Welcome back to the final chapter of our journey through the changes in design and safety in ambulances. Y2k had come and gone as the pre-hospital care delivery model changed again. Regional governments are now responsible for providing EMS services. Familiar with overseeing policing and the fire service’s need for technology, local governments demonstrate their support in modernizing and improving ambulance operations.
Paramedics watched as technology guided their future. Updated defibrillators and laptops now record and then transfer patient information via Bluetooth technology. Ambulance vehicle operations became similarly technology-dependent and are now under the same umbrella. The data was blended, making it directly interdependent.
Past ambulance accident findings only reviewed by police services are applied to the learning curve. Continuing education within the ambulance service adopted defensive driving strategies for responders and support staff service-wide. The progress made by original equipment manufacturers (the Fords and Chevrolets of our world) was now matched and outpaced by ambulance conversion manufacturers and peripheral technology engineers and suppliers.
Information is power. With that realization came industry-specific vehicle monitoring. Having data in real-time was an innovation that changed everything. Suddenly, as a supervisor, my colleagues and I could follow crews and their vehicles under our direction, including their vehicles’ performance and driving behaviour. A bonus was the dispatch information now at our fingertips. By combining the information, supervisors can better manage crew safety, monitor their locations and foresee potential hazards. All of this, for multiple situations electronically in the mobile environment, improves service delivery.
Knowing instantly when a crew was in a grey area pushing the rules initially drew some attention. Technology was viewed as invasive. Once paramedics’ safety was identified as the priority, with fleet operations being the second reason the computers were employed, crews got on with their critical inch of the business. The reasoning that brought supervisors running was accepted and expected, much like the professional standards for patient care. Paramedics often had a helping hand before it was asked for.
The arrival of the new technology was like handing someone a sixth sense. Paramedics often advise over the radio when they are experiencing a vehicle problem. My favourite example was a crew that reported their emergency lights were not as bright as they should be and that their siren was projecting a sad-sounding tone as they slowed, approaching intersections. A quick scan of their vehicle performance information revealed that all of the individually monitored batteries displayed low voltage.
The online diagnosis: the most likely culprit was the alternator, not a specific battery. Sharing the findings over the radio and advising the paramedics to return to base following the assignment was a turning point for the buy-in from them and other paramedics listening. Experienced responders will often resist change and doubt claims of the benefits of new technology when it is not directly patient-related. In the case of this electrical fault, the crew faced an imminent vehicle failure. Able to send the data from the ambulance in a screenshot to the technicians before the service visit closed the loop.
Fleet monitoring made its case early on following the rollout. EMS chiefs' decisions could now rely on solid facts that point out costs and savings. Comparing the ongoing data also reveals trends enabling leaders to make informed projections with their fleet operation. Safety concerns and the consequences of delaying change could be demonstrated in black and white during operational and budget discussions.
Supporting paramedics’ safety while promoting fiscal and operational efficiency with the bonus of being environmentally conscientious is the trifecta of achievements that never came up in conversation in the early years. Sharing data to corroborate recommended improvements is another tool in the Chiefs’ kit to strengthen reports to administrators and politicians. Patients, paramedics and the community are all first-place finishers in a journey never envisioned as a race.
Although there were several advances realized over the years in ambulance safety, the three posts presented here do not represent the total picture. My experience and findings come from working on the frontline as a paramedic in London, contributing as a member of the joint health and safety committee and as a supervisor overseeing fleet maintenance. Extensive input from other paramedics’ the Ministry of Health staff in fleet services in Toronto, the Ontario Ministry of Labour Occupational Health and Safety branch and last but not least, the teams that I knew and respected at Crestline Coach and ACETECH made the process possible. I believe many accounts on the same topic remain untold by other medics.
I am speaking from the retired seats. Seeing the flood of electronic information while juggling the problems on a shift is the pastime I miss second most from a lifetime in EMS. First and foremost, I miss the interaction with and opportunity to support our dedicated caregivers serving the public. Following the social media coverage and reports of first responders' calls strikes my nostalgic nerve every time. For some readers, hearing an aging medic rant probably hits their funny bone, laughing at this Traumasaurus’s expense. If my fading memory serves me correctly, I think it’s the ulnar nerve for the technical practitioners. Just saying…