Field Operations and Medical Command Communications

But first…

..

Radio 101…..

Types of Radios

• Base Radio– High power– Uses elevated antenna / tower

• Mobile Radio– Intermediate power– Uses roof mounted antenna– May use in doors on AC power (e.g., ED)

• Handheld Radio– Low Power– Integrated antenna– May use external antenna extension

• Scanner

Options in Public Safety Radio Systems

• Radio Spectrum– VHF, UHF, 700/800 MHz

• Analog vs. Digital • Conventional vs. Trunked

– Simplex – Duplex - Trunked

Radio Spectrum

150 MHz +/- 450 MHz +/- 700-800 MHz 4.9 GHz

New Public Safety Broadband

Analog vs. Digital Networks• Analog

– Translate an audio signal into radio frequency signals– Can also carry data by converting it to an analog signal

via a modem

• Digital– Translate an audio signal into a digital bit stream of ones

and zeros using “vocoder”– Stream is sent over the airwaves and decoded at the

receiving end– Receiving radio translates the digital stream into an audio

signal equivalent to the original voice message

Analog vs. DigitalAnalog Signal

Clear Signal

Signal begins to degrade

Signal unreadable with lots of static

Digital Signal

Clear Signal Clear Signal

Computer cuts signal

off when it becomes

unreadable

Simplex Radio Systems

• Transmits & receives on single frequency

• “Talk Around”• Like family walkie-

talkies

Radio A

Tx: 155.340

Rx: 155.340

Radio B

Tx: 155.340

Rx: 155.340

Radios C and D

Tx: 155.340

Rx: 155.340

Simplex Radio and Base Stations

Port. Radio A

Tx:155.340

Rx: 155.340

Base Radio B receives signal from Port. Radio A

Base Radio B

Tx:155.340

Rx: 155.340

Port. Radio C

Tx:155.340

Rx: 155.340

Port. Radio B too far away to receive signal from Port . Radio B

Simplex Radio and Base Stations

Port. Radio A

Tx:155.340

Rx: 155.340

Base Radio B

Tx:155.340

Rx: 155.340

Port. Radio C

Tx:155.340

Rx: 155.340

Base Radio A transmits with strong signal that is received by both portable radios.

Simplex Radio with Private Line(AKA Tone Squelch)

Hospital A

Tx: 155.340 Tone A

Rx: 155.340 Tone A

Hospital B

Tx: 155.340 Tone B

Rx: 155.340 Tone B

Ambulance C

Tx: 155.340 Tone A or B

Rx: 155.340 Tone A or B

Only radios with Tone A (or no tone squelch) will hear transmission from ambulance.

Duplex Radio System with Repeater

Port. Radio A

Tx: 467.950

Rx: 462.950

Base Radio B receives signal from Port. Radio A on 467.950

Base Radio B

Tx: 462.950

Rx: 467.950

Port. Radio B

Tx: 467.950

Rx: 462.950

Repeater

Base Radio B automatically repeats received signal on 462.950 with very strong signal received over wide area

Conventional Radio System

EM

S

Fir

e

Pol

ice

One frequency = one user group

Trunked Radio System

“A pool of radio channels available to any user when required. Channels are removed from the pool when needed and returned to the pool when not in use”

Defined

Trunked Radio System

• UHF Bands (450, 700, 800, 900 MHz)

• Radio frequencies shared among all users

• Computer Controls Radios and Base Stations

• Each Radio Has Unique Address

• Each radio affiliates with single tower

• “Talkgroups” replace frequencies

• APCO Project 25

Trunked Call Processing

1. Call Request

Push to Talk(PTT)

VoiceChannels

ControlChannel

SystemController

Trunked Call Processing

2. Call Set-Up

VoiceChannels

ControlChannel

SystemController

“AssignsChannel 2”

Trunked Call Processing

3. Transmission

VoiceChannels

ControlChannel

SystemController

Receive

Transmit

Trunked Radio Network

Radio set on EMS Talkgroup

Radio set on Police Talkgroup

Trunked Radio Network

Radio set on EMS Talkgroup

Radio set on Police Talkgroup

Trunked Radio SystemsPros and Cons

Disadvantages• Technically complex• Requires new equipment• Relatively expensive• Fireground limitations

Advantages• Efficient spectrum

use• System redundancy• Interagency

communications• Supports future

growth• Statewide / regional

coverage possible

EMS Operations / MEDCOMCommunications

0 Min 5 Min 10 Min 15 Min 20 Min

Dispatch Communications

Field Ops Communications

MEDCOM Communications

EMS Field Operations Communications

• Purpose– Provide mission critical communications between all

responders and dispatch• Interagency Communications Between

– 1st Responders – BLS – ALS – other Public Safety• Applications

– Downgrade, upgrade, or cancel response– Scene safety / vehicle placement– Provide update on patient status – Determine status of hospitals

