Radio vs Phone reports

[CentralCalEMT]

Where I work, over half our coverage area in the mountains has no cell reception. However, we have a good repeater system in place so there I will use the radio. That being said, I prefer to use the cell phone when available. It is easier to paint the picture when you have two way conversation.

 

[WestMetroMedic]

Sorry, I didn't convey my message very well yesterday morning while I was sitting in bed typing on my cell phone.

We have moved all of our communications to Radio for a couple reasons.
1. When the fit hits the shan, everyone and their sister is going to be busy on their cell phones calling their third cousin to say they are okay. Using a cell phone is not a resource you can count on in a large scale incident. Your radio, which you have to have, will always work in a properly engineered and built system. During the bridge collapse in over 3,000 PTT events, there were 5 PTT events that didn't make it through, and they were public works users.
2. Practice every day, like you are getting ready for the next big one. We failed to communicate effectively that day for many reasons, and there were many links in the chain that didn't work perfectly. At the end of the day, we didn't have any significant failures, but we did learn a lot. We rely on our WMRCC for a large scale incident because they are essentially our metro-wide ATC tower. They tell us what hospital can accept our "Red" patient and 2 "Yellow" patients, what hospital is closed, and they also track which patient goes where, which is vital in the reunification process.

In a busy metropolitan area that uses a digital trunking system, no one who really can afford a $500 scanner is all that interested in listening to paramedics ask a doc to pronounce a 83 year old woman with gout. They want to hear the police talk about taking lunch breaks. Radio Reference Live Audio Feeds (soon to be soundify) is the primary feed provider to all of the smartphone apps, and their TOS explicitly state that their feeds are not to include frequencies or talkgroups that have a primary purpose of EMS patient information.

When I am receiving medical direction, I often prefer to have it a one way at a time street, so that I can convey my message without getting interrupted, and likewise, I have to wait for the Physician to complete their message.

 

[NomadicMedic]

In addition to the points MetroWest made, a trunked radio system can be engineered to allow priority users access to the system. For example, we share our system with other state and county services, but EMS has priority over road crews or animal control. In a period of busy airtime, lower priority uses will receive a "system busy" or "bonk" tone, while higher priority users will have access.

In addition, in a properly engineered trunked radio system, the vendor is obligated to deliver a certain reliability standard. In our case, it's >96% portable radio coverage. We have multiple redundant systems and a full crew of engineers and infrastructure techs who's only job is to keep our radio system operational.

It's simply not prudent for a system of our scale to rely on someone else, like a cell phone company, when it comes to any aspect of our communications.

For those that don't have robust network infrastructure to deliver communications, I can see using a cell. For those of us that are lucky enough to have it, using a radio for doc consults is second nature.

 

[firecoins]

I like the cell phone. There are people running around with scanners and what not. And I don't want the patient hearing both ends. I have my reasons for the privacy. I am okay with it being recorded for qi stuff and legal protections. Most of the time, I am just giving a cc and am eta since I am within standing orders ALS wise.

 

[NomadicMedic]

I don't care if the patient heard both sides of a conversation. It's about them.

And as far as scanners go, we have a digital system, not able to be monitored on a "regular" scanner. Most people won't spend the 500 for a digital capable scanner. And frankly, most of my reports are pretty run of the mill, with no patient info, aside from sex and age.

The patient privacy aspect is not a reason to not use a radio. It's really just determined by your system. Some use phones, some radio. It's not really a huge deal. Both get the job done.

 

[RocketMedic]

I prefer radios, but nurses prefer phones. Since I talk to hospital nurses, I generally use the phone.

 

[DrParasite]

Is there a non-local reason to use a radio instead of a cell phone?

nationwide reasons to use a cell phone:
1) more secure/can't be picked up on a scanner
2) full duplex
3) multiple cell phones can call multiple doctors with great ease
4) much easier to run a phone line to the ER instead of installing a mobile base station and running an antennae to the outside.

again, all these reason are not region specific.

can anyone list any non-region specific reasons to use a radio instead of a cell phone?

 

[NomadicMedic]

1) if privacy is an issue, a secure, encrypted digital talk group is not able to be heard on scanners.
2) non commercial infrastructure dependent. It doesn't fail when the cell network fails.
3) allows priority communication in times when the cell network may be overloaded.
4) allows multiple providers, docs, incident commanders to conference on one channel.
5) allows on scene providers to coordinate with multiple facilities on one talk group. (Think MCI when patients are going to multiple facilities...)
6) no need to dial. Immediate communication.
7) most infrastructure can be paid for and maintained by grants.

Shall I go on? It's a simple thing... Regions that have good radio systems, systems that have been engineered to perform properly, use them for everything and have no complaints. If your radio system isn't performing up to snuff, that's a problem for your administrative staff to work out. And in that case, I can see using a cell phone.

It's just a matter of system preference. But for public safety communication, you should not be relying solely on a commercial cell phone network. When they fail, they fail spectacularly and it's when you really need it.

 

[DrParasite]

But for public safety communication, you should not be relying solely on a commercial cell phone network. When they fail, they fail spectacularly and it's when you really need it.

this is probably the one factor that many people (myself included) often forget.

I do think that a cell phone is better way to give a patient reports. but you absolutely need to have some kind of backup system in place in case the cell system does go down.

