Emergency Medical Services: "Rampart, This Is Squad 51"

Not to date to some members, but many in the fire and emergency service clearly remember the title of this article as how paramedics Johnny and Roy on the TV show Emergency! would call the emergency department (ED) for medical orders and to advise of the patient’s condition. They could be practically anywhere, break out the big orange box with the telephone handset-style transmitter/receiver, screw on the antenna and talk to Rampart via VHF radio.

Some readers out there may have actually used this same system or something similar; I was fortunate enough to have my ED radio mounted in the back of the rig. We would have to hail the comm center, advise where we were and what ED we were going to and request a med channel for that specific ED.

The comm center would then assign a channel, send an alert tone over the air to raise the ED, and after they acknowledged the tone, we could provide the patient information or request medical orders.

While this worked well during transports, it didn’t help us much if we were away from the rig attending to the patient and needed to talk to the ED.

So, with this system, we kind of went backwards in communications.

Sure, we could use a landline to contact the ED if we were in a patient’s home, but if we were working a vehicle crash on the highway or attending to a patient who had been thrown from a horse, one of us had to go back to the rig to call the ED.

That problem was solved by the cell phone. Well, kind of.

Cell phones allowed us to call the ED directly without having to call the comm center, and we could do that from pretty much anywhere—as long as we had cellular coverage. As we all know, cellular coverage was limited or nonexistent when working in the mountains, rural areas and even areas outside major cities and traffic corridors. This still holds true even today.

Understanding this challenge, many agencies then built in radio talk groups or frequencies on their UHF or 700/800 systems so we could talk to the EDs from the field on our radio system. As long as we had coverage, which we typically did on our system, we should have been able to get through to the ED.

But again, terrain, distance from towers and even building construction could cause issues with reliability. However, between cell phones and the radio system, the thought was that one of the two should work, and this has generally been true.

Technology has allowed us to move forward with radios and cell phones, but there has been no one perfect solution. Through all of these advances, we have still been limited to voice communication only as coverage allows; in some cases, we’ve even reverted back to radios.

But that is all about to potentially change as technology continues to advance and with the advent of the D block.

My agency, in conjunction with our base hospital, is currently field-testing a camera system that transmits both audio and video from the field to the ED via cellular 3G/4G. While it can be mounted in the back of the rig, it’s also portable, so it can be removed and taken to the patient if needed.

Coverage issues still exist and the quality of the image and sound is much better over 4G than 3G, but this is certainly technology moving our EMS communication ability forward.

Ultimately, the hope is that coverage issues can be resolved so that regardless of where you are, you will be able to communicate. This is where the D block comes in.

This band of spectrum, in the 700 MHz range and referred to as broadband, is specifically dedicated to public safety with the intent of improving interoperable communications across the country. Most of us are already familiar with broadband because we’re using it now at home or on our personal cellular devices. The amount of data that can be transmitted over this spectrum far exceeds anything in our current narrowband systems. By taking this technology and placing it on a dedicated public-safety network, the potential advances in our ability to receive and send information are almost limitless.

As this system is built out, the intent is to provide this coverage everywhere. Testing, design and implementation is already occurring in many areas, and location shouldn’t be a limitation. Whether you’re in a rural location, on the road or in a metro area, the intent is that this system will work across the board for all responders, thus eliminating another communication barrier.

Technology is rapidly advancing, and we need to keep up because it’s changing the way we do business. Broadcasting and receiving audio and video to potentially every responder on a call always seemed to be in the future, but the future has become now.

Remember, though, that some things never change. Whatever technology brings us in our ability to communicate to the ED, we’ll still start off with “Rampart, this is Squad 51.”

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.

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