EMS communications: Doing more with less
Cash-strapped agencies can do more with less by leveraging the communications tools they already have and taking advantage of free or low-cost software applications
By Greg Friese
EMS incident planners are in the midst of a paradoxical era of increasing availability and capability of communication methods and capped or even shrinking budgets.
Fortunately, cash-strapped agencies can do more with less by leveraging the communications tools they already have and taking advantage of free or low-cost software applications.
Multiple-patient incidents, such as a motor vehicle collision, an active shooter or a natural disaster, develop rapidly. Incident reports from 911 callers and early responders flood the communications center but often lack important details to make decisions about deployment of scarce resources.
In addition, audio transmission after bystander interrogation might not adequately prepare emergency responders for the injuries, access, extrication and transportation issues they are about to face.
Here are some ways to do more with less in communications during EMS response.
Using existing devices
According to the "Our Mobile Planet" survey, 44 percent of Americans have a smartphone.[i] An important pre-planning step is to survey the smartphone ownership rate and comfort of your membership with apps and capabilities of their phones. Your department may also provide a smartphone or tablet to crews or individuals for routine use, like electronic patient care reporting, that could also do double duty for increasing communication capabilities.
Nearly all smartphones, as well as laptops and tablets, have the capability to capture media, post that media to public or private websites and share that media privately or publicly. Privacy settings allow control over who can upload and view images or videos.
An image could show a structural collapse to help an extrication and rescue team select the proper tools. A short video might properly guide ambulances into a transportation staging area or point out landing zone hazards for a flight crew.
Use existing 3G/4G networks or mobile WiFi hotspots to upload and share media during an incident. Make sure to understand the upload speeds of your mobile devices before an incident so you can adjust the resolution settings of your camera. Remember, during a large incident, mobile networks will likely be at peak usage as bystanders and other responders upload videos and images while also making phone calls.
Apps and web-based software
The devices we use day-to-day, on- and off-duty, are capable of running applications and accessing websites for navigation, group texting and video messaging and video and audio broadcasting.
Google Maps and Bing Maps can provide driving directions for out-of-area responders, show street-level detail of structures unfamiliar to responders and identify pros and cons of various egress routes for ambulances transporting patients. Google Maps has indoor maps of some airports, casinos, museums and shopping centers.[ii] Viewing a shopping center map before arriving might help a paramedic crew get to a patient sooner.
Instant messaging services like Google Talk, Yahoo! Messenger, ICQ and AOL Instant Messenger allow text conversations between individuals and may have the capability for video chat, file sharing and adding other users to the conversation.
Instant messaging and text messaging might be used to broadcast dispatch information, check personnel and resource availability, ask quick questions when radio transmission is unwarranted or unavailable or share videos or photos of the incident. If you are already using an instant messaging service on your tablet or PC, check for its availability as a smartphone app.
Skype software combines text, audio and video capabilities with the ability to call phone numbers. Just as Skype can bring a remote guest speaker into the training room, it could bring webcam video from the incident scene to a computer screen in the incident command post.
There are also many apps that will broadcast video from a webcam or smartphone to a unique URL that can be privately or publicly shared. Educators and managers regularly use Google+, UStream, Blog Talk Radio and JustinTV for distributing training programs and planning meetings. The software and hardware capabilities could easily apply to incident communications and monitoring.
Public domain incident data
Before and during an incident, emergency responders can access helpful public domain data. Weather applications can display current conditions, like wind speed, humidity and temperature, as well as forecasts that might impact an ongoing incident.
Many traffic cameras broadcast live video and regularly refresh still images on the web. Freeway cameras in Milwaukee, Wis., controlled by the Wisconsin Department of Transportation, are refreshed every three minutes. An accident scene, including number and type of vehicles, presence of fluid spills or smoke or access concerns, could be viewed before arriving.
The social web is a treasure trove of data. Use an advanced Twitter search to sort through tweets by keywords, hashtags, people and places. Narrowing a search to people in or near an incident might harvest photos of the incident or even details about the number and type of injuries.
Other social networks and media sharing sites, such as Facebook, Google+ and YouTube, might have user/bystander-generated content that will be valuable to incident responders and planners.
Quick launch of communications apps and websites
Use desktop shortcuts for top of mind and fast launch of communications apps from the ambulance's mobile data terminal. Train responders to recognize and use these icons. Many smartphones have the capability to create custom launch screens for apps and widgets.
Dedicate a launch screen for incident response tools, and include a weather widget, shortcut to local traffic cameras, a video and image sharing app and Twitter search.
Like with any aspect of incident response, don't wait until an actual incident to practice using these communication devices, apps and software. Practice during day-to-day and low-stress operations.
For example, if you are providing EMS support at a marathon, position a webcam at the 26 mile marker. Stream that video to an EMS command post at the finish line. Monitor the video for runners in distress, and relay bib numbers and outfit details to medical personnel at the finish line so they can prepare to receive runners most likely in need of assistance.
During a public education event, broadcast the event using uStream or Google+. Embed the live video in your organization's blog, and share the link on your department's Facebook page and Twitter account. Instead of a face-to-face event, schedule a virtual layperson CPR training, open house or question-and-answer session. Use a smartphone to broadcast the CPR demonstration or give a tour of the apparatus bay. Encourage questions on Twitter, and monitor for an event hashtag to view those comments and questions.
Remember your roles and responsibilities during an incident. Use these communications tools and techniques to enhance existing duties, like capturing video with a smartphone during size-up or incident walk-around, without compromising the safety of yourself or others.
Finally, always know and understand your department's Standard Operating Guidelines for capturing and sharing audio, video and images during and after an incident.
[i] Our Mobile Planet. Smartphone Penetration in the United States. http://www.thinkwithgoogle.com/mobileplanet/en/graph/?country=us&category=DETAILS&topic=DETAILS_PENET&stat=PENET01&wave=wave2&age=all&gender=all&active=stat. ThinkInsights with Google. Accessed on October 14, 2012.
[ii] Indoor Maps Availability. Google Maps. http://support.google.com/gmm/bin/answer.py?hl=en&answer=1685827. 2012. Accessed on October 14, 2012.