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Now more than ever people are understanding the value of emergency services. Citizens of every country comprehend the scope of this job and have a new appreciation for it. Treating the ill as well as rescue operations is there highest priority. The men and women who provide such pre-hospital care are aware of the risks and at times erratic disposition of the EMS service. Pre-hospital care is given when and where it is called upon whether that is in an urban development with vertical issues or in a rural area where damaged roads and remote areas make it near impossible for an EMS unit to access. Despite these challenges, EMS workers rise above and always seek out the best rescue option with the resources they have available. The courage and grit of these EMS individuals cannot be underestimated. Images flood the tv screen of firefighters and EMS professionals running toward the danger while everyone else is fleeing the scene. These specialists deserve the benefits of every tool that will assist them in providing the best care possible within the challenging circumstances they face. This paper will evaluate the EMS systems and argue that technology, in fact, is outdated in many of these units and needs to be updated to provide a more comprehensive care toward individuals facing pre-hospital trauma.
It is important to understand that a hospital cannot manage a crisis or disasters by itself. Developed countries such as the USA, the UK, and Australia already have developed systems in place that integrate pre-hospital and inter-hospital facilities. In developing countries, a pre-hospital emergency service may not exist, and resources may be scarce. If we can upgrade technologies to integrate all the pre-hospital and hospital resources together, then we can provide the means to effectively treat and manage daily emergencies and disasters in an organized way, and also provide good quality emergency medical care to those parties involved.
What is digital trucking and why does it matter? That’s a great question and one that I am defining in this study. For years now technology has been advancing to aid in globalization and the development of developing countries. Drivers must be equipped with software that keeps them abreast of emergencies as well as monitors their health and safety to ensure proper care is being provided fully. Advancements in technology are changing the medical landscape and changing how patient care is provided. Blood pressure, temperature and even blood alcohol are becoming less evasive and more accurate. Emergency vehicles need to be equipped with the same advancements as the hospitals so the patient care is consistent and quality is not diminished due to a portable system. When a real tragedy, like 911, happens that’s when the EMS real time data counts. It would be incredibly helpful in these situations if a defibrillator, for instance, called 9-1-1 the second it was powered up, sending dispatchers and all responders the exact GPS coordinates of the cardiac arrest, and then sending ECG sections on arrival and after every analysis? What about opening a two-way voice link directly to the device so that EMDs can ensure CPR is started and assist in managing the cardiac arrest before 9-1-1 responders arrive? When a car crashes, it deploys an airbag. As soon as it is deployed many cars communicate and report the crash to a call center like On Star. The automatic crash notification (ACN) sent from onboard sensors of the car tell us a lot about crash dynamics however, very few EMS systems ever use this data to decide an appropriate response and transmission of this data to the responders is nearly unheard of. Ironically, often time’s key data remains un-transmitted via the ACN because some attorneys and some owners do not want 9-1-1 to receive an indisputable record of certain parameters at the moment of the crash. This data is paramount in helping to provide on the spot emergency care and save lives.
Transportation related risk factors are cause for concern and warrant upgrading EMS systems. EMS systems are outdated and in need of new technologies for the safety of the driver and so they can respond to emergencies faster. Many have argued that these emergency systems need better communication to respond faster and safer to emergency issues. Since 911 our country has been on high alert and has a greater sense of the importance of preparedness in emergency situations. We have been fortunate as a country to have some of the best in healthcare, roads, emergency response times, and hospital care. In China, for instance, inadequate routes cause injuries each year and even death. Moreover these Poor road networks and low vehicle expansion efforts have caused many risk factors for EMS mobility in China. The strain placed on these emergency rescue systems have blistering effects that extend farther than the edges of the region (Jiang, Song, Zhong-Ren, Cong, Levy & Remais 2017). In developing countries and most placed the standard of transport is car, bus, motorbike etc. China is vastly impoverished in the areas of transportation making it difficult for much needed emergency care to reach their destinations in a timely manner. Government is looking for ways to improve these pathways including consideration of alternate options. As transportation transforms, so too does the health of China’s population. There is a weakness is China’s rescue and emergency system. Poorly trained staff have fatal on site results often ending in pre-hospital death. However the problem is not just China, there are several developing countries such as India that lack the proper roads and are coupled with over population making it very difficult to maneuver in the event of an emergency. Jiang, Song, Zhong-Ren, Cong, Levy & Remais (2017) say that up to 80% of the fatalities are related to road traffic injuries. Furthermore, the reporting system on accidents and injury is flawed and unreliable. It has been such an issue in these developing countries that many have ceased in walking and biking for fear of injury and death. Better roadways are paramount to the safety of these people. In addition, updating the EMS systems to accurately report and analyze the injury is just as important. There should be a universal system that all enforcement can use to update emergencies and truncate the response time.
