Sunday, July 31, 2011

The Humans are Dead

All---

In case you've not noticed before, I've added some news feeds to the blog, about topics related to themes in this blog.  (There's a tab up top!)  As I was glancing through this afternoon, I came across this article from the York Daily Record about the county looking for a more accurate way to track EMS (ambulance) response times.

Photo by Coolcaesar
This, I think is one of those things that I think most people assume is far more technical and precise than it is.  If I were to ask ten people on the street how EMS responses were recorded and reported, both in real time and for statistical purposes, I'm not sure what they would say.  I doubt many would say, "It's based on what you say on the radio."

Here's how it works in our area, and it's somewhat similar in most places.  This process holds true for both volunteer and professional EMS units, though the professional units are usually stationed at their ambulances and so don't require a second alert tone.

  1. Dispatch receives an alarm (e.g., a 911 call or a Life Alert).
  2. Dispatch sends alert tones to an EMS unit.
  3. After two minutes, Dispatch sends second alert tones to EMS unit.
  4. EMS crew assembles, and reports on the radio that they are responding.
  5. Ambulance drives to scene.
  6. When ambulance arrives at scene, driver reports on the radio that the unit is on scene.
  7. When the ambulance is ready to leave the scene, the driver reports that, as well as the current mileage on the odometer.
  8. Ambulance drives to hospital.
  9. When the ambulance arrives at hospital, driver reports on the radio that the unit is arriving at destination, and reports the ending mileage.
Seems simple and reasonable when you see it spelled out like that, and it typically works pretty well.  For better or worse, though, it depends on humans.    Someone must report and someone must hear.  Someone must speak clearly and someone must understand correctly.  No one can forget a step, or the entire record is essentially meaningless.

For instance, in our area, we are permitted to take a patient to an out-of-county hospital if they request, but we are required to report on the radio our time leaving the county and our time back in the county. (Among other reasons, so that dispatch doesn't try to divert us to another call, but also so that our response can be accurately timed and recorded.)  It's an easy thing to overlook while on a run.

Even if the calls are made as they should be and understood as they should be, the information has to be recorded and input.  

Things get even murkier when it comes to recording which district the response is in.  It's important for a number of reasons to know how often our EMS unit covers a call in another territory.  This information comes entirely from two sources: a note made by the dispatcher, based on their understanding of the geography; and a note made by the EMT who fills out the reports, based on their understanding of the territories.


Some areas have begun using GPS, RFID, and other technologies to track the real time movements of emergency personnel, but these tools are expensive -- not to mention invasive.  In our area, GPS systems are used to record the speed of ambulances, but not to actively monitor locations or to track response times or route efficiency.

NASA Android,
photo by Geoff Stearns
This is an interesting topic specifically, but I think it also plays into a broader conversation about relying on humans in this increased technical era.    We have come to expect mathematical precision in everything, and every year that passes increases the needle-point fineness of the precision we expect.    When we don't have the precision, we fear we are wasting money.  We fear we are jeopardizing public safety.  People will cry about government waste and the safety of the children.

And, then, when technological solutions reduce the number of employees required to conduct business, we lament lost jobs.  When humans are replaced by machines, we weep over the dehumanization of our civilization.  When we track people's movements and record their performance to the millisecond and millimeter, we object to the invasion of privacy and grumble about micromanagement.

And, yet, we want precision.  We want accuracy.  We want what we call scientific certainty.

But we want it with a human face.

'Tis a pickle, my friends.  'Tis a pickle.

.Nevets.


9 comments:

  1. My thoughts were going in a similar direction (wanting things simpler in this great age of technology while being disgusted by the huge job cuts that are on the news every day) the other day when I was at one of those portable stoplights that have apparently replaced the flagmen or flagwomen in construction zones.

    Pickle doesn't begin to describe it ...

    ReplyDelete
  2. It's a very big pickle. Humans are pretty hard to please, I've found.

    But, more importantly, why is the mileage for the ambulance recorded? For working out response times or to work out fuel spent?

    Also, why does dispatch need to send 2 alert tones? To ensure they can respond?

    ReplyDelete
  3. Pickle indeed. There are bound to be errors either way--while people are able to make decisions based on the circumstances and computers can't so easily, there are also human mistakes, which happen frequently enough.

    ReplyDelete
  4. It all sounds very organised, Nevets, but like Jake I wonder why you need two alerts?

    BTW how often do you do this work? It must take it out of you, doesn't it?

    ReplyDelete
  5. @KLo - I was okay with the portable stoplights when I first saw them hours from nowhere along the Alaska highway, where projects could lay dormant for two weeks or more, but still needed flow control. I haven't seen them elsewhere yet. I'm not sure how I'll feel about it.

    @Jake - We're a volunteer unit so we respond from our homes. We get about four minutes to make it to the ambulance and go into service. Because we don't report in until we make it to the ambulance, the second tone is just in case we didn't hear the first because they have no way of knowing whether we're on our way. Sometimes there are problems with a radio tower and the tones don't signal right, so it's good to have a second alert.

