When High-Tech Fails: Back to Plan B

by Joseph Cahill

Cars are equipped with two types of brake systems: (a) the main brake system required for normal use; and (b) an emergency brake system, which serves as a backup if or when the main system fails. Use of the main system involves pressing a set of pads against a metal disc that provides the hydraulic action needed to stop the car when a brake pedal is depressed. The emergency system uses a completely different set of pads – usually pulled by cables when a hand lever is triggered.

Because two completely separate systems are installed, the reason for a failure of the main system would not affect the second system’s performance. A complete second brake system is required because, if a second system were not available, failure of the main brake would disable the entire vehicle. For that reason alone, the installation of a backup brake system that admittedly may be redundant nonetheless serves a very important purpose.

The same level of redundancy for other types of systems is uncommon in the modern automobile because very few of the modern car’s other systems have the same level of importance as the braking system – the failure of which might possibly lead to destruction of the entire vehicle as well as its occupants.

Needed: An Emergency Brake for EMS In the overall U.S. Emergency Medical Service (EMS) network, few systems have the same level of importance as a car’s brake system – and very few are so integrated and interconnected that their failure might well cause a complete shutdown of the EMS network as a whole. However, there is one system that meets both of the criteria – importance and integration – that make a car’s brake system uniquely essential. That EMS system is dispatch and communications.

EMS communications systems typically have three major purposes: (a) system entry; (b) dispatch capability; and (c) ability to update. System entry is the point at which the request for help is received into the system, usually by telephone. The dispatch and update functions provide clear and continuous communications between central control and the units in the field.

Danger of System Failure Many EMS systems use relatively complicated phone and computer systems to control the flow of information and facilitate the operation in other ways. When working properly, these complicated systems are a valuable asset. Unfortunately, though, they are not immune to failure – caused, perhaps, either by outside forces such as a cyber attack or the loss of outside electrical power and/or by internal problems such as faulty equipment or a software failure.

When the high-tech tracking systems fail, dispatch centers are forced to go “old school.” The centers then revert to methods that were in use prior to installation of the modern high-tech systems. Pen and paper are among the most common, and most reliable, of the old tried-and-true backup “systems” available.

An Old Solution for a New Problem Even when an agency replaces the old-school pen and paper, there still must be a backup plan available for continuing operations during a technology failure. Not completely discarding the old forms can provide the basis for starting an effective continuity plan.

Similarly, units in the field can fall back to their previous low-tech modes of operation. Prior to wide distribution of radios to emergency responders, dispatching was carried out, very successfully most of the time, by use of a telephone or teletype system. A return to that mode of operations would be a rather cumbersome task and the operational essentials might be unfamiliar to many staff members, of course. However, those inconveniences pale in comparison to a complete loss of dispatching capacity. During a system failure, the movements of the unit and their changes in status could still be reported as the unit arrives at various locations.

Over the long term, obviously, technology will continue to advance – and so will EMS dispatch and communication systems. However, within the currently foreseeable future, although the “old school” systems may not beeal (which is why they have been replaced by higher-tech systems), they can still serve a useful EMS purpose by ensuring the continuity of operations. Improvements in technology are wonderful, but they also have a nasty habit of failing at the most inopportune times – and when they do it pays to have a plan B on the backup shelf.

___________________________ Joseph Cahill, a medicolegal investigator for the Massachusetts Office of the Chief Medical Examiner, previously served as exercise and training coordinator for the Massachusetts Department of Public Health, and prior to that was an emergency planner in the Westchester County (N.Y.) Office of Emergency Management. He also served for five years as the citywide advanced life support (ALS) coordinator for the FDNY - Bureau of EMS, and prior to that was the department’s Division 6 ALS coordinator, covering the South Bronx and Harlem. Much in demand as a speaker – he has addressed  venues as diverse as the national EMS Today conferences and local volunteer EMS agencies – Cahill also served on the faculty of the Westchester County Community College’s Paramedic Program and has been a frequent guest lecturer for the U.S. Secret Service, the FDNY EMS Academy, and Montfiore Hospital.