By PHILIP THOMPSON
Recently, my company was involved in a prolonged extrication after a motor vehicle slammed into the rear of a tractor-trailer truck. It was one of those “big ones,” where it seemed like everyone came out to help—four ambulances, numerous police cars, one helicopter, fire police units, and multiple engines arrived on scene. Additional police units were deployed to divert traffic from its regular pattern.
On hearing our dispatch tones, I went to our service building, but there were already enough EMS units in service; I ended up sitting in a standby ambulance, listening to the radio. It was a learning experience. I was proud. Command was quickly established by one of our town’s most experienced chiefs. Joint EMS command quickly followed, coordinated by one of our newest EMS officers. Dispatch and command worked seamlessly with the increasing volume of radio traffic as units went into service. Soon, both dispatchers were heard over the radio, helping each other deal with the increasing radio traffic. Luckily, the duty dispatchers included two experienced first responders who regularly rode with the agencies to incident scenes. We knew each other well and easily recognized voices faster than call signs.
However, problems started to appear. Command called for specialized equipment required to stabilize the vehicles. I clearly heard the request while sitting in the ambulance; the message was properly acknowledged, and there was no hint of miscommunication. Although the message was not read back, there was no hint of transmission problems. The day was clear with no wind and, with traffic stopped at the incident location, no background audio noise. Good radio discipline was in place, with each unit moving to tactical frequencies for operations. Everyone was using short and descriptive phrases instead of codes, just as they were trained to do. It was an ideal environment for perfect communications.
Ten minutes passed, then 10 more, and Command asked for an update on the needed equipment. Dispatch had missed the message. The request had not been processed. I don’t know if dispatch was overwhelmed with other radio traffic or consumed by the flood of citizen or other phone calls, but it was clear that the original request for equipment had not been processed. There was no blaming equipment failure this time. The missing piece of equipment was essential; without it, all those firefighters, police officers, and EMTs could not make rapid progress on scene. So, what happened?
In his related study, R.P. Timmons1 found that responders often experience sensory overload conditions, which creates communication deficits. In one test, 40 percent of radio communication messages were misprocessed. Across 29 actual and simulated incidents, 38 percent of radio messages were missed for no apparent reason. Age and experience did not affect performance. The contributing factors included the intensity of the situation and the level of distraction at the command position. Timmons suggested that commanders operate in an isolated space such as inside a command vehicle or a limited-access room.
As the situation was winding down, one ambulance was still trying to locate the scene. That ambulance crew had been dispatched to a “motor vehicle collision, Main Street, north of Route 123.” (For confidentiality, the actual location of the exit will not be given.) However, Main Street and Route 123 do not intersect! Like the resource request, the message was in the clear and properly acknowledged. Somehow, the ambulance driver created a mental picture that the scene was on Route 123 North and the way to get there was by Main Street—an impossible task. So, instead of trying to find out where to go, the driver mentally changed the message to one that made sense to him—travel north on Route 123—ignoring the tidbit that the accident was not on Route 123; it was on Main Street. As the ambulance became progressively desperate to find the incident, the scene commander eventually dedicated a person to provide turn-by-turn directions. Because of this action, the unit finally arrived on scene. It took an enormous amount of radio traffic to change the ambulance driver’s mental picture of the scene location even though all the messages were clearly received, acknowledged, and accurate.
As I browse through communications magazines, read Internet groups, and attend meetings, people seem to be trying to convince me that technology is the answer to communication problems. Many vendors promise our communication issues will be solved once more frequencies are available or when I buy a multiband radio, install a trunked radio system, or deploy new cellular phone technology. Although technology might be part of the solution, is there something easier we can do—and do it now?
Some suggestions immediately come to mind. As data packets have headers that convey message priority and urgency, what about prefacing those vital few messages that need special attention with a header? Messages such as “Urgent Resource Request” prior to your message might cognitively distinguish that message from the normal chatter. Keep the number of priorities limited to “Urgent,” “Priority,” and “Normal,” and limit types to “Resource Request,” “Order,” “Safety,” and “Normal”; it doesn’t really matter as long as your officers and dispatch agree to preface the list. A short tone burst can also be sent before an important message; just give that transmission extra attention. Another approach would be to establish a “connection” with the other party by using three messages: “Dispatch from Command,” “Command go,” “Dispatch—I need …” instead of one message such as “Dispatch—this is Command, I need ….” Writing down messages helps to remember them, even if you don’t ever read the paper.
I was amazed at how my own mental picture of the scene developed just from listening to the radio. If you have the resources, consider assigning one of the command staff the role to maintain situational awareness extending past the immediate scene to include dispatch. The staff officer can track requests; prepare logs in preparation of filling out ICS 201, 202, and other forms; monitor progress; and ensure proper interpretation of messages while getting ready for the next operational period.
Effective communication is essential to coordinating multiple agencies. Carry a recorder, and review your recordings as part of the incident debriefing. Online scanners also provide an opportunity to listen to agencies around the country to use as examples. In my area, I do not have “big ones” very often, so listening to scans on the Internet provides some good models to emulate.
Building a shared mental image of an incident over a voice radio system is an immense challenge. Often in the chaotic early phases of an incident scene, we fill in the missing details from our own experience. Ntuen2 suggests a framework of sense making that connects the physical structure of an incident to a related information structure and, in turn, to the participant’s cognitive structure. The driver of the lost ambulance filled in missing details when connecting the information to his cognitive image of the incident. I wonder what might have happened if the scene was noisy, people didn’t trust each other, or the radios weren’t working well. We probably would never have noticed the missing ambulance!
Practice critical thinking during all of your calls. Explicitly question yourself as to what assumptions you make, what data are missing, and what data you really need. Does that last radio transmission make sense? Put yourself in the mind of the person receiving your messages; is there some extra piece of information that will prevent misinterpretation of your intent? Ask your deputy what he heard and understood over the radio. Practice techniques on how to avoid creating ambiguous messages. While we wait for improved technology, improve radio communication reliability by taking a moment and stepping back from being in command; you might discover some valuable opportunities for improvement just by listening carefully.
REFERENCES
1. Timmons, R. P. (2009). Sensory overload as a factor in crisis decision making and communications by emergency first responders. (Doctoral dissertation). Retrieved from www.alaskalandmobileradio.org.
2. Ntuen, C. (2006) The knowledge structure of the commander in asymmetric battlefield: The six sights and sensemaking process. Retrieved from http://oai.dtic.mil.
PHILIP THOMPSON is a 30-year public service veteran and an NR-EMT/EMT-B and a line officer with Morganville (NJ) First Aid and Rescue. He is working on his PhD dissertation investigating first responder technology issues and recently founded a software company developing custom mobile emergency management applications.