    @G'Eagle - "There are bound to be errors either way..." Such a good point!

    @Frances - It is pretty organized, and when it works it works very well. Hopefully the two alerts now make sense.

    I'm on call 8 to 12 nights a month. It's very draining, but it's a lot more satisfying and feel like it plays to my skill set a lot more than my day job.

    ReplyDelete
  6. So interesting! Such a high stress job. I've always wondered, when you get home after a call, do you find it hard to wind down, or are you utterly exhausted and pass out right away?

    ReplyDelete
  7. @Jennifer - That's a great question, and probably worth of it's own post but the short answer is that most of the time it's hard to wind down, but sometimes I just crash.

    ReplyDelete
  8. That truly is a pickle. Makes me wonder what we're supposed to do? It's probably also the reason people keep making movies and writing stories about overbearing "precise" governments and computers taking over humanity.

    ReplyDelete
  9. @Michelle - I think the truth is that we're imperfect and the world is imperfect, and no matter what we do, there will always be improvements to be made and any solution for anything will have trade-offs.

    ReplyDelete

Label Cloud

#DarkAndTwisted (5) a razor wrapped in silk (2) about me (5) absolute (1) acceptance (1) accountability (1) advice (54) aesop (2) agents (2) agony (1) aikido (6) alaska (2) alcohol (1) alex mackenzie (1) aliya whiteley (1) allegory (1) allergies (1) alone (1) amaretto (1) ambulance (17) anchors (1) andy dick (1) angel lost (1) anthology (4) anthony pacheco (1) anthropology (4) applesauce (1) approach (1) appropriateness (1) arashi (1) archaeology (1) archaeololgy (3) argyle (1) art (1) audio (3) author (11) award (1) background (1) bacon (2) bar (1) battlestar galactica (1) bbs (1) beauty (1) ben folds (1) bhangra (1) bioarchaeology (1) biography (2) birthday (1) blog tour (1) blogfest (9) blogging (5) blogosphere (2) blogsclusive (14) blurb (1) bones (2) book (4) boring (1) born to fly (1) boss (1) boundaries (1) braai (1) bravery (2) bridge flag (1) brutal (1) business (3) c + c music factory (1) c n nevets (108) c s lewis (1) cabin (1) cafepress (6) cantaloupe (1) career (2) cat (1) challenge (2) character (11) cheesy (1) cherry republic (1) christmas (4) chuck palahniuk (2) chumbawumba (1) cinderella (2) cinders (4) clarissa draper (2) classification (3) clive cussler (1) commentary (4) community (1) compelling (1) complete (1) confidence (4) conflict (1) conformity (1) confusion (1) congress (1) conspiracy (1) contest (31) conversation (1) cooking (1) cottage (1) courage (5) craft (4) creation (2) creep (2) crime (1) crime writing (36) criminal (2) criticism (2) critiques (2) crow (1) culture (2) cussler (1) cutting (1) dark (11) davin malasarn (3) death (1) deb markanton (4) deborah swift (1) deduction (1) definition (2) description (2) destruction (1) development (3) dialectic (1) dialogue (1) direction (1) discussion (2) dog of the north (2) domey malasarn (5) dr. who (1) drama (3) dramatic (1) dream (1) drugs (1) edit (2) editors (4) emotion (1) ems (8) emt (3) endings (1) ennui and malaise (4) entry (1) epiphany (1) escher (2) essay (2) ethics (3) everyday (1) evil (3) excerpt (3) exercise (1) existentialish (4) existianlism (2) experience (3) experimental (1) fables (1) facebook (3) failure (1) fairy tale (2) fallibility (1) fantasia (1) fantasy (2) fear (5) feedback (3) fiction (26) fit (1) flas (1) flash (22) flash fiction (8) flight (1) flying knee (1) food (2) forensic anthropology (3) forensics (5) frances garrood (2) frustration (1) fun (2) fwiww (1) game (1) gary corby (3) gawain (1) genre (29) germ (1) ghost (3) gideon (1) gift (4) give away (2) golden eagle (1) government (1) growing up (1) grumbling (3) gsa (1) guest post (13) hair metal (1) harry potter (1) health (4) heavy metal (1) hegel (6) help (3) historical fiction (3) history (3) holiday (1) home (3) hopeless (2) horror (3) hot dish (1) houseboat (2) humans (1) humor (1) idea (2) imagination (2) impressionism (1) indiana jones (2) induction (1) influences (1) information (5) insight (1) inspiration (2) intentionality (1) international (2) internet radio (1) interview (2) introduction (2) investigation (1) iticism (1) jabberwocky (1) jack higgins (2) japan (4) jc martin (1) jeffrey