Modern dispatching of firefighting and emergency medical services has become more than a simple reaction to an urgent problem. It is also the strategic husbanding of often scarce resources, in a time when budgets are tight and competitive pressures are intense. "We have very stringent...
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Modern dispatching of firefighting and emergency medical services has become more than a simple reaction to an urgent problem. It is also the strategic husbanding of often scarce resources, in a time when budgets are tight and competitive pressures are intense.
"We have very stringent response times (mandated) under a performance bond. We must place a paramedic ambulance at the scene of an emergency in no more than eight minutes from the time that the call is received. Failure impacts lives as well as dollars," said Patrick Smith, president and CEO of the Regional Emergency Medical Services Authority (REMSA). This non-profit group is headquartered in Reno, NV, and provides paramedic ambulance service in a 17-county area, covering 6,000 square miles, with just 14 ground and one helicopter ambulance. The management tool it uses is VisiCAD, a real-time interactive computer mapping and data system designed specifically for the purpose by American TriTech, based in San Diego.
REMSA is one of more than 40 public and private ambulance services around the world which have adopted the system. Other users include the Denver Fire Department, the St. John Ambulance Service (New Zealand's largest, in Auckland) and the Staffordshire Ambulance Service NHS Trust, which covers 1,000 square miles and a population of 1.5 million people around Stafford in the United Kingdom.
For Smith and his colleagues at REMSA, the VisiCAD system provides not just an address where a medical emergency is occurring, but also a computer-displayed map, the status of near-by units and their relative locations. The locations are constantly updated by a Global Positioning System (GPS) receiver in each ambulance that is linked to the central dispatch center by an 800 Mhz digital wireless radio system.
That same system also feeds data to the ambulance crews, which allows the most efficient use of resources. Each ambulance has access to a database which contains the Dr. Clawsen's Emergency Medical Dispatch Protocols and other data. A scanner allows the incorporation of additional grabbed visual information, such as the layout of a mobile home park or of a public park or the floor plan for a hospital, hotel, casino or other large public building with multiple entrances and levels.
These images and other site-relevant data become intelligent attributes which pop up when the location is entered into the system. The computer map, derived from Bureau of the Census TIGER databases that have been visually enhanced, is scalable.
Included in the database is intersection and routing information, which is dynamic, based upon previous experience and including environmental factors such as weather and the time of day and the day of the week. This constantly updated history allows REMSA to assign and position its crews efficiently.
"We know that we are going to need all units in position during a weekday rush hour," Smith said, "But at 5 A.M. on a Sunday, for instance, we may need only three crews and ambulances to meet the demand. Anytime an ambulance is dispatched, the system adjusts the other units to new positions so that they can respond in the most timely manner. The American TriTech system is the heart of our dispatch system. It provides maximum efficiency because it will scale to any user-defined box. The dispatcher can tell that ambulance crew exactly where to turn, and can monitor their location from the GPS as they respond. We use a dual screen system, with the map on one monitor and the location data on the other with line-by-line directions."
REMSA has one of the smaller VisiCAD EMS systems deployed. A more typical user is the Acadian Ambulance Service of Lafayette, LA, which covers 26 of the state's 64 parishes with 140 ground ambulances, four helicopters and two fixed-wing air ambulances. Acadian uses a VHF radio dispatch system to communicate with its crews and feed back GPS data to the dispatch center. The ground ambulances also receive data from the central dispatch through mobile data terminals. Acadian uses an integrated paging system with automatic reminders to alert crews when they have been at the site of an emergency too long.