Emergency Medical Services At the Crossroads (2007) / Chapter Skim
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5 Advancing System Infrastructure
5 Advancing System Infrastructure
Pages 149-174
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From page 149... ...
And systems are under development that may eventually allow prehospital EMS personnel in the field to view complete patient health records and potentially replace paper-based ambulance "run records" with electronic data submissions. Set against this backdrop of evolving technology, however, is the basic reality that most EMS systems do not have the resources needed to make major system upgrades.
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From page 150... ...
EMERGENCY NOTIFICATION AND DISPATCH The development and implementation of a single nationwide number to call in emergency situations was a major advance for the U.S. emergency and trauma care system.
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From page 151... ...
In addition to improving federal coordination, this office will develop and disseminate information concerning practices, procedures, and technology used in the implementation of 9-1-1 services and will also administer a grant program to enable 9-1-1 call centers to upgrade their equipment. The National 9-1-1 Office is housed within the National Highway Traffic Safety Administration's (NHTSA)
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From page 152... ...
This can be medically dangerous because in many emergency situations, callers are incapacitated or unable to speak, or they are unaware of their exact location. The inability to pinpoint the caller's location has resulted in a number of widely reported incidents in which victims have died because rescue workers were not able to arrive in time, even though considerable resources were mobilized to find the caller (DOT Wireless E91-1 Steering Council, 2002)
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From page 153... ...
Phase I Phase II U.S. Population 85 percent 71 percent Public Safety Access Points (PSAPs)
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From page 154... ...
These rules require VoIP providers to (1) deliver all 9-1-1 calls to the customer's local emergency operator, (2)
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From page 155... ...
ADVANCING SYSTEM INFRASTRUCTURE TABLE 5-3 Next-Generation 9-1-1 Today's 9-1-1 Future 9-1-1 Primarily voice calls via telephone Voice, text, or video from many types of communications devices Minimal data Advanced data capabilities Local access, transfer, and backup Long-distance access, transfer, and backup Limited emergency notification Location-specific emergency alerts possible for any networked device SOURCE: DOT Intelligent Transportation Systems, 2006. noted, it is based on 1970s technology and focused on wireline phones.
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From page 156... ...
In addition, there is no definitive research demonstrating which data elements have clinical utility. Telematics services appear to be moving toward furnishing automatic, instantaneous notification of emergency events to multiple emergency care
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From page 157... ...
As a result, some communities have established 3-digit numbers -- often 3-1-1 -- that can be used in nonemergency situations. Operators receiving such calls are able to make triage decisions and if necessary refer a call to a 9-1-1 call center; they can also refer calls to other appropriate government agencies.
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From page 158... ...
The default position for dispatchers is to assume that a ground ambulance is needed. Air ambulances are not typically called until an emergency responder on the ground (police, first responder, or emergency medical technician [EMT]
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From page 159... ...
A major function of state EMS offices is ambulance credentialing and inspection. In 2003, 41 state offices were involved in credentialing ambulances, while 42 state offices were engaged in ambulance inspections.
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From page 160... ...
. Air Medical Services Air medical operations, including those involving both rotor-wing helicopters and fixed-wing aircraft, have become an increasingly significant component of U.S.
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From page 161... ...
The Atlas and Database of Air Medical Services (ADAMS) -- developed by academic researchers and supported by the Federal Highway Administration and NHTSA -- now provides a map of available air medical service areas across the United States.
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From page 162... ...
, medical equipment, and transport protocols regarding hospitals and trauma centers. In addition, states should establish dispatch protocols for air medical response and should incorporate air medical providers into the broader emergency and trauma care system through improved communications.
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From page 163... ...
. In addition to these emerging technologies, numerous other advances in medical treatment are likely to impact the level of care EMS personnel are able to provide to patients.
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From page 164... ...
Communications among EMS, public safety, public health, and other hospital providers are even more problematic given the technical challenges associated with developing interoperable networks. As a result of these challenges and the need for improved coordination, the committee recommends that hospitals, trauma centers, emergency medical services agencies, public safety departments, emergency management offices, and public health agencies develop integrated and interoperable communications and data systems (5.2)
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From page 165... ...
Such efforts need to be expanded nationwide. Public Safety Communications Voice communications improvements initiated by the federal government in the aftermath of the terrorist attacks of September 11 have focused on fire and police but have often overlooked EMS (Center for Catastrophe Preparedness and Response NYU, 2005)
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From page 166... ...
SOURCE: Public Safety Wireless Network Program, 2005.
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From page 167... ...
Health Care Data Systems NHTSA's Emergency Medical Serices Agenda for the Future set forth five goals for the EMS information system of the future: (1) adopt uniform
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From page 168... ...
. The availability of uniform, reliable EMS data has been a long-standing concern that emerged as major priority during the development of the Emergency Medical Serices Agenda for the Future: Implementation Guide in the late 1990s.
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From page 169... ...
Therefore, the committee recommends that the Department of Health and Human Services fully involve prehospital emergency medical services leadership in discussions about the design, deployment, and financing of the National Health Information Infrastructure (5.3)
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From page 170... ...
to provide feedback to individual service providers regarding patient outcomes and provider performance. This project meets a number of the goals established by the Emergency Medical Serices Agenda for the Future and can serve as a model for other communities across the United States.
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From page 171... ...
2003. Ambulance crash-related injuries among emergency medical services workers––United States, 1991–2002.
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From page 172... ...
2003. Can first responders be sent to selected 9-1-1 emergency medical services calls without an ambulance?
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From page 173... ...
1978. Emergency Medical Serices at Midpassage.
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