel that allows the multiple Pls.

Several companies are also working to refine dispatch for EMS applications. American TriTech, San Diego, has developed the Windows NT-based VisiCAD for Ambulance system to give dispatchers data access and control, with redundancy, in a multitasking client/server system. EMS providers can customize the system for their operation and dispatch using point-and-click procedures.

On-site biomedical telemetry continues to improve as well. Racom Products, Cleveland, has produced a cellular-based, full-duplex system to allow remote simultaneous transmission of voice and electrocardiogram (ECG) data to the base hospital from an accident or rescue site. The 3W Life-Tel system operates portably on lead-acid batteries.

Testimony before the U.S. House Telecommunications subcommittee this spring indicated the need for ubiquitous nationwide wireless networks to support wireless E9-1-1 calls. The committee’s chairman, Rep. Billy Tauzin (R-LA), has introduced H.R. 3844, the “Wireless Communications and Public Safety Enhancement Act of 1998,” which, among other things, calls for extensive development of automatic collision notification (ACN) technology to speed EMS and rescue response time.

“We heard of the importance of getting help to a victim of a car crash in the first 60 minutes-the ‘golden hour,’ and how speeding emergency services to the site can save lives,” Tauzin said in June.

Section 6 of the bill proposes a funded R&D program, administered by the National Highway Traffic Safety Administration (NHTSA), for a comprehensive ACN system that transmits information about a crash to emergency personnel by a wireless telephone in the vehicle. The research would also develop a uniform wireless telephone interface for motor vehicles to permit transmission of crash data and voice-activated, hands-free use of all models of wireless telephones.

Jeffrey Michael, chief of the Emergency Medical Services Division of NHSTA, testified that the legislative agenda is in line with his agency’s EMS agenda.

“NHTSA currently conducts crash research with trauma centers and trauma and EMS systems nationwide. … In addition, our Crash Injury and Research Network currently provides NHTSA with a test bed for many of this section’s goals. The agency’s ACN deployment program in Erie County, NY,-the only complete ACN system-has experienced six crashes. In all cases, the system has worked effectively,” Michael said.

David K. Aylward, executive director of the ComCARE Alliance, Washington, DC, a coalition of more than 20 EMS professional, public safety and wireless industry organizations, discussed one crash during the Erie County tests in May.

“A young man drove off a highway into a ravine. His car was part of a test funded by the DOT that put automatic crash notification technology in his car. Before he could get out of the car, the dispatcher was asking him over his car phone what condition he was in. Before he could limp back to the highway, emergency personnel were there to help him,” Alyward said.

John Melcher, director of information systems for the Greater Harris Co.

9-1-1 Emergency Network, Houston, also testified in support of ACN.

“Networks must be configured to accept automatic crash notification information and other live data. … This may sound like a developmental project of NASA proportions, but it is, simply, a matter of using existing tools in a collective and coordinated fashion. Integrating voice and data via dig ital networks is nothing dramatically new.

“The example [Congress sets] will forge the relationships necessary to integrate wireless service providers, trauma care specialists and 9-1-1 professionals,” Melcher said.