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On Sept. 11, ED staff desperate to communicate with colleagues and family members found that cell phones and land-based lines didn’t work. Others experienced that situation even in cities thousands of miles from the disaster sites. When disaster strikes, you’ll need as many options for communication as possible, according to Dennis Swick, RN, CEN, EMT-P, EMS coordinator for emergency services at Columbus (OH) Children’s Hospital.
Here are several ways to communicate with hospital departments, staff, and other facilities during a disaster, and pros and cons for each:
• Cellular phones.
Many facilities choose cellular phones as a backup system in case the traditional phone system is non-operational, both for communication with outside facilities, as well as intrafacility uses, notes Swick. "This system is adequate for a local failure of phone service," he says. "However, when this occurs as a result of a disaster or crisis situation, cell phone capabilities are either off-line due to the disaster, or the system is used beyond its capacity and subsequently goes off-line." This occurred in the hours following the terrorist attacks in New York City and Washington, DC, reports Swick.
"This effect reached far beyond these cities, however," he adds. "In my home of Columbus, OH, cellular service was disrupted as many people attempted to call friends and family." To compound the problem during a disaster, the media often use cellular phones for computer modems and uplinks that can tie up a system for hours, adds Swick.
• Paging systems.
Swick notes that paging systems are affected the same way as cellular phones. "It is extremely common for hospitals to contact key personnel by means of a paging system," he says. "But for the same reasons stated above, a paging system would quickly become unreliable."
• Two-way radio.
Communication between the scene and the ED is typically done via cell phone or two-way radio, says Swick. "While two-way radio communication may be more reliable, it is not invulnerable," he notes. "This system can also be overused, causing communication to be difficult."
• Truncated system.
Some large metropolitan areas use a radio system called a truncated system, notes Swick. "This system is very convenient during routine times, because each hospital, each sector of the city, and in some cases each vehicle can have a defined channel," he explains. This decreases traffic on any one channel and is more difficult for nonrescuers to scan and listen in, says Swick. "The disadvantage is that this system is similar to cell phone technology and is computer-driven, so it carries similar vulnerabilities," he adds.
• Amateur radios.
One innovative solution to the problem of communicating from the disaster site to the hospital is the use of amateur radios, says Swick. "For example, the city of Columbus has included members of the Central Ohio Amateur Radio Operator’s Association in its city disaster plan," he reports. This group has a standing relationship with the Central Ohio chapter of the American Red Cross, says Swick. "In the event of a disaster, this group assigns designated [amateur radio operators] to respond," he explains. "One goes to each ED in the area, and one to three personnel go to the scene, depending on need."
Then, using their own amateur radios with their own power source, on frequencies that are typically much less busy, they communicate with each other in conjunction with the on-scene incident commander, says Swick. "They can inform a hospital when patients are en route, and hospital EDs can communicate with each other," he says. "This system results in 12-15 people who tend to know each other talking to each other on familiar terms, rather than countless EMS crews calling hospitals, and hospital radios being answered by a variety of personnel with varying levels of radio familiarity." (For information on amateur radio operators in your area, see "Sources/resources" at the end of this article.)
• The media.
If all else fails, Swick suggests asking the media to put out messages, such as asking staff to report to work early or to consider coming in if they are scheduled to be off. (For more information about how to communicate with media during a disaster, see "Assess how you convey information during a crisis" in this issue.) "The news media typically are scrambling to get any statement at all and will usually make such an announcement in exchange for the smallest statement," he says.
Swick gives the following example: "XYZ Hospital assures us they are doing all they can to prepare to handle the potential situation. To do this, they are asking evening shift nursing staff to try to come to work one or two hours early." However, Swick notes that you may encounter resistance. "Some media agencies take the stance of what’s in it for us?’ while others are very willing to help," he says. To prevent inconsistent messages, he advises cultivating relationships with members of the local media in advance.
Getting the word out via news reports also can prevent staff from showing up at the disaster site, he adds. "The natural thought is I can help out at the scene,’ when the truth is that EMS providers and the fire and police departments have protocols and training for such situations," Swick says. "Often the immediate scene area poses several hazards that hospital-based employees are simply not trained to handle."
For more information on communication during a disaster, contact: Dennis Swick, RN, CEN, EMT-P, Emergency Services, Children’s Hospital Emergency Services, EMS Program, 700 Children’s Drive, Columbus, OH 43205. Telephone: (614) 722-4350. Fax: (614) 722-6890. E-mail: SwickD@chi.osu.edu.
The American Radio Relay League (ARRL) is the national association for amateur radio and will put health care personnel in contact with local emergency coordinators of the ARES (Amateur Radio Emergency Service). Contact: American Radio Relay League, 225 Main St., Newington, CT 06111-1494. Telephone: (860) 594-0200. Fax: (860) 594-0259. E-mail: firstname.lastname@example.org. Web: www.arrl.org.