EMERGENCY SERVICE TECHNOLOGY

By: Clark Staten, EMT-Paramedic
Past Chairman, National Society of EMS Administrators

The 90's have been described by some as the "Information Age". Undoubtedly, the events of the past decade have changed the way in which we record, transfer, store, retrieve, and evaluate information. In large part, the advent of the personal computer (PC) has drastically affected the way we perceive and utilize information. It's introduction has opened new possibilities for personal, professional, and organizational growth and development.

During the past ten years, vast strides have been made in regard to emergency service administration and operations. More enlightened members of the emergency response community have discovered that there are many more effective and efficient ways to direct and analyze our function. Many forward-thinking emergency managers have adopted methods and practices developed in the private sector and created hybrid models for use in Fire, Police, and EMS departments.

In order to better understand the advances that have been made, and to explore the applications of the future, we need to review the history and capabilities of personal computers. In this retrospection, let's move backward in time and examine the technology and how it has changed the emergency services.

THE 1970's AND BEFORE (THE PAST):

One of the first computers was called ENIAC; it weighed thirty (30) tons, was two stories high, and covered more than fifteen thousand (15,000) square feet of space. It was built and went into operation in 1946. It did amazing things for it's time.

It is probably not commonly known that the International Business Machine (IBM) Company did not introduce a desk-top personal computer until 1981. Several other desk-top computers had, however, been introduced by various other companies in the late 70's. Names that come to mind were Osborne, Apple, Tandy, Kaypro, Xerox, Victor, and Morrow. The late 1970's and early 1980s were a turbulent time in the development of PC's, as various manufacturers attempted to transfer known technology from "Mainframes" to small computer platforms.

The early PC's were vastly underpowered and slow, by today's standards. Many did not have hard disk drives, and other stored data on "cassette-type" tape drives. Extended or expanded memory were still a dream. Many small platforms actually had less than 640K of RAM (Random Access Memory), and yet users were amazed about the way that the 8086 and 8088 CPU (Central Processing Unit) machines performed (e.g. forerunners to 80286, 80386, 80486 central processors of the 80's & 90's). Color monitors were not in use and no one had ever heard of a "Mouse" pointing device.

Early users were thrilled that the "micro-computer" was finally on their desk. They no longer had to access or learn mainframe operating systems. They suddenly could control the input and output of data, rather than depending on a "computer specialist" in some other agency or department. The "personal computer (PC) revolution" had begun.

Early emergency service applications of computer power were primarily run on large mainframe type machines and were generally limited to personnel and inventory records. The advent of PC's changed the uses of computers in several areas of emergency operations. The earliest transferences of work probably occured in the administrative areas of police and fire departments. As in private industry, emergency service secretaries and record keepers quickly saw the capability and suitability of personal computers for inputting, storing, and retrieving of temporary data.

Another important task that was developed for the emergency computers was that of computer-aided-dispatching (C.A.D) of emergency equipment. So called "system status management" programs were developed that helped managers/dispatchers to effectively allocate resources, based on availability and public demand. Most were data "input-intensive" and required dispatchers to spend a great deal of time keypunching information into the database.

Communication, in general, were changed by digital and "chip" technology. Radio frequencies could be then be synthesized rather than crystal controlled. This ability caused far greater latitude and control of frequency changing capabilities and allowed radios to be smaller and have more features. With digital chip technology, a hand-held transciever or scanner could listen or transmit on as many as one-hundred frequencies.

All in all, the 1970's and early 80's saw tremendous advances in both technology and the use of it. However, it should be noted that during the 70's and early 80's, many emergency response agencies and personnel didn't avail themselves of the advances in computer technology. Whether it was the complexity of the process, or the mindset of the emergency community; most did not develop the skills or buy the equipment needed to apply the benefits of the vast technical advances that had taken place.

Unfortunately, all too many departments were mired in the traditions and practices of the past. Veteran fire and police officials did not understand the technology or it's uses. It was, therefore, easier to cling to the file cabinets, telegraph keys, and paperwork of the past than to accept the computer technology and young "technocrats" of the future.

