Communications in the air medical industry has acted as a lifeline for providers since its start. Most services use two standard types of radio communication: very high frequency (VHF) and ultra high frequency (UHF). VHF is a communication option that uses ranges from 30 Mhz to 300 Mhz. VHF is commonly referred to as “line of sight” communication and is ideal for the relaying of information over short terrestrial distances. Not commonly affected by atmosphere or electrical equipment, VHF frequencies are a reliable source of communications for the air medical industry. UHF is another commonly used frequency option in the prehospital environment. Unlike VHF, UHF frequencies use a spectrum of 300 Mhz to 3 Ghz, the same spectrum that modern cellular phones use. These frequencies are useful for longer range communications when used in concurrence with local repeaters to relay signals. Both UHF and VHF frequencies are still currently in use, but newer technology has surfaced to increase the reliability and range of air medical communications. ¹⁰

The use of satellite-based devices has been a mainstay in aviation for many years. Global positioning systems (GPS) rely on satellite up links to provide aviators and ground crews with real-time position updates and directional assistance. The use of satellite technology has now found its way into other aspects of medical transport. Most air and ground emergency medical service (EMS) units have relied on complex radio hardware, which uses repeater systems to communicate with other units and the communications base. These systems are reliable but can pose problems when communication is initiated from low outlying areas. The introduction of the satellite phone messaging system (SATphone) has solved many of these issues. ¹⁰

The SATphone operates by sending messages to satellites of the vendor for processing. The message then is routed to its destination via a landline or cellular network. Verbal communication is made through headsets on the internal communication system inside the aircraft. This technology prevents limitations during communications and allows access from virtually anywhere and in any type of meteorologic condition. ¹⁰

Prehospital 12-lead electrocardiographic (ECG) interpretations have become an invaluable tool in the diagnosis and proper treatment of acute myocardial infarction (AMI). The use of cellular telephone services has now given the field practitioner the ability to transmit these tracings to the receiving facility to facilitate treatment. Research has shown dramatic decreases in patient morbidity rates with use of this system. Many varieties of monitor defibrillators possess the ability to transmit ECGs with the placement of the appropriate upgrades by the particular vendor. Among these is the Rosetta-Lt model 7100 data translator for the LifePack 12 (Figure 13-1). This upgrade allows transmission over UHF, VHF, cellular, and landlines during continued transport in a moving vehicle. Fully formatted 12-lead ECGs can be transmitted in less than 1 minute. Once the transmission has been initiated, the tracing is received at the facility of choice at a stationary central computer with printing capabilities. Recent studies have shown a marked decrease in “door-to-drug” times and in diversion of EMS crews to appropriate facilities capable of performing cardiac catheterization. Currently, research is being performed to assess the effectiveness of the same transmission relayed to a specific cardiologist’s handheld personal data device. ⁵

Patient care reports (PCR) are an essential tool for the relaying of information from prehospital providers to receiving hospitals. ^3,8 Significant upgrades in this field have allowed for more efficient tracking and documentation of patient encounters. The practice of paper charting and patient flow sheets has been replaced with the introduction of digital charting through the use of portable computer tablets for prehospital personnel.

Many products are available on the market, such as Panasonic’s Tough book, Toshiba’s Tablet PC, and Golden Hour software; these products are increasing in popularity among air medical and ground EMS personnel. These charting devices are wireless and portable for easy mobility. They are encased in a shock-mounted carrier, which makes them extremely durable and well suited to meet the demands of both air and ground transport teams. Keyboards on the units are sealed to prevent contamination from bodily fluids encountered during transport. Some key benefits of digital charting are the ability to transfer precise patient information to receiving facilities and the ability to perform research and trends in patient care. The computerized format also allows for a more accurate approach to quality assurance and improvement.

To ensure the safety of both crew members and on-board patients, air medical transport units must be constantly tracked by communication officers. The Federal Aviation Administration (FAA) and individual flight programs set requirements for current position reports on all aircraft. When aircraft fail to meet the time requirements for these reports, emergency procedures are put into action.