Texas State Health Plan: 1987-1988 Page: 55
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CHAPTER VII
AMBULATORY CARE/EMS
An improved regional emergency medical ser-
vices (EMS) communications network
PRIORITY throughout the state, emphasizing an up-
ISSUE graded radio communications system be-
tween emergency medical and other public
safety units.
PROBLEM STATEMENT: Communications are essential for the EMS
system; however, because of Texas' vast area, rapid and clear
communications are often difficult. The Very High Frequency (VHF) band
which is used by most EMS units in Texas can only be used for simplex
(communication in one direction at a time) operations, and this band is
often congested, especially during crisis situations. In addition, because
the initial communications link between patient and EMS is usually by
telephone, the 9-1-1 emergency telephone number will be addressed.
BACKGROUND AND POLICY ANALYSISIn the EMS system, communications are necessary
from hospital to ambulance, between ambulance and
police or fire units, and between ambulance and
patient evacuation aircraft (helicopters or fixed-wing
airplanes).
In the VHF band, there is only one frequency
recognized for hospital-ambulance use while Ultra
High Frequency (UHF) has ten channels available for
medical emergencies. In addition, frequency pairs
are allotted to UHF, thus providing duplex capability
(talking and listening simultaneously) and making
telemetry and Advanced Life Support (ALS) systems
possible.
With UHF, hospital personnel and the paramedic or
emergency medical technician (EMT) at the scene
can talk freely, without having to wait for the other to
stop transmitting. The doctor can interject with in-
structions when necessary, and the EMT can ask
questions or provide immediate updates on the
patient's condition. VHF limitations do not permit this
flexibility of communications. Not only is VHF less
flexible, but because of congestion on this band,
critical transmissions are at times drowned out by
other users.
Across Texas, only 98 of the 254 counties have
hospitals with UHF base station communicationsequipment (Figure A ). However, some of these
counties may have hospital emergency rooms and
EMS units which have only VHF radios or no radio
equipment at all.
Equipping local EMS vehicles and emergency rooms
with radios is an expensive proposition. The
necessary number of radios statewide will cost an
estimated $10 million at 1986 prices.1 Delaying the
purchase would add approximately 10 to 12% to the
cost each year. In addition, maintenance, trans-
mission towers, permits, and training would increase
the estimated cost another$5 million.
In 1968, American Telephone and Telegraph
designated 9-1-1 as the "universal nationwide
number" for telephone access to the emergency
response system, whether it be fire, police or
medical emergency.2 This number was chosen be-
cause it was shorter and easier to remember under
adverse conditions than a standard seven-digit
phone number. Furthermore, as a universal emer-
gency number it would be easier for travelers and
new residents to phone for help.
As of October 1985, 33 Texas communities were
providing 9-1-1 emergency telephone access (Fig-
ure B). These 33 communities represent about 19%
of the state's population. Harris County is also1987-88 TEXAS STATE HEALTH PLAN
55
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Texas. Statewide Health Coordinating Council. Texas State Health Plan: 1987-1988, report, 1986; Austin, Texas. (https://texashistory.unt.edu/ark:/67531/metapth1586615/m1/67/: accessed July 16, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu; crediting UNT Libraries Government Documents Department.