The 1980's & 90's (THE PRESENT):

Remember ENIAC from the past (see Pg.1)? It is interesting to note that the fact that a 1990's model laptop 386/33Mz IBM Clone can add, subtract, and perform math functions at least fifty times faster than the earlier, gigantic, ENIAC. Current hardware is so sophisticated that it can cause millions of instructions to be instantaneously passed to various components within the computer in a matter of seconds.

At the risk of being accused of using a cliche' of today, the 1980's and 1990's have been "awesome" in terms of technical advances in personal computer technology. Probably, no one decade in history saw more or greater changes in our capability to develop and manage information than did the last one.

The desk-top computing machines became smaller, lighter, faster, and more graphically capable. The intricate DOS (Disk Operating System) command line systems of the past were replaced with various kinds of GUI's (Graphic User Interfaces....with MicroSoft's Windows being a typical example. Various kinds of "mouse" pointing devices became part of our computer vernacular. Computer Central Processing Units (CPUs) have come from a speed of 4.77MHz in the late 70's to 50MHz in some current 1990's models (X10 increase in speed).

Advancements in computer software have kept pace with the development of hardware. New and complex software has been developed that will allow users to easily perform accounting, word processing, desk-top publishing, graphics, computer- aided-design, and many other functions. Demographics, population shifts, inventory control, equipment use data, nter-active training, and other types of analysis programs are benefiting the manager of today. By combining faster hardware with more sophisticated software, greater productivity has been demonstrated. Business and government have began to sit-up and take notice.

The emergency services have also benefited from this surge in the advancement of technology. Computer work terminals have been placed on Local Area Networks (LANS) in many fire/police/ems stations. Municipal response records are now frequently kept by entering data at the station terminal or even from a mobile terminal in a vehicle. Several police agencies have mobile cellular or radio links directly from a car to the NCIC (National Crime Information Center) or state computer mainframe system.

This networking arrangement the police with almost instantaneous information on "wants and warrants", as well as providing a "rap sheet" of past offfense for the person entered into the system. A similar setup also allows paramedics to keep Mobile Intensive Care Reports, and firefighters to keep NFIRS (National Fire Information Report system).

Many emergency communication centers and hazardous materials units are reported to be carrying cellular technology and on- board computers that allow access to; water grid maps, addresses, phone numbers, chemical databases, MSDS sheet programs, occupancy databases, fire safety inspections and building preplans. Almost any database that can be accessed on a telephone land-line can be used, directly from the scene. This provides incident commanders with a vast amount of available information upon which to make better decisions.

Computer technology has also enabled the development of cellular telephone technology. Mobile telephones and pagers have had a tremendous impact on business and emergency response agencies. Current chip configurations for hand-held portable telephones make them light weight enough to be taken almost anywhere....including the scene of an emergency. With the added reliability and country-wide accessibility of these "tiny" transceivers, and the launching of several "SAT-COM" satellites, it would appear possible to communicate with anyone....anywhere.

Many emergency dispatch centers have installed computer work stations for each dispatcher. These work stations expidite and assist the decision-making process and maintain an ongoing list of available resources. In more sophisticated systems, Loran-C radio locaters uses satellite triangulation technology to locate vehicles and radio transmitters to within 100 ft. of their actual location on a computer generated city grid map. Personnel emergencies are immediately reported with the touch of a button, as well as the location of the distress signal.

More advanced systems also record and maintain a history of a given address/location for future reference. This history keeping capability provides a list of past occurances at a specific location. It could also be used to store and catagorize patients, past medical conditions, and medications. A criminal history of an individual or location could also be stored and generated. Many municipalities have found the practicality of sharing information between emergency agencies and several have joint communications centers that can access the same databases. Computer-Aided- Dispatch of the past has grown up.

