EMRC Comms to Hospitals

[bwhite]

Question: I was in Sinai Hospital's ED a few months ago and heard them work with a distant medic unit on the way in. During the entire time (quite a while) I was near the radio I only heard this conversation and no other. Is/Are the comms that come in this way controlled by a sort of "gatekeeper" at EMRC (thus filtering out non-applicable radio traffic) or do hospitals have their own frequency ?
I'm thinking the former, but, the lack of any other comms triggered the question.
Thanx

 

[troymail]

EMRC in Maryland uses standard frequencies across the state. Units call through EMRC "Call 1" and get assigned a "Med channel" by the controller. These are typically broken down by "regions" in the state. Some trunking systems have "800 Mhz patches" to the system (AA county, etc.).

See : http://www.henney.com/chm/mdfdmap.htm

 

[bwhite]

During the hour and a half I was next to the radio I only heard this comm between Manchester's medic that came in 1/2 hour after calling in. I'm guessing that the hospital would have been on Med 3 even though Carroll is usually Med 6. Hard to believe there would have been no other radio traffic in Balto for that time. I'll try listening in on 463.05 & 463.125 and see what happens. Thanx

 

[troymail]

Units typically call in through EMRC for notification about a patient they are bringing in or for guidance from a doctor when protocols indicate it. However, in this area, it is generally not necessary to notify the hopsital when transporting to their facility. One exception I'm aware of in my area is Laurel Regional Hospital - I think they expect notification for all incoming pts.

Units will also typically call in for mass casualty (car wrecks with multiple pts that might overwhelm a single ER), cardiac arrests, and other situations where they want the ER to be prepared for them when they arrive.

When I was active with an ambulance company in southern PA, the units made notification to the ER while enroute there for ALL transports no matter how minor. In the Baltimore area, that would be pure overkill - many units would probably arrive at the ER before the air was free to make a report.

So, it varies from area to area.

 

[GARRETT]

It is usually up to the Medical Director of that jurisdiction, Example: Calvert Co.'s Medical Director requires "all" 911 ambulances transporting a patient to their facility to notify the hospital on the Med radio, regardless of the priority of the patient, of course some times that is ot feasable due to short eta's or what is going on in the back and the driver will tell the dispatcher to notify them instead. Each base station at a hospital is controlled by EMRC for the MED channels they will alert the hospitals base station similiar to a pager and activate their base station. the hospitals have no idea what MED Channel they are talking on because it is not displayed anywhere on the base station radio. EMRC has to advise the Ambulance what med channel to swith to depending on availability of med channels and only EMRC has that information. Each county is assigned a primary and secondary med channel and 1 of 4 tone codes to use. I do believe the base stations at the hospitals have a monitor button so if for some odd reason the er staff wants to monitor a med channel they can but they usually do not have time or any reason to do that.

 

[bwhite]

I think you hit the nail on the head Garrett.
I think that EMRC is controlling when the squawk box squawks and not.
Thanx

 

[spanner]

The same for Washington County.

Washington County Hospital DOES NOT LIKE TO BE SUPRISED with a patient, no matter the priorty.

Washington County uses Call 2, Med 2 and 8.

 

[rmiles]

Also keep in mind that MD EMRC uses the standard "CALL & MED" channels which are duplexed. The ambo's in the field Tx to the ER on one freq, and the hospital Tx back to the ambo on a second freq. PSP currently use the same type of setup, which is why you cannot hear the patrol units unless you switch to the MON freq. This differs from a repeater where everyone listen on the output freq and Tx on the input freq. I think this was the more likely scenario that you experienced. There were probably several consults going on while you were there. You just did not hear them because it's a duplex system. Just my 2 cents.

 

[bwhite]

So for the Balto region, is there a "general" best-bet freq to monitor? I'm guessing Med 3.

 

[jpsmith2]

Cecil uses Call 1, Med 4 and Med 8... These are also the channels Baltimore County, Howard, Harford, Carroll & Anne Arundel have patched into their TRS according to the database. They are all in the same "region" according to Miemss, so it makes sense.

Looks like the city uses Med 2 & 3 and Howard also has Med 6.

 

[ocguard]

It should also be stated that the hospitals themselves are not actually using a med radio. EMRC controls all of the actual radio equipment (the Med channels) at various tower sites throughout the state. Once EMRC assigns an ambulance or a medic unit to a med channel, they then patch that med channel, via a fixed means (dedicated landline circuit or microwave), to the hospital(s). The hospitals themselves do not maintain UHF radio equipment. The "base stations" in the hospitals are actually just connections to EMRC.

It is because of this that any EMS field unit anywhere in the state can communicate with any hospital in the state, regardless of proximity to that hospital. Once the consult is complete, EMRC dissolves the patch between the med channel and the hospital's base unit. If a field unit has a critical case, and may need additional on-line medical direction, they may request that the patch be left up so that they can reconsult immediately.

