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Introduction
The Washington Emergency Medical Services and Trauma Act of 1990
declared that it was in the best interest of the citizens of Washington
to establish an efficient and well-coordinated statewide emergency
medical services and trauma care system. A statewide Emergency Medical
Services Communications System is a part of such a system that will
ensure these goals become reality.
One mandate of the legislation was the establishment of the
Department of Health's Office of Emergency Medical Services and Trauma
Systems (OEMS/TS). As one of its goals, the OEMS/TS was directed to
develop a statewide Emergency Communications Plan. The objective is the
development, implementation and continuous improvement of a statewide
EMS communications system.
The Department of Health established the Office of Emergency Medical
Services and Trauma Systems in 1990. Sections in the OEMS/TS include:
Education, Training and Regional Support; Prevention and System
Analysis; Trauma Service System Development, and Licensing and
Certification. The Communications Consultant position in the OEMS/TS is
the result of the Washington Emergency Medical Services and Trauma Act
of 1990, that directed the Department of Health to develop minimum
standards for an effective emergency medical communications system.
Chapter 246-976 WAC directed the Department of Health to develop a
statewide EMS Communications Plan. Additionally, the development of
minimum standards or guidelines was directed for communications
equipment and telecommunicator training. The OEMS/TS contracted for a
statewide EMS communications study. This study assessed the status of
EMS communications systems in Washington. It found that the quality of
EMS communications differed considerably throughout the state. Minimum
management levels for a statewide EMS Communications System Program were
recommended. Also, recommended was the creation of a full-time
Communications Consultant position in the OEMS/TS. The Governor's
Steering Committee on EMS and Trauma Systems has made recommendations on
desirable capabilities for a statewide EMS Communications System. These
and other recommendations have been incorporated in the development of
this Plan.
The development and implementation of a statewide EMS Communications
System will provide a means to make the entire emergency medical
services and trauma systems operate more efficiently. Ultimately, the
goal is the development of a statewide EMS Communications System that
ensures that all citizens receive quality trauma care.
Concepts
of EMS Communications
Emergency communications begins
with the detection of an emergency incident and ends
only with the full resolution of the emergency.
An Emergency Medical Services and Trauma Care Communications System
must provide the means to use, mobilize, manage and coordinate emergency
medical resources during normal and adverse situations. An EMS
communications system must integrate sufficient communications paths and
operational capabilities to provide access to the emergency services or
public safety networks.
The state EMS Communications System will use the Washington State
Patrol microwave network as its framework. Statewide coverage is
obtained by locating repeater sites near selected medical trauma
facilities. These sites will not be located with local communications
systems, where possible. Selecting different locations for state and
local communications systems should expand local communications coverage
and provided redundancy in most cases. The EMS Communications System
will use VHF, UHF, satellite and other technologies to maximize its
efficiency.
As a two-component system, the EMS Communications System consists of
the statewide component that uses the WSP microwave network and local/
regional EMS communications system. In the planning of the statewide EMS
Communications system, the State (first-component) identifies the goals
and factors that need to be coordinated statewide. These goals are used
as guidelines in the development of local/regional EMS communications
systems.
The Office of Emergency Medical Services does not operate EMS
communications systems. It acts in the role of coordinator and
facilitator for local/regional communications systems. OEMS focus is on
the process and its results. The state will not be involved with the
daily operations of individual communications systems. It is concerned
with the interfaces and interactions between communications systems.
Items of interest include the degree to which the communications systems
provide public access, medical communications for basic and advanced
life support, radio coverage and EMS communications training standards.
As an integral part of this concept, local/regional
(second-component) EMS communications plans will be prepared according
to state guidelines. The local/ regional EMS communications plans are
tailored to satisfy local/regional emergency medical service system
needs. They will be compatible and interoperable with other emergency
medical services throughout the state. Technical and daily operations of
local/regional EMS communications systems are the responsibilities of
the local/ regional EMS agencies. OEMS will provide assistance when
requested.
EMS communications are the exchanges of information necessary for the
functioning of the Emergency Medical System. Emergency communications
begins with the detection of an emergency incident and continues through
the dispatching of manpower and equipment necessary to respond to the
emergency scene. It extends through the treatment of the patient at the
scene and during the transport of the patient to the hospital. EMS
communications ends only with the full resolution of the emergency.
The exchanges of information necessary for effective EMS
communications are consolidated into several key points. These key
points must be incorporated in the development of EMS communications
systems:
Citizen Access
The EMS communications system must be able to receive and process any
requests for emergency services or medical assistance. All individuals
must be able to request medical, fire, police, rescue or other emergency
assistance.
In most of Washington, the nationwide 9-1-1 Telephone Number Concept
is used to contact the emergency services or public safety networks.
Enhanced 9-1-1 (E9-1-1) will be statewide by the end 1998. E9-1-1
provides automatic telephone number and location identification.
Vehicle
Dispatch and Response (VDR)
Communications systems must provide the means to dispatch vehicles
promptly to the emergency scene, upon notification. Communications
systems must enable the dispatchers to talk with responding vehicles
while enroute to the scene, at the scene, while enroute to the emergency
medical facility and their return to availability for further
assignment.
Local procedures may require the direct alerting of ambulance, rescue
and hospital personnel by monitor or paging receivers, by two-way
portable radios with selective call capability, or telephone. However,
alerting over the SMC is prohibited.
Medical
Control/Coordination (MC)
The EMS Communications System must provide a clear channel of
communications to allow the exchange of treatment information between
Advanced Life Support (ALS), Basic Life Support (BLS) and emergency
medical personnel. The ability to exchange information while at the
scene and while enroute to the emergency medical facility is essential.
In the VHF spectrum, the H.E.A.R. Frequencies, 155.340 MHz is used
for Medical Control. Channels 2-6, 7 and 8 (MEDCOM) will be used for
Medical Control in the UHF spectrum. Channels 1, 9 and 10 will not be
used for Medical Control. Channel 7 will be used for Air-to-Ground
communications.
Statewide
Medical Coordination (SMC)
A Statewide Medical Coordination channel will enable ALS, BLS and
emergency medical facility personnel to talk when a vehicle is out of
its primary area or unable to contact the facility through the Medical
Control channel of their area. SMC channel 1 may be used during critical
situations where the use of the Medical Control channel would be
impractical. Use of the SMC must be limited.
Initial Air-to-Ground communications may be established at emergency
scenes using the SMC 1 channel. It will be used during disaster
situations for statewide emergency medical coordination.
Interagency
Communications
Many agencies use various frequencies for the mutual aid. The use of
these frequencies to contact these agencies during emergency will be
coordinated by the OEMS These frequencies will be included in the state
EMS Resource Directory.
Medical
Resource Coordination (MRC)
Coordination of EMS resources of emergency medical facilities and EMS
providers during normal, disaster or mass casualty operations is
crucial. EMS communications systems must provide this capability.
Telephone communications during normal operations are excellent means.
However, during disasters telephone services, particularly cellular
telephone, will be greatly reduced or nonexistent. Radio communications
may be more survivable during disasters.
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