In reading the article, Alternate risk measures for emergency medical service system design there is a serious problematic issue within the availability of emergency vehicles when requested. Findings show that they are unable to serve demands and critical issues within the EMS systems. Additionally user access has caused slower response times and it is suggested that users not get the same emergency access due to some being an emergency and some not. Noyan (2010) points out that the key to success within the EMS systems on emergency vehicles is the effective response time. He goes on to say that the problem with many of these systems, in a real life situation, is the communication to the whereabouts of the emergency. Furthermore, budget constraints and political bureaucracy have hindered the advancement of technology in these areas. How does a country plan for uncertainty in these conditions? Ambulances, or any other EMS have minutes to respond to life and death instances. Updating GPS whereabouts of vehicles will no doubt aid in response times. Additionally determining who or what is an emergency should also aid in response time. Technology should be advanced enough to handle multiple calls, determine risk, and effectively summon EMS workers and vehicles to be dispatched to the emergency.
Felder and Brinkmann (2002) suggest that every person should not be given equal access to emergency service irrespective of locations. It’s true that not every call should be given emergency status. Perhaps a queuing system of sorts would vet the unqualified to the qualified. Lower and middle class countries tend to carry the burden of injuries many of which are quite horrifying. Providing equal access to users is an important issue in EMS system design (Felder and Brinkmann 2002). Perhaps in the development of technology there could be a citizen’s access line or app developed that would put the end user with more access to quickly get aid. Much like the Life call commercials depicted an elderly person falling and pushing a button to quickly dispatch and EMS system. There could even be a lanyard given to those that sign up for the service to have access to call an emergency in seconds after or during its duration. Often time’s police arrive on the scene minutes later and each second is precious to saving a life of someone. Putting the power in the hands of the individual would aid in recognizing the emergency and getting an EMS vehicle dispatched. Felder and Brinkmann (2002) suggest that every person should not be given equal access to emergency service irrespective of locations. This theory would help to distinguish that process. For example, if three calls or beeps come in for emergencies, the dispatch employee could then use a protocol to evaluate which of these is truly an emergency or even the severity or degree of the incident. There is very little that will mess up a supply chain like a lack of communication. This causes a deficiency in the reliability and movement of raw goods or services (Randall, Defee, & Brady, 2010). Transportation has given us a means and utility to provide services to remote and offsite locations that previously were not accessible and not possible. As important as this feature is, advancements in technology have not supported it.
Research shows that many do not see trucking as able to meet demands in their current state. Previous attempts at efficiency proved to be slow and out of date. Many companies are switching carriers frequently seeking out a carrier who can be reliable and efficient (Randall, Defee, & Brady 2010). This is a response from a motor carrier customer who isn’t concerned with shipping costs as much as the efficiency of delivery. Motor carriers resume today includes flexibility in responding to changes and the web and technology is a big part of that. Now think of that in terms of an emergency. When a tragedy strikes there is not two different EMS groups to choose from. There is one that is dispatched via ambulance as a response time. Conversely there are different responders that can be seen on scene before EMT has a chance to get there such as: police or fireman. While one can argue standard dispatchment gets the job done advancements in technology are necessary to evolve distribution. As supply and demand increase so will production and shipping from manufacturer to distributor or customer.
The globalization of the economic sector has widened the gap between consumers and production. No longer is “Made in the USA” common place. Most businesses manufacture their products in other countries. Many of these delivery trucks have antiquated means of communication. My grandfather drove an eighteen wheeler for a long part of his life. There were no cell phones or advanced communication. CB radios were all they had and that was advanced for the 1940’s. Without question we have seen technology advance that each era has benefited from. The standard transport system these days has all types including water transport via cargo and shipping vessels to all continents. Manufacturers are looking for ways to improve the logistical systems to accelerate the delivery to the consumer. This is a look at the automotive space and delivery of those parts. River transport is vital to many across developing countries and European regions. With the addition of marine transport to the shipping mix, there are chances for improvement. One of the many risks involved is the sea traffic making a crowded space. Technological evolution can aid in the dispatch of these ships and create safe and efficient shipping lanes. In addition Makarova, Khabibullin, Belyaev, & Mavrin, (2016) found several risks to maritime trade such as macroeconomic, instability, and geopolitical. In each of these situations both for transport and EMS the advancement of technology is paramount. While many continue to use traditional trucking, marine transport is increasing. By utilizing automatic identification systems in analyzing delivery, and risk one can improve efficiency of the logistical process and aid in a competitive advantage for the manufacturer. Overcoming internal and external risks is imperative to the logistics of efficient delivery by sea. Having evolving technology within transport systems is key and developing an intellectual system will prove to optimize logistic support. The product whether an emergency service or a good for sale should be routed to the customer in the fastest way possible.
