August 12, 2021 | By George Tamborelle – Paramedic Supervisor, Bangs Ambulance
Helping Bangs Ambulance stay connected, keep the community safe
As a paramedic supervisor, I keep track of the crews, the resources we have available here at Bangs Ambulance. I have to make sure we have enough staffing each day to get the job done. And as a scene supervisor, it’s my job to go out and assist the crews on any call that that would need an extra set of hands.
We’re in constant contact with our 9-1-1 dispatch center and fire, EMS and police units. And our 800 megahertz radio system is usually pretty reliable. But there are some areas where our communication system would just drop offline. We wouldn’t be able to ask for the resources that we needed or coordinate with the hospitals or the 9-1-1 center to get those additional resources.
And that’s where FirstNet® is helping us.
Coordinating with the hospital
If we have a patient that we need to take to a specialty resource center, we have to coordinate with the local hospital and then coordinate with the receiving facility. Many times that becomes difficult in a rural setting, because the other resource hospitals don’t have our radio channels. And we have to handle that communication via a phone or some kind of a data link.
Plus, we’re seeing a higher population density out in our rural areas, which means we’re responding further out. People are calling for things that they didn’t historically call for. Ithaca is not a large city. But people do like to move further out away from the population center. So, once you get out into those areas, communication can become very spotty.
Without reliable communication, there are several risks. There is a safety risk if we need more resources – like a law enforcement agency, or a fire response – and we can’t call for those additional resources. We also have the other side of it – getting that patient, to the facility that can best suit their needs.
Expanding needs with COVID-19
People are calling for illnesses that they didn’t use to activate 9-1-1 for – like mild trauma and lacerations. And we’re ending up further out in these rural settings.
We are also seeing a lot more of the COVID-19 calls because of the pandemic. People do not want to go to the hospital. So we need to coordinate and reassure them. If they’re having a cardiac issue, but they’re afraid to go, we coordinate with the hospital. We do that via phone to keep it more private and protect the patient’s confidentiality.
So, where we would historically travel to a patient and take them to the hospital, now we’re doing more telemedicine. We’re talking to the physicians at the hospital and coordinating resources to get that patient where they need to be rather than travel to the hospital for care.
For example, if we have a cardiac patient who’s got a history of atrial fibrillation, we would contact the hospital by phone with that reliable connection and talk to the doctor. We would send an EKG over the data link to the hospital. They’ll be able to see that EKG and see there is no change from the previous EKG and advise that person to follow up with their primary care physician.
Helping transmit critical data
There’s a lot of information that needs to pass between the paramedic doing the transport or on the scene and the doctors at the hospital. We need to send 12-lead EKGs. We need to send vital signs to them. And all of that can go over that link. But that link has to be reliable at all times.
We can’t drop that transmission. If we do, then the data gets lost or we have to re-send it. And that takes additional time. If we get it right the first time and get that data across on the link, then the doctors can quickly make those decisions. What we don’t want is to be sitting on the scene for an extended period of time, trying to make a transport decision. We need that information immediately.
FirstNet is helping us by providing a more reliable means of communication to the physicians, to the resource centers. It allows us to transmit the EKG, the vital signs to the hospitals to make those transport decisions quickly. The last thing we want is to start transporting to a local facility when a facility further away would be more appropriate.
Historically, we haven’t been able to get the cell coverage. With FirstNet MegaRange™, we have that reliable communication all the way to the receiving facilities. So, we can continuously update the providers at those receiving facilities on the patient’s status and interventions we’ve done. And we can give them an up-to-date estimated time of arrival. So, they’re ready for us.
With that new service, it’s amazing because we don’t drop that connection. We can make those phone calls. We can get those resources that we need. And we can make sure that we’re providing the best patient care that we can.
Working towards positive outcomes
Some of the situations where we need connectivity are life and death. If we can’t transmit that EKG and the doctor decides that that patient needs to go to a specialty resource, it could be a life or death situation. If we start transporting to the closest facility, we are heading in the wrong direction. Without that reliable connection – to get the information to our hospital, for them to say, go to a different hospital – it’s a matter of minutes between a positive and a negative outcome.
Recently, we had a patient who was in a rural area, and we were able to keep that link, transmit that data. The patient was having a STEMI – an active heart attack. Because we were able to transmit that data, the cardiac team met us in the emergency room. And 10 minutes after we got the patient to the emergency room, they had them in the Cath lab doing the intervention.
The outcome was positive, and the patient is in recovery.
George Tamborelle is a paramedic supervisor with Bangs Ambulance in Ithaca, NY, and has been a paramedic for 24 years.
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