Regardless of which system you use (because radio systems, even multi-million dollar ones, have and will go down at the worst possible times, usually involving power failures), always make sure you have a backup plan in place, and are familiar with how it works.

 

[lightsandsirens5]

this is probably the one factor that many people (myself included) often forget.

I do think that a cell phone is better way to give a patient reports. but you absolutely need to have some kind of backup system in place in case the cell system does go down.

Regardless of which system you use (because radio systems, even multi-million dollar ones, have and will go down at the worst possible times, usually involving power failures), always make sure you have a backup plan in place, and are familiar with how it works.

Exactly.

We use radio (VHF I think) primarily, but I have seen it go down on my shift. In the event that fails, at least as far as dispatching goes, dispatch has the number to the crew landline, and if that doesn't work, they call the supe and get the crew cell numbers and dispatch us via text.

Pre arrival reports either go radio or crew cell to ER landline. If that is down we will try to call out text a nurse or tech and let them know we are inbound.

We also have a fair number of ham operators on the service that can be utilized, but it takes a while to get them notified and operational.

At the last service I worked for, my station was a half mile from county dispatch, so when the radio went down, we would just head over to dispatch and hang out there so we could get dispatched, I dunno what you'd call it....in person?

 

[Aidey]

I like the cell phone. There are people running around with scanners and what not. And I don't want the patient hearing both ends. I have my reasons for the privacy.

I don't care if the patient heard both sides of a conversation. It's about them.

I can think of a couple instances where I don't want the patient hearing either end of the conversation, and it is in their best interest.

1. Fatality car wreck. Automatic trauma activation for anyone else in the car. My patient is the driver who A) Doesn't know the other person died. B) is fine and C) is definitely going to be charged with a crime. I do not want the patient hearing me say "This is a trauma activation because of a death in the vehicle".

2. Psych patients who are delusional/psychotic and don't believe they are delusional/psychotic. Saying things like "I'm en route with a 24yo male who is reporting his blood has all been replaced by acid" just ends up confusing the RN on the other end of the line.

3. Patients who are being lied to by their families about why they are going in. "Ok grandma, you're going to see the doctor because you have a fever" can really be "Grandma was diagnosed with stage 4 colon cancer, but we've decided not to tell her and just keep her comfortable."

 

[WestMetroMedic]

Nothing personal, but all are great examples of lying to patients. Ethically and professionally, very gray.

Also, volume knob.

 

[Aidey]

1. It wasn't my place. I already had a patient I could barely control on my hands. In the ED it took several people to manage her after PD told her.

2. Because telling delusional patients they are delusional ALWAYS works out well for us.

3. Again, not my place. Just because I don't agree doesn't mean I am going to go against a family's wishes, especially after they have gone out of their way to tell me they aren't telling her.

With our system the patient generally can't hear the hospital, but they can hear me.

 

[NomadicMedic]

I can think of a couple instances where I don't want the patient hearing either end of the conversation, and it is in their best interest.

1. Fatality car wreck. Automatic trauma activation for anyone else in the car. My patient is the driver who A) Doesn't know the other person died. B) is fine and C) is definitely going to be charged with a crime. I do not want the patient hearing me say "This is a trauma activation because of a death in the vehicle".

2. Psych patients who are delusional/psychotic and don't believe they are delusional/psychotic. Saying things like "I'm en route with a 24yo male who is reporting his blood has all been replaced by acid" just ends up confusing the RN on the other end of the line.

3. Patients who are being lied to by their families about why they are going in. "Ok grandma, you're going to see the doctor because you have a fever" can really be "Grandma was diagnosed with stage 4 colon cancer, but we've decided not to tell her and just keep her comfortable."

It doesn't matter if you're on the phone or radio for any of these. If I'm calling the doc to terminate efforts on a code, I'll step away from the action and call on my radio. You can always step away for a moment to make a notification.

As far as power failures bringing down radio systems, please note that I continuously refer to ours as robust. That means back up power. Multiple paths to get signal to the towers from the dispatch center. 800 MHz radios that can swap to site trunking if the network fails. We have back up radio sites and a portable site with trailer mounted tower that can be deployed as needed. It's important to know the capabilities of your communication system. When things go sideways and you're the first person on scene at a 25 person MCI, that radio will become your best friend, provided you know how to use it.

 

[ffemt8978]

Each has their place, and both should be used depending upon the call. Crew members need to be proficient in the use of both.

For hospital reports, where we are beyond the range of the hospital because HEAR is a non-repeated network, cell phones work best for us. It allows us to call in our initial report to the hospital at least 30-45 minutes before we arrive. Something to keep in mind that most mutual aid frequencies are not repeated, which means they are of limited range.

On scene communicating with dispatch or other units, we use the radio.

 

[Aidey]

It doesn't matter if you're on the phone or radio for any of these. If I'm calling the doc to terminate efforts on a code, I'll step away from the action and call on my radio. You can always step away for a moment to make a notification.

I guess I should have clarified. We generally never call the hospital until we are en route, which means no stepping away. Our portable radios don't have the ability to call the hospital. If you have the ability to step away and call/radio then no, it probably doesn't matter much which method you use. My point was that there are cases where you might not want the patient to hear what you are saying to the hospital, even if it is about them.