THE FUTURE:

Future developments in the use of computers stagger the imagination. Someday soon, we will probably see computer terminals in the front of most Police, Fire, and EMS vehicles. These terminals will direct us to the scene of the emergency with digitalized street maps. The terminal will provide information about any incident that has occured at the location previously. It will give us pre-plans for hazardous materials or other dangerous situations. The terminal will generate response time and other pertinent reports that will track our progress and efficiency.

On-Board our "vehicles of the future" we will have computer controlled communication units with radio repeater capabilities. Each crew member will wear a comfortable, lightweight headset that will enable communication with each other, the dispatch center, the hospital, the city computer, a voice mail, and record keeping system. The radio systems will be multi-tasked and trunked, so that any department can communicate with any other... instantaneously.

Medical records will be obtained and stored by simply saying, "Computer....Recorder on!". The computer will then constantly monitor Electrocardiogram reading, drug drips, and record any and all findings that the medics note. Further miniaturization will allow blood gas analysis and other blood studies to be done at the scene and almost instantly. Treatment protocals will be immediately available, either by radio link to a physician or direcrted by a computer library with an artificial intelligence "expert system".

Computerization of "CAT-SCAN" type equipment, using sound waves or other electronic phenomena will give detailed analysis of the body and facilitate appropriate trauma and medical emergency treatment. Patient assessment data that is being gathered and recorded by the on-board vehicle computer will be instantly reviewable by the hospital that is going to recieve the patient. Diversions of ambulances will be computer determined and will automatically take into consideration the patient load and capability of each receiving facility.

Identification of an unidentified criminals will be accomplished by matching an "on-scene" computer generated video image of the suspect and database records of all known or suspected perpetrators. Fingerprints will also be obtained and matched by computer to verify an identification process. A complete history of the criminal, his methods of operation (M.O.), and current suspicions will be compared by the computer and analysis given to the police investigator for his/her action. Comparison "mug-shots" will be computer drawn at the scene and witnesses will then be able to identify any matching suspects in a timely manner.

Known criminals or mental patients that are "on-the-streets" could be electronically tagged with a emitter that could automatically be tracked by a computer. Electronic release programs could be expanded to include almost all non-violent offenders with the aid of computer surveillance. A computer record would constantly be recorded of the movement of these monitored individuals, and could be immediately reviewed in the event of suspicion. Security computers could automatically note any unusual movement or action on the part of any convicted criminal and activate an police alarm mode that would direct him/her to be detained by the nearest police unit or, (if necessary to prevent a violent act), "shocked and disabled" by a built-in "taser-type" device. While civil libertarians might balk at such a system, repeat offenses and offenders could become a thing of the past.

The same sort of locater devices could be used to insure firefighter/rescuer safety. A computer tracking device could identify an individual or unit at the scene of a large emergency and provide an ongoing monitoring of their location and consciousness. If the rescuer were to become incapacitated, or didn't move for a predetermined amount of time, am alarm would sound at the command post. This alarm could also be activated by pushing a portable radio button, or activating an emergency beacon manually. If radio contact could not be established, a search of the last known location of the individual could be undertaken immediately.

CONCLUSIONS:

The effective uses of computers in the emergency services environment have just begun to be realized. Undoubtedly, many more applications and capabilities will be discovered and exploited during the coming years. Computer experts predict that many of the author's "predictions of the future" are closer than many of us might realize. Many, if not most of these ideas, can be expected to come into being (in some form) during the career of today's "rookie" police officer, firefighter, or EMT.

The capability and practicality of the emergency service computers of tommorow will be determined by the needs that are identified and developed.... today. It would appear to be the responsibility of those emergency responders that have some expertise or ability in this area to foster and facilitate the effective use of our future computer resources.

Without the imput and guidance of the "computer pioneers" of today, we can not achieve the maximum benefit for the emergency responders and citizens of tommorow. With that devotion and participation..... many lives can be saved, our jobs can be performed more effectively, and our world can become a happier, healthier, and safer place.

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(c) Copyright by Clark L. Staten, 1991
All rights reserved, unless otherwise assigned.
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