Last I knew, shock trauma is equipped with a repeater system that allows the attending trauma physician to take part in a consult via portable radio. When a field unit requests a trauma line with shock trauma, EMRC patches them into shock trauma's base unit as well as to the trauma line repeater. This allows the trauma phycisian to participate in a trauma line activation from anywhere on the UM campus. When a field unit requests a trauma line to shock trauma, EMRC will sound the "warble" tone, similar to that heard over many fire dispatch channels. This is to alert the trauma physician over his/her portable.

If a county uses it's 800mhz system to communicate with hospitals, EMRC maintains base stations for that county's system. For instance, EMRC has three base stations for Baltimore County; one for TG-221, one for TG-224, and one for TG-228. When a unit calls for a patch on TG-221 and is directed to TG-224, EMRC connects then TG-224 base station to the appropriate hospital. TG-224 is NOT patched to UHF MED-4. If a unit is consulting on TG-224, you cannot hear any part of it on UHF MED-4, nor visa versa. All of the 800mhz "Call" talkgroups within Region III are 'slaved' together with UHF Call-1 on the EMRC Region III console so that one EMRC operator can answer all channel requests, regardless of it's source. This is why you will sometimes hear the EMRC operator answering a Baltimore City unit on Baltimore County TG-221 or a Harford County unit on Baltimore City A6, etc.

As for who and what patients should get medical consultation, the Maryland Medical Protocols for EMS Providers states that...
1. All Priority 1 patients require on-line medical consultation.
2. All Priority 2 patients who have persistent symptoms or need further therapeutic intervention(s) require on-line medical consultation.
3. Notification (“information only call” that can be through EOC or EMS communication system following local standard operating procedures)should be made to the receiving hospital for Priority 2 or Priority 3 patients, whose symptoms have resolved and whose vital signs are within normal limits.
ON-LINE MEDICAL CONSULTATION MAY BE OBTAINED AT ANY TIME FOR ANY PATIENT, IF DESIRED BY THE PREHOSPITAL EMS PROVIDER, PEDIATRIC AND SPECIALTY CONSULTATION IS ENCOURAGED FOR TRAUMA AND MEDICAL PATIENTS. CONSULTATION WITH PEDIATRIC AND SPECIALTY CENTERS SHALL OCCUR SIMULTANEOUSLY WITH A BASE STATION CONSULT.

In the Baltimore area, your best bet is to monitor the county's 800mhz system talkgroups, as most of the metro counties use their 800mhz systems in lieu of the UHF MED channels. As a matter of fact, most of these countys' units have removed the UHF equipment from their units, or not re-installed it into newly acquired units. Baltimore County, Baltimore City, Harford County, Anne Arundel County, Cecil County, Carroll County, and Howard County are all part of MIEMSS Region 3 which is assigned:
Call 1 (492.950/467.950) PL 167.9
Med 4 (463.075/468.075) PL 167.9
Med 8 (463.175/468.175) PL 167.9
As someone else mentioned, you have to monitor both frequencies in the pair, and you will only hear field units if they are close by, as there is no repeater function with these channels. This is called "half-duplex" (one half of the system is duplex) and is kept this way for two reasons:
1. There is no need for the field unit's transmission to be re-transmitted at high power; no one but the hospital needs to hear it
2. The hospital can receive while transmitting; if the physician is giving orders and the patient's condition changes, the field unit can transmit and the hospital will recieve the transmission despite the fact that it is still transmitting.

 

[bwhite]

good info ocguard, that pretty much explains what I was and was not hearing.
I don't have an 800 scanner that works at this location so I will try the 463 freqs. Thanx

 

[tolley]

OCGuard is correct. Here on the Upper Shore in Region IV, we have dedicated Med Channels on our Motorola radios for hospital consult. The Upper Eastern Shore System uses Med-A and Med-B while Dorchester uses Med-C and Med-D. Any transport unit or medic in need of a physician consult first contacts Talbot Center on Med Call to get a channel assigned. That channel is then patched to the requested hospital. I have heard calls where a medic has requested a patch setup between physicians from Shock Trauma, Easton Memorial, PRMC, and Johns Hopkins all at the same time!!
If we are enroute to Delaware it works the same way. We contact Sussex or Kent Center to request a Med Channel on their 800 MHZ system.

 

[ocguard]

Tolley,
You are shedding light on something I was not sure about. I know that EMRC doesn't routinely handle things in Region IV. You're saying that your county dispatch centers handle the hospital patching? What if you need a patch to a Baltimore hospital? Does EMRC have to have a hand in that part of things? I was always curious about this, especially in the OC/Salisbury area.