Emergency Pre-Hospital Care
Spring 2002 preliminary investigation
- to determine the communication technologies currently used
and those on the horizon, and their advantages and disadvantages
- to determine and list the systems currently used
(technology type, number of each type, cost,
whether built to order or commercially available, etc.)
- to recommend the type of system that Northern Westchester Hospital should obtain
and whether they should buy a commercially available one
or have a student team build a prototype of one they will build themselves
(buy or build decision)
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.
Two significant problems exist:
- 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
- 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.
- Patients who suffer trauma might require immediate
intervention from a surgeon on arrival at the hospital; surgeons are not
routinely on staff within the emergency department and must be called in when
- Cardiac patients who, studies have demonstrated,
survive in greater numbers when clot-busting drugs are infused rapidly on
presentation to the emergency department
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
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.
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.