deaver (1) jennifer hillier (7) jon jones (1) journal (1) jpop (2) jurisdiction (1) jurisprudence (5) justice (1) justification (1) kanjani8 (1) kansai oniisan (5) kathy reichs (1) knowing (2) koontz (1) kung fu (1) law (5) learning (1) legacy (1) lies (2) life (8) light (1) limits (1) linear (2) lines (2) lite (1) literary (3) literary fiction (10) literary lab (4) literature (3) loren eaton (3) louis lamour (1) love (1) lt host (1) ludlum (1) lydia kang (1) lyrics (1) mandarin chinese (3) marilyn meredith (3) marketing (5) marriage (1) martial arts (3) marxism (1) mascota (1) meaning (1) melons (1) memories (2) mentoring (1) mercury rising (1) meta (1) michael crichton (1) michael malone (1) michelle davidson argyle (9) minnows (1) misha (1) mma (2) monday moment (1) monty python (1) mood (1) moplo (1) morality (4) motion (1) motivation (2) motive for murder (1) mr. saggy (1) mug (1) murder (5) muse (1) music (2) mutilation (1) myster (1) mystery (5) mystery men (1) narrative (1) neanderthal (1) neo-orthodox (1) nevetsize (15) nevetsosophy (1) news (38) nick diaz (1) non-linear (1) nonsense (1) northern michigan (1) nostalgia (3) not subtle (1) notes from underground (3) nothing changes (1) nothing happens (1) novel (9) novella (1) obfuscation (1) obsession (1) octopus (1) oetzi (1) on call (1) one point (2) oops (1) opinion (1) original (2) osaka (2) outline (3) p g wodehouse (1) pain (1) pancakes (1) paradox (3) paranormal (1) passion (1) perceval (1) persistence (1) person (1) personal (66) phil loring (1) philosophy (9) piano (1) pictures (1) pie (1) pink floyd (3) place (1) plot (5) plug (1) podcast (3) poetry (1) police (3) politics (2) poll (1) pomo (1) post modern (1) potential (1) pouland ann dvorjak (1) pov (6) power (1) practice (2) pre-writing (3) precision (1) pretty (1) priorities (2) prize (13) process (8) production (1) progress (3) projects (3) promotion (9) prompt (2) pscyhology (7) psychological suspense (27) public defender (1) publication (24) puffin (1) pun (1) querying (2) question (8) r n morris (5) rachel in the oc (1) rachel thompson (1) radio (1) rambling (2) random (3) rant (2) reader (4) readi (1) reading (10) real stakes (10) realism (2) reasoning (1) recommendations (1) redemption (1) rejection (6) relationship (1) release (2) religion (1) request (3) research (1) response (1) results (1) review (6) revision (2) riddles (1) rights (1) rj clarken (1) rj ellory (5) romance (3) rose (4) rules (2) russia (1) rusty nail (1) ryan david jahn (6) ryne douglas pearson (2) sample (2) scifi (1) scotch (1) scotland (1) scott bailey (1) scottish (1) second person (1) selfhelp (4) serial killer (1) serial murderers (1) setting (1) seuss (1) shirt (2) short (1) short story (28) shush (1) sisko (1) skills (1) skulls (1) sleepy (1) slice of life (1) smoke (1) smugness (1) smurfs (1) social (3) solitude (11) solomon matthews (1) soundtrack (1) specialization (1) speculative fiction (1) spiral (3) spirit (1) sports (1) star trek (3) stephen king (1) steven seagal (1) store (1) stories for sendai (9) story (42) strengths (1) structure (6) struggle (29) stuff (2) style (27) sublimation (19) submission (11) suffering (1) suicide (2) summer ross (2) surrealism (1) suspense (6) sweet (1) sword stained with royal blood (2) synonyms (1) system (1) tactless tuesday (10) taekwondo (1) takoyaki (1) taphonomy (1) tara maya (2) taste (1) tater tots (1) tea time with serial killers (2) teaser (3) technique (7) ted kennedy (1) teddy bear (1) teen (2) teilhard (1) telling (2) terminal instar (5) tesol (1) the dirty dozen (1) the girl with the dragon tattoo (1) the life of brian (1) the muppet show (1) the wild grass (1) theme (3) theory (1) therapy (2) thinking (2) threat (1) thriller (5) tim stretton (4) timeline (1) tips (20) tone (3) top gun (1) top ten (1) topic (1) trailer (6) transformation (1) translation (1) travel (1) tribute (1) trivia (1) trolls (1) twisted (3) twitter (5) ufc (1) update (26) uzziel (1) vacation (1) veggie tales (1) video (1) violence (2) vogon (1) voice (11) volunteer (1) vomit (1) vonda mcintyre (1) walgreens (2) website (2) western (2) whatif (1) whining (2) william faulkner (1) winner (2) wip (6) wisdom (3) word choice (2) writing (174) wu xia (1) ya (1) yamashita tomohisa (1) yin and yang (1) yuan chengzhi (1) zhao peng (1) zoe winters (1) zora neal hurston (1)