In order to look at the development and implementation of an EMS system prior to hospital care, one must seek understanding the costs and risks involved in its implementation. Many of the developing countries such as India struggle with patient care and are burdened with disease and malnutrition in many rural parts of these places. I know in Haiti, many villages have “sick camps” or huts where individuals who are sick go to ride out the illness or to die because the location is so remote there is no communication available to reach them. Brown, Douglass, Ejas, & Poovathumparambil (2016) outline, that pre-hospital care is vital to preserving and evolving the health care system for the critically injured. They go on to say that in India this system is under-developed. It seems to be a pattern that many nations and countries operate on antiquated equipment providing a poor quality service to the people who live there.
In 2011 they launched the (ANGELS) Active Network Group of Emergency Life Savers network to address the gaping needs for EMS and pre hospital care in India. “Developing acute care systems in a locally appropriate manner, while focusing on utilization of locally existent resources, increasingly is being recognized as a development priority and has potential for important implications in morbidity and mortality.”(Brown, Douglass, Ejas, & Poovathumparambil 2016). The success of the ANGEL system will prove to aid other neighboring developing cities. Research shows that low and middle class countries struggle with EMS systems that won’t break the bank in providing care to their patients. EMS systems of the West are no comparison and relevancy to those countries. “The World Health Organization (WHO; Geneva, Switzerland) estimates that injury is responsible for 12% of all deaths in India and another 60% of deaths are attributed to non-communicable disease” (Brown, Douglass, Ejas, & Poovathumparambil 2016). It can be argued that medical treatment in other developed countries are not as advanced. However, these people are human beings and while antiquated in a lot of their practices, they deserve an updated way to get emergency services to them. Many of these towns are rural at best. Having technology to aid in finding and treating them will save lives.
As we have seen in this study the availability of the EMS system is directly linked to the financial health of the country and in most cases is hindered by financial constraints. Pre hospital care is deficient due to lack of an organized system and many patients suffer a worse fate, even death, as a result. It is estimated to have shown that 24 million patients die each year in low- and middle-income countries due to unprepared pre-hospital and in-hospital medical systems (Kotsiou, Srivastava, Kotsios, Exadaktylos, & Gourgoulianis, 2018).
Without question an EMS system must contain a large spectrum of care and resources. It must be organized in a way that promotes effective utilization. Greece, like many countries, is not using tele-medical systems in spite of improvements to technology. Though Greece’s economic recession may be stealing the limelight, the National Health Service as well EMS has been majorly affected by austerity (Gourgoulianis, 2018). There are some issues with the way that the Greek handle updating its technologies. Findings show that they have dispatch stations with full capabilities and medical equipment. They serve demands now within full life support measures in yet have not updated these critical components.
Every culture handles emergencies and situations differently. Updating technology will only help to aid in your effectiveness and relevance going forward. I know in Ohio, where my family is from, there are strong spiritual beliefs regarding health and healing. For instance, when my grandmother came froma Mennonite/Amish background. When she got sick a few years back, she refused to go for treatments due to the cultural belief that God would heal her. She did agree to go but only for diagnosis. In terms of cancer the treatment is chemotherapy to which she refuses. Ironically, she was taking morphine for pain because the cancer was spreading and ultimately led to death. When we went up there for the funeral, my uncle Wayne still drives a horse and buggy. The belief is that cars and medicine are worldly things. He too was ok riding in a car that I drove but can own one. Cultural beliefs have a huge part to play in the availability of doctors to aid in these patients care.
In reading the article, “Why snakebite patients in Myanmar seek traditional healers despite availability of biomedical care at hospitals” it says, due to rural locations of farmers often times they try traditional healing methods or none at all (Schioldann, Mohammad, Kyaw, Halliday, Thwin, Chit, & Peh, 2018). It goes on to say that a lot of times it’s the belief about the snakes and their bite that keeps them from seeking medical attention. However, the main reason for using a traditional healer was the difficulty with transportation, cost, and lack of antivenom.
In Conclusion, change is hard and no one likes it, but we owe it to the people of every town, nation and country to provide adequate transportation and updated medical equipment and service. Technology should be advanced enough to determine risk, and effectively summon EMS workers and vehicles to be dispatched to the emergency even in a rural location. No one should ever feel left behind due to inadequacies and deficiencies in EMS services or public roadways. I believe government can and should get involved in updating technology on a federal level.
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