GPS-Equipped Vehicles and the EMS Infrastructure

One of the principal components of the emergency medical services (EMS) infrastructure is the fully equipped ambulance. But a number of other vehicles, such as paramedic “fly cars” – vehicles that are used by paramedics to respond more quickly to the scene of an accident, but are not themselves capable of transporting a patient – and various support and supply vehicles also are of increasing importance. EMS units everywhere perform a number of common functions – including, for example, providing treatment during transportation. Realistically speaking, though, many if not most EMS units are poorly equipped to provide long-term care at a fixed location. For that reason, the EMS vehicles lacking the capability to provide transportation are used for other purposes.

Many modern EMS agencies use advanced GPS (Geographic Positioning System) technology to track their vehicles. The GPS systems include a device, mounted to the vehicle, that collects signals from satellites in orbit high above the earth. By comparing its current position to the positions of a number (three or more, usually) of these highly sophisticated satellites the GPS system can determine with astounding precision – through the use of extremely sophisticated geometric calculations – its own location on the earth.

The EMS GPS system differs in several important ways, though, from the GPS systems that many everyday citizens now use to find their way around and/or to travel from one city to another in that the EMS device also can communicate back through the satellite system to a base computer. In many communities this capability allows messages from the base to be forwarded in real time to the vehicle operator.

Judicious Rationing & Other Ancillary Benefits Many EMS fleets, particularly those in larger metropolitan areas, use the GPS devices to ensure that the vehicle nearest to the scene from which a request for assistance has been received can be quickly determined by comparing the probable travel distances of several vehicles in the same general area. Obviously, anything that speeds the resource to the need translates directly into more lives saved that might otherwise have been lost.

On a “routine” working day this capability not only reduces the EMS response time but also allows system managers to shift some vehicles to areas where resources may already have been depleted. An added benefit is that the system managers also have greater assurance that their units are where they are supposed to be. The overall improvement in productivity is sufficient reason in itself, of course, to purchase the GPS unit, because it keeps overall system costs down by helping the EMS agency use its resources most efficiently.

There are, however, several additional gains that are realized, but not always recognized. When a major traffic accident or other incident occurs, for example, the closest units can be dispatched to assist, as is done in responding to more routine incidents. In most cases, though, all first responders in the area want to assist in the response. For practical and operational purposes, however, not all of the responders within driving distance can or should be allowed to respond – for two reasons.

The first reason is that there is a “tipping point” beyond which additional resources start to crowd each other out. The second reason is that, if all the resources available in a fairly large geographic area are deployed to the same incident scene, there would be none left to respond to the routine calls for assistance that will still come in from other locations in the same area. When a major incident does occur, therefore, the careful husbanding of what are usually scarce resources in any case allows better management of the overall EMS fleet. Moreover, in the event of a truly overwhelming disaster the “rationing” approach may be the only way to locate unstaffed vehicles. Also, at a time when any vehicle might quickly become a truly life-or-death resource, the imposition of judicious limits on vehicle use may help bring the entire fleet back on line at a faster clip.

An additional point worth consideration: Because communications to and from the vehicle are via satellite, the catastrophic loss, in whole or in part, of the local community’s communications infrastructure – e.g., cell towers, radio repeaters, and trunking systems as well as phone lines – is immaterial to the effectiveness of GPS-equipped vehicles. For that reason, a system purchased to improve productivity on a day-to-day basis also can help: (a) to maintain control over limited resources during a major incident; and (b) to assist in re-forming the system during or after a truly catastrophic disaster. 

Joseph Cahill
Joseph Cahill

Joseph Cahill is the director of medicolegal investigations for the Massachusetts Office of the Chief Medical Examiner. He previously served as exercise and training coordinator for the Massachusetts Department of Public Health and as emergency planner in the Westchester County (N.Y.) Office of Emergency Management. He also served for five years as citywide advanced life support (ALS) coordinator for the FDNY – Bureau of EMS. Before that, he was the department’s Division 6 ALS coordinator, covering the South Bronx and Harlem. He also served on the faculty of the Westchester County Community College’s paramedic program and has been a frequent guest lecturer for the U.S. Secret Service, the FDNY EMS Academy, and Montefiore Hospital.



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