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A Bad day with a Good Ending
Michael Smith, President, General Devices Note! While the scenario described below is fictitious, most of it is an actual depiction of Tucson's ER-Link EMS T elemedicine System, which is currently undergoing Beta testing. The urgency algorithm is also something presently in development, and may one day be a standard feature of most automobiles. These, as well as many other innovations are representative of what highly advanced EMS systems across the nation will be able to provide in the coming years. Advanced communications, such as Tropos' broadband wireless system are helping to bring these life-saving closer to reality. Imagine that you are having a bad day - a really bad day! You are in your car with your family and suddenly a truck swerves into your lane...the last thing you recall seeing is white - just white! Your airbags have deployed and you and your entire family have become crash victims. The good news here is that this accident happened in Tucson, Arizona. Within minutes the police AND several EMS ambulances arrive on scene. EMS immediately gets you, your wife and your kids out of the wrecked car and into ambulances. Somehow, the medics knew how many people were in the car, who they are, that the car was in a really bad accident - they even knew your daughter is a diabetic and that you are being treated for high blood pressure! Within seconds, you have an IV and oxygen mask, electrodes on your chest, a sensor on your finger and a blood pressure cuff on your arm - all your vital signs are now being monitored. A trauma surgeon located at Tucson's University Medical Center (UMC), 14 miles from the crash scene, now examines you and decides that you must go there rather than the nearby hospital which is only 3 miles away. He makes this decision based on what he sees of the data from the monitor, the report from the medics and the video image of you that he sees on the computer screen he is managing the call from - he decides that wants a CT scan of your injuries and the screen tells him the nearby hospital doesn't have one. As he is working on you, the trauma team is already starting to assemble. Your wife and kids have also been examined by the distant trauma surgeons. They determine that because only minor treatment is needed for some small cuts and bruises they should be taken to the nearby hospital. Seventeen minutes later you enter the UMC Trauma Center, are met by the surgeon (based on the visual assessments; the main trauma team has already been dismissed), and you get a CT scan and have your 3 broken ribs set. The next day, you are back home on pain killers and have an assortment of testimonial black and blue marks. The car is totaled but you and your family are back together, in good shape. If this accident had not happened in Tucson the story could have been quite different. Why? Notification of the accident may have been delayed; precious time would have been lost as police would have arrived at the scene...and THEN called the ambulances. Chances are that you may have been brought to a hospital that did not have the required facilities to treat your injuries. If you had any complicating medical issues or if you had been on special meds, it could have gotten worse… Your good luck was the result of two things: ER-Link and On-Star. Here is how it all began to happen... Your car's built-in On-Star system not only automatically notified the Public Safety Access Point (PSAP) of the accident and its location, but it also provided critical information about the accident - the car's speed; the regions of impact; the G-Forces sustained; the number of people in the car, and that the air-bags were successfully deployed. This information was fed into a computerized "urgency algorithm" which was able to estimate the severity of injuries for all passengers. With this information the hospital knew there was a high probability of a serious injury and that they had to move fast to provide care within the "Golden Hour" to avoid complications and minimize the extent of the injury. Tucson FD/EMs' ER-Link, the latest innovation in Emergency Medical Services, was then put into action. ER-Link is an EMS Telemedicine system that allows hospital-based physicians to be "virtually present" in the ambulance, allowing them to direct care as if there were actually there. Cameras mounted inside and outside the ambulance and controlled by the physicians at the UMC Trauma Center allowed them to examine both the patient and the wrecked car. With their ability to see the car, the hospital-based team was able to accurately determine the mechanism of injury. Working with the on-scene paramedics, the team was able to examine each patient and perform an accurate assessment of everyone's condition. Because of this first-hand assessment, the physician felt that a CT scan was needed for you, which determined where you were to be taken. As for the other crash victims, the physicians were not only able to see them, but they were able to speak with them. The physicians were able to reassure the family members that you are going to be "OK" and explained why they were going to a different hospital. This provided much needed reassurance that everyone was being taken care of properly. The foundation, designed and installed by SmartWave Technologies, that makes ER-Link possible is Tropos' high-speed broadband wireless mesh network from Tropos Networks and General Devices' E-Bridge EMS Telemedicine System. Together these two systems provided the essential mobile communication infrastructure and instrumentation that allows the distant physicians to see high-resolution, full color and full motion images and get real-time medical data of patients in ambulances, from anywhere within a 250 square mile region surrounding the City of Tucson. Unlike cellular-based communications systems, the Tropos broadband wireless system provides significantly higher data rates, even from a moving ambulance!). In addition, with its bandwidth reservation feature, bandwidth availability is reliably accessible when its needed. ER-Link not only provides EMS Telemedicine, but also has significant improvements in communications, documentation and information management for activities ranging from disaster response to meeting day-to-day EMS needs. Tucson's ER-Link teams up with Tropos, SmartWave Technologies and General Devices to form the first commercially available citywide system of its kind in the country. It is a new tool to help save lives and will be a model for other systems to follow.
Links: The views expressed in this Guest Commentary are those of its author and are not necessarily reflective of Tropos Networks views. Tropos Networks, its partners and customers are not responsible for the third-party Guest Commentary content. back to December 2007 newsletter
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