Top EMS Game Changers – #1: Cellphones
Mobile phones changed day-to-day EMS operations more than any medical device or innovation
What if the most significant EMS innovation of the last 25 years isn’t a medical device at all, but an everyday item owned by over 90 percent of the U.S. population? I’m talking about the smartphone in its embryonic state: the cellphone.
I wasn’t an early adaptor of cellular technology. I still owned a rotary phone well into the ‘90s – a no-frills source of pride for me, like shoveling my own driveway when it snowed (I have less snow and less pride since we moved south). It wasn’t until a year after I became a paramedic that I even considered going mobile.
In 1996, I had a partner who ran a business from the cab of our ambulance. I’d be in the back doing things to patients while he’d be steering around pedestrians, playing with the sirens and giving radio reports, all while negotiating prices for imported footwear on a flip phone the size of a chalkboard eraser. I admired his resourcefulness, not to mention his detachment.
It wasn’t partner envy that convinced me to go cellular, though; it was desperation.
Can you hear me now?
One of the agencies I was riding with put mobile phones on their rigs for two reasons: as back-ups for portable radios, whose range was something less than the size of our district, and as geeky hook-ups for 12-lead field transmissions. Unfortunately, those phones were often disconnected from their chargers and left that way long enough for early-generation NiCad batteries to lose what little juice they had.
I can’t tell you how many times I inherited dead phones – about as often as the radios didn't work, I guess. I considered my options: (1) declare preemptive catastrophic communication failures – like, weekly – and do whatever I would have done if I’d graduated medical school; or (2) find another way to discuss presenting problems without having to borrow a bystander's BlackBerry.
I decided on the latter and started shopping for my very own cellular device. I chose the most basic flip phone Verizon carried, mostly because they offered a 19 percent discount to EMS providers. You got the instrument, the charger and 70 minutes of talk time for less than $20 a month. Messaging? I figured I didn’t need it. Data? Not an option.
Suddenly I was a high-tech have instead of a have not. I congregated with other cellphone-a-philes, knowing I was just as plugged-in as they were to an increasingly mobile world. I kept my phone charged so I could call hospitals or medical control whenever we were out of radio range or if I wanted something other than a push-to-talk conversation.
I was master of a domain I defined as anyone or anyplace I might want to call anytime. But that worked both ways
From high-tech tool to way of life
Like most of you, I became reachable 24/7. I didn’t plan it that way. Who did? Suddenly there were calls in the car, calls at the store, calls on calls. Even compared to my personal-best record for most pagers carried at once – four – this cellphone thing was intrusive. It was also convenient at times, like when I needed to update my wife, partners and bosses about my coming and going.
As I got used to my non-stop connection with the rest of the world, the impact of mobile phones seemed to be leveling out. Then sometime around 2007, when I began working as a medic in Nashville, smartphones were introduced, and day-to-day EMS changed more suddenly and more profoundly for me than at any time since I’d started in 1992.
All those protocols, prescription drug names, ACLS algorithms, poisons, coma scales, burn formulas, lab values and Spanish translations I used to carry in booklets and notepads were suddenly available on line with almost no delay. Can’t remember the generic name for Prinivil? Just Google it. Want to double check the dose of diltiazem for rapid a-fib? No problem. Wondering how to ask “Where does it hurt?” in Hungarian? As easy as pite.
As if that weren’t enough, we also got news, maps, calendars, calculators, Facebook, email, the weather and even Angry Birds. Today, those features are among the 2 million apps available for download. It’s as if the Earth were suddenly rebooted as a digital planet.
And yet I miss my rotary telephone – that clunky and overpriced but indestructible unit made by Ma Bell. I never had one break or need new batteries. Sure, it was heavy and not at all mobile, but the voice quality was so much better than what we get through cellular networks.
And it was really hard to hack.