EMS Field OperationsCommunications

• Communication modes– Radio– Cellular– Mobile data terminals

• Challenges with multiple agencies– Use of multiple frequencies / bands– Proprietary frequencies

• Unwilling to allow other agencies on their frequencies

MEDCOM Communications

• Field to Hospital (MEDCOM Center)– Provide pre-arrival notification to hospital– Receive direct medical control

• Pre-Arrival Notification– Enough info to find an ED bed

• Direct Medical Control– Authorize certain medical treatments– Physician consultation– Physician “heads up” notification

MEDCOM Communications

• Modes– Radio– Cellular– Web-based notifications

• System should be highly reliable– Offer redundant capabilities

• Need for recording – Maybe required– Essential component of retrospective CQI

Communications and CQI

• EMS communications systems provides excellent means to monitor system performance in real time and retrospectively

• Dispatch and Field Operations

– Monitor response times / overall system function– Provides source for on-scene, concurrent CQI

• MEDCOM – Monitor clinical performance– Provides source for case reviews

Recording Communications

• Multi-channel digital recorder– Allows for electronic file transfers

• Confidentiality of communications– May be subject to FOIA – MEDCOM should be considered confidential

• Use in CQI– Random selection– Sentinel events– Selected cases

Radios and the Medical Director

• Should Medical Directors have Radios?• Why?

– Monitor system operations – Field response

• Allows for “cherry picking”

– MCI Response

• What type of radio(s)?– Portable vs. mobile vs. scanner– May need permission from agency / state

• How do you acquire the equipment?

Primary Rule for the Medical Director and Radios

Listen instead of talk!!!

Disaster and Interoperable Communications

Disaster Communications

• Ineffective communications most constant disaster response deficiency

• Interagency Communications– Between field responders

• Between EMS agencies / Between disciplines

• Essential for effective ICS– Between field and hospitals

• May use Regional Medical Coordination Center

– Between field and Emergency Operations Center

– Between local and state officials

Landline and Cellular Phones

• Cellular phones not reliable in disaster

• Landline systems may be overwhelmed

• GETS / WPS– Priority systems for

wired and wireless phones

• www.gets.ncs.gov

The GETS Calling Card

GETS USER

GETS USER

ORGANIZATION

GETS priority is invoked“call-by-call”

Calling cards are in widespread use and easily understood by the NS/EP User, simplifying GETS usage

GETS is a "ubiquitous" service in the Public Switched Telephone Network…if you can get a DIAL TONE, you can make a GETS call

US GOVERNMENT PROPERTY. If found, return to:NCS (N3), P.O. Box 4502, Arlington VA 22204-4502

WARNING: For Official Use Only by Authorized Personnel.

Web-Based Resource Tracking and Alerting Systems

• Used during non-disasters to monitor hospital status

• Connect all key resources– EMS – Hospitals – EOCs

• Provides Real Time – Casualty care capacity– Bed availability

• Alert hospitals and others of MCIs

Web-Based Resource Tracking and Alerting System

Health Alert Networks (HAN)• CDC Bioterrorism Cooperative

Agreements• Goal: Provide a high-speed network to

rapidly alert public health and emergency responders

• Currently in all 50 states– Coordinated by each state

• Alerting options– E-mail / Pager – Phone – Alerting by jurisdictions and by roles– Variable alerting based on event priority

Amateur Radio in Disasters

• Amateur Radio (HAM) Support in Disasters– Highly knowledgeable volunteer operators– Extensive amateur radio network / infrastructure– Provides redundant emergency communications

• Radio Amateur Civil Emergency Service (RACES)– Sponsored by Local / State Government– Volunteer operators certified, regularly train / exercise

• Amateur Radio Emergency Service (ARES)– Non-government sponsored amateur radio operators– Organized in clubs– Often affiliated with RACES

911 References

• Federal Communications Commission 911– E-911: http://www.fcc.gov/911/ – VoIP: http://www.voip911.gov/

• National Emergency Number Association– http://nena9-1-1.org/

• Assoc. of Public Safety Comm. Officials– http://www.apcointl.org/

EMD References

• NHTSA EMD Program– http://www.nhtsa.dot.gov/people/injury/ems/Reorder%

20files%20for%20CDRom1.htm

• National Academy of Emergency Dispatch– http://www.emergencydispatch.org/

• APCO Institute– http://www.apcointl.com/institute/

• PowerPhone– http://www.powerphone.com

• New Jersey EMD Guidecards– http://www.state.nj.us/health/ems/guidecard.htm

Disaster and Radio References

• Government Emergency Telecommunications System (GETS)– http://gets.ncs.gov/

• CDC – Health Alert Network– http://www.phppo.cdc.gov/HAN/Index.asp

• Radio Amateur Civil Emergency Services– http://www.races.net/

• Free radio frequency / system information– http://www.radioreference.com/