If you have received any training related to EMS provider safety, you have likely heard the term 鈥渟ituational awareness.鈥�
The National Association of Emergency Medical Technicians (NAEMT) course manual for 鈥淓MS Safety鈥� defines situational awareness as 鈥渢he state of being aware of what is happening in order to understand how information, events and a person鈥檚 actions will affect his or her goals and objectives, both now and in the immediate future.鈥� Simply stated, situational awareness is gathering information to make better decisions or actions.
EMTs learn to gather situational awareness with standard inquiries:
- Is the vehicle stable?
- Are there wires down?
- Is there a fire hazard?
- Has the assailant left the scene?
- Do I need lifting help?
Those were great starts, but technology now lets us have real-time information about situations outside of our immediate scene. Situational awareness can include information specific to the medic鈥檚 current call, as well as the way their entire shift may play out.
- Are there any hospitals in our area on divert (maybe their CT scanner is down or they don鈥檛 have a cardiologist available)?
- Is there a shortage of an important EMS medication or IV fluid?
- Is there a multiple-patient incident a few towns over that we may get called to or that will fill emergency departments in the region?
- Are the units we usually call for mutual aid unavailable due to mechanical issues?
- Is there a spike in overdose cases indicating a new shipment of a bad drug has reached the population?
- Does an unusually high number of patients complaining of rashes and headaches indicate the presence of an infectious disease?
There are two types of software systems available in healthcare that help ask and answer these questions. Specifically, I am referring to surveillance and alerting systems, and EMS agencies should be aware of and take advantage of both.
Surveillance systems
Surveillance systems quietly run in the background and scan millions of pieces of data from EMS patient care reports, computer aided dispatch (CAD) records and many other sources to identify trends. The concept is nothing new, but its application to EMS is a little more recent. Surveillance systems identify unusual spikes or dips in EMS call types, locations, patient complaints, medications administered and many other fields. The changes are analyzed, sometimes by software, and sometimes by humans, to spot trends and adjust the EMS system to meet the demand.
Surveillance software can also detect system changes that may be due to some form of a threat, including biological or chemical terrorism, or an infectious disease being introduced to the population from someone who recently traveled abroad. Surveillance software can also identify increases in drug overdose activity, allowing public health and law enforcement to focus efforts to stem the tide before more lives are lost.
and are both examples of systems that conduct surveillance for their customers, although they also do much more.
Alerting software
Other systems can improve situational awareness by sharing information about the healthcare environment with users. This information may come from the aforementioned surveillance efforts or from system participants manually entering updates. Alerting systems then broadcast the information to subscribers by a variety of means, including computer desktop alerts, phone calls, text messages and even pagers.
In Wisconsin, platform has been used for several years by hospitals to post bed availability data as well as communicate critical supply or equipment needs. In recent years, hospitals have begun to post bypass alerts when they have facility issues, such as CT scanners down, computer system outages or phone line interruptions. They also share when they cannot accept certain patient types due to physician or staffing shortages.
The EMResource system also facilitates mass casualty alerts within the system by prompting hospitals in the vicinity of the incident to enter the number of red, yellow and green patients they can immediately receive. This information is shared with EMS units at the scene who can log into the mobile version of EMResource and see the data in an app, and with hospital staff who can view the screen and help coordinate destinations for the patients needing transport.
Put data to work for your agency
EMS leaders and providers are encouraged to become subscribers and get these important notices to enhance their situational awareness and improve patient care decisions. Communication centers can also be subscribers to improve their situational awareness as well as share the information with all the public safety agencies they coordinate with.
Both uses of these software platforms take situational awareness to a new level for all public safety responders. Now it is up to leaders and providers to take advantage of the systems and put the information to work for their agencies.
References
1. Hedeen, G., Kaduce, M., & Koper, J. et al. (2023). EMS Safety. Jones & Bartlett Learning.
