There has been a lot of discussion about the D block in the fire service, and we have put forth a significant effort to try to get this band of spectrum allocated to public safety. If you’ve been in exile or hiding under a rock and don’t know what the D block is, it is a 10-megahertz portion of spectrum in the 700 megahertz band. It sits right next to a portion of this band that has already been licensed to public safety and would give public safety 20 megahertz to work with.
As public-safety communications systems have and continue to evolve, from VHF and UHF to 800 and now 700 megahertz, this 20 megahertz of spectrum would provide the basis for a public-safety broadband network, capable of carrying voice and data. The data portion is the key, as this includes high-resolution video, connectivity from the field to other field units and connectivity back to our own systems. All of this would be public-safety grade, which means that it should be more reliable and resilient than commercial networks, especially in times of disasters.
So, why is this important to EMS?
Well, as the title implies, technology improvements are rapidly moving EMS forward. To the point of beaming up? Well, not yet. But if you think about a direct-connect phone, it flips open and makes a beeping sound and you can talk to someone on the other side of the country. If they put it on the right frequency, we could talk to the shuttle or International Space Station, not unlike the communicator that Captain Kirk used in Star Trek.
While we don’t have tricorders yet either, we’re getting closer with every passing day. We now have access to portable ultrasounds and CT images in the field. We can perform some blood tests, run 12-lead cardiac rhythms, take digital photos of the scene and perform constant vital-sign monitoring. The next step is pushing that to the emergency department so the receiving physician can see all of this in real time. In our current environment, this is not feasible, but with dedicated, public-safety grade spectrum, this could be a reality.
At the National Association of State EMS Officials meeting in Wisconsin in October, Kevin McGinnis, communications expert, talked about a number of possibilities that could occur if the bandwidth is obtained. He reiterated that we need to get away from thinking voice only, as broadband data can allow for so many more options for the patient and the provider.
From improving situational awareness to establishing a common operating picture to even better diagnostic applications, he stressed that the ability to improve patient care could grow exponentially. Community paramedicine (a completely different article) could become another subspecialty of EMS and the future of healthcare with the ability for a paramedic to be with a patient at their home, performing procedures and running tests, transmitting the entire encounter over an audio/video feed to a physician at an emergency department and then jointly deciding whether or not the patient needs to go to the ED, their own doctor or a different facility.
We know that ED-loading is an issue, so having the ability to choose an alternate care path based on technological data and information sharing is a plus for everyone involved. So now, we are “beaming” the patient to the most appropriate facility, not just the standard ED visit.
These are just a couple of examples of how a broadband network can improve EMS as a whole. From the fire perspective, there’s no reason why we can’t operate like the Marines did in the movie Aliens. The lieutenant (IC) is in his armored personnel carrier (command vehicle) with real-time audio and video feeds to each of his Marines (firefighters). He’s able to monitor their biometrics (vitals, temperature, cardiac rhythm), he can see what they see, and they can transmit infrared images as well.
Let’s take it a step further and give them a four-gas and radiation monitor as well as personal location devices (GPS), and all of this information can be recorded as part of the incident file. The IC then transmits the building plans to each firefighter so they can see where they are in the building based on their GPS locations, thus allowing them to see escape routes, standpipes and the layout of their operational areas.
We have the technology. Some of these are being tested and implemented as you read this. But without the additional spectrum, the full ability of these technologies will not be realized and our personnel will be left watching science fiction shows, wondering if and when we will truly move into the future.
Norris W. Croom III, EFO, CMO, is the deputy chief of operations for the Castle Rock (Colo.) Fire and Rescue Department. He’s been a member of the EMS Section since 1998 and currently serves as the section’s director at large.