Emergency Medical Services in PG County, Maryland Integrate New Media Technology Such as GPS and Tablets Into Ambulances in Effort to Streamline Patient Care

• Emergency medical workers and firefighters began using radios in the 1940s, and still use a similar form of communication to this day

• Modern ambulances within the Prince George's Fire/EMS Department are equipped with radios, CAD technology, and GPS to decrease response time and improve patient care

• Advancements are being made both locally and nationally to equip EMS workers with more innovative forms of communication, like tablets and Google Glass

When EMTs and Paramedics in Prince George’s County, Maryland are dispatched to the scene of a medical emergency, they do not respond to the call for help alone. To improve the responder’s knowledge of the call conditions and location of the emergency, they are equipped with an arsenal of advanced communication devices. On a typical call, the average Basic Life Support (BLS) team will bring with them a radio, a GPS device, computer aided dispatch (CAD) technology, a laptop, and a personal cell phone.

Together, these devices allow the EMTs to maintain a constant link with a central communications center, and provide a secure form of communication between responders in the field and medical professionals in the emergency room destinations. However, the use of these different forms of technology in emergency medical services is not new to the 21^st Century, and date back as far as the mid 1940s. As media technology innovations in the modern digital age continue to progress, EMS agencies must decide how they will incorporate these new technology into patient care practices.

The History of Fire/EMS Communication Technology Dates Back to the 1940s, and Employs Some Techniques That Are Used Still Today 

According to a report by the United States Fire Administration, the use of communication technology by emergency workers began in the mid 1940s when fire departments in the United States began to utilize single-channel, two-way radios to communicate between fire and EMS personnel on the scene of an emergency. Before this, the only viable form of communication was face-to-face, which required firefighters and EMTs to be within “shouting” distance of an officer or incident commander.

A drastic improvement in communication technology came in the late 1960s, when fire departments began issuing personal, multi-channel radios. Almost 50 years later, these multi-channel personal radios are still the primary medium of communication for firefighters and EMTs when responding to calls. In a survey given to 30 active EMTs and Paramedics in Prince George’s County, MD, a vast majority listed personal radios as the #1 tool used to establish and maintain communication during a medical emergency.  




Ambulances in within the PGFD Department are equipped with radios, CAD technology, and GPS to decrease response time and improve patient care

While radio communication continues to be the communication medium of choice for emergency medical workers in the field, fire and EMS departments certainly have not ignored the technological advances that have been produced over the past several decades. One of the most important and revolutionary innovations to the communications side of emergency medical services has been the introduction of Computer Aided Dispatch (CAD) technology.  These CAD systems allow emergency personnel to access a plethora of information provided by the central communications center. For example, when an ambulance is dispatched to a medical emergency, the EMTs can access all the information about the call, view a GPS map that finds the quickest route to the destination, and view information about other Fire/EMS resources in the area.

A screen shot of the Computer Aided Dispatch (CAD)
system from the base station computer at 
Branchville Volunteer Fire Department

Firefighter/EMT Steven Hamrick of
Branchville VFD checks information about
an EMS call on the CAD

Much of the information presented on the CAD systems is made possible because of recent innovations to technology within the 911 call receiving facilities. Within the past 15 years, a system known as E911 (or Enhanced 911) has been integrated into most emergency communication centers. When an emergency call is placed from a cellphone, the E911 system allows 911 call-takers to automatically access two vital pieces of information: the phone number and GPS location from which the call was placed.  The implementation of these new technologies over the past few decades has allowed EMS responders to access more information about the medical emergency in a much shorter period of time, which in turn has lead to decreased response times and increased patient survival rates.

In addition to radios and Computer Aided Dispatch technology, the Prince George’s County Fire/EMS Department has also equipped each ambulance with a ToughBook field laptop. This device allows EMTs and Paramedics to generate an electronic patient care report (ePCR) that records all the medical information about the patient and tracks all pre-hospital medical procedures that are performed.  The implementation of these laptops has greatly increased the efficiency of field documentation, which is important for both legal purposes and ensuring the continuity of patient care between EMS and hospital staff.

Both local EMS departments and those across the country are incorporating new and innovative mediums of communication to provide for EMTs and Paramedics

As the modern technological era continues to produce new ways in which we can communicate and remain connected in more efficient ways, the leadership of Emergency Medical Services departments must decide how new technologies will be incorporated to improve patient care. According to Assistant Chief Spiro Dimakas, the Prince George's Fire/EMS Department plans to unveil two major innovations within the next three years. 

The first change will come as a replacement to the ToughBook laptops that are currently used to document calls and generate electronic patient care reports. The county plans on equipping each ambulance unit with a touchscreen tablet that will be used as a more efficient method of documentation. The tablets will be preloaded with an advanced program that should be able to account for any possible situation that could happen during a medical emergency. By creating a system in which the care providers choose from a series of predetermined options, the need for a laptop and keyboard will be practically eliminated. The addition of a touchscreen tablet will also provide a simpler method for acquiring patient consent signautures and 'transfer of care' signatures from Emergency Room nurses; both of which are vital steps in the legal side of emergency medical care. 

The second change will be the addition of "Automatic Vehicle Locator" technology, which will be applied to every emergency vehicle in the county. The Automatic Vehicle Locator (AVL) is simply a GPS device that is placed in the vehicle's engine compartment and links directly to the central communications of the county. By gaining the ability to track the precise location of emergency vehicles within the county, dispatchers will be able to assign the closest physical unit to an emergency call. The goal of implementing this technology is to drastically decrease the time it takes for certain units to respond to calls, and optimize the allocation of emergency resources through the physical space of the county. 

While local Fire/EMS departments in Prince George's County try to enhance patient care with these new technologies, other departments across the country are trying new and exciting ways to incorporate technology into their practices. One of the more innovate ideas comes from Emergency Medical Services in Chicago, Illinois. According to an article posted by mobihealthnews.com, Chicago EMS will be equipping their EMTs and Paramedics with Google Glass, a technology that allows video to be shared from a camera integrated into a pair of glasses. The idea behind this technology is that video taken by the Google Glass wearers will be streamed directly to hospitals so the Emergency Room staff can get a first person view of what is happening in the ambulance. This would give the doctors and nurses a better opportunity to prepare for the patient, as well as give medical oversight and instructions to the EMTs and Paramedics.

Although this innovation provides a lot of advantages to the process of responding to medical emergencies, many EMS personnel are responding to it with negative feelings. In the same survey discussed earlier of EMTs/Paramedics is PG county, 51% of respondents stated they were either neutral or opposed to idea of incorporating Google Glass into their patient care practices. It is interesting to see this level of negative response, considering 100% of respondents stated that current EMS technologies (radio, CAD, cellphone, GPS) either moderately improve or greatly improve patient care. 

Perhaps a reason for this inconsistency is that some EMS providers feel that the current dynamic of human instinct and technological assistance is working well, and that any new advancements would only further serve to take control away from the trained EMTs and Paramedics. Either way, the trend of meshing modern technology and Emergency Medical Services is something that has been occurring for over half a century, and it seems like it will only accelerate with rapid technological advancement. EMS workers must be willing to train diligently in order to understand and adequately use the new technologies that are assigned to their ambulances. The overall expectation of Emergency Medical Services is to provide the best possible medical care to those who call for help, and with the proper integration of modern technology, that expectation will continue to be met and exceeded.