GPS: Global Positioning or Problem for EMS?

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Paramedic, educator, and friend Steve Kanarian sent me this article to share with Everyday EMS Tips readers. Have you had problems with GPS or watched partners struggle to use a map book after becoming reliant on a GPS? Read and share your thoughts about GPS in EMS in the comments. Thanks Steve.

Technology has infiltrated all aspects of our society making our lives more efficient. Emergency medical services’ use technology in all phases of our jobs. Patients call for 9-1-1 assistance using text or cell phones. Emergency calls are received by operators who use computer aided dispatch to prioritize and dispatch calls. We use electronic monitors to measure a patient’s ECG, oxygen saturation and capnography readings.

Ambulances are using global positioning systems to locate the call or best route to the hospital. Each link of the EMS system is vital in getting rapid care to the patient in an emergency and must be reliable to save lives. Our dependence on technology is underscored during disasters or blackouts where we lose communications. Technology is used to benefit the patient but not a replacement for experience and common sense.

Is GPS Reliable?

Lately I have been questioning how reliable GPS is for EMS use. GPS is definitely a nice tool to have in our arsenal when traveling in an unfamiliar area during a transport. But how reliable is GPS when depended on for rapid responses in life threatening emergencies?

I personally have experienced problems with GPS not recognizing a town or village, not having a street entered into the database or taking an out of the way route because of programming glitches. Some GPS units require the user to enter the specific neighborhood of a town or city to accurately enter the street. Most recently GPS sent me around in circles because there was a new bridge in Arlington, VA that had not been entered in the GPS database. Miscommunications between crew members can also result in ambulances going to the wrong hospital. “I thought you meant Columbia on Broadway?”

Bad satellite signals and signal interference are some of the most common glitches and happen when something gets in the line of sight between your GPS device and the satellite network. Without a clear and strong signal, your device can’t accurately establish your location. Tall buildings, dense foliage, mountains and even reflective objects can cause such a problem.

Map Books

I grew up in EMS using maps. There is always a street you have not heard of in your area or you can get sent out of your service area or town. You should always carry a map. A map offers a second source of information and a source for direction when GPS fails.

Verbal Address Entry into GPS

As an EMS supervisor I have seen problems affecting response times and patient care. A common problem causing extended response times occurs when a crew member verbally enters an address into a cell phone which brings the unit to the same street but in the next town. The EMS system is also open to variable results from GPS when each provider is using their own cell phone or GPS unit to guide them to a call. I am alarmed to see crews that operate with no map as a back-up to GPS. What do you do if GPS service is not available or the GPS unit freezes? In the end the patient suffers.

Accurate and Efficient GPS Use

GPS will locate the call location providing you enter the information in correctly and there is satellite communication available. GPS data must be confirmed when receiving the information from the dispatcher, when entering the info into the GPS unit and again while responding to the location. Similar to the 5 Rights of Medication Administration GPS data must also be confirmed and verified. A benefit of GPS is the ease of navigation when it is a location we respond to often and you can recall the location from past destinations. GPS will also take into account traffic conditions which may affect our response times. Is it best for us to go through the traffic area using lights and sirens or bypass the location? Does your service have policy for using GPS or bypassing the most direct route? Clearly the best solution is to know your service area to ensure the quickest response times. We need research looking at the reliability of GPS under emergency response conditions.

An experienced EMT or Paramedic knows his or her response area well. They have taken the time to learn shortcuts and best routes to the hospitals. What is the rookie to do? The best solution is to have your partner look up the location on a map while you are entering the location in GPS. Using your brain to determine the best route into the call area is safest then depend on GPS for the turn by turn location of the call address. If you are working solo in a response units the stress of responding quickly and both using GPS and looking the address up on the map can cost precious time.

A danger of our technology based world is that we turn our brains off and think of other things while we are driving or providing patient care. We are trained not to blindly trust the ECG monitor or pulse oximetry, we have to critically look at the GPS route and trust our instincts to question the route.

The recent crash in San Francisco clearly underscores the problem with depending on technology while performing our jobs. Asiana Air 214 pilot Lee Gang Guk told investigators after the crash that he found the approach “very stressful” and “difficult to perform” with such a large plane and the absence of an electronic system that tracks a plane’s glide path, which was down for maintenance, according to the report.

Although EMS mistakes are usually one patient at a time this plane crash dramatically shows us what happens when decision makers depend on technology and particularly when the technology is not available.

Solutions when using GPS

  • Update your GPS unit software with the latest updates
  • Make sure the address is correct when acknowledging the call location
  • Ensure the address is entered into GPS correctly
  • Have your partner look up the location on a map and guide you to the response area
  • Keep focused on the response and question GPS instructions that do not seem correct
  • Document area specific problems with your agency to avoid re-occurrence.
  • Submit inaccuracies to GPS mapping services to increase accuracy of GPS maps.

Submit Map Updates

Each year, you can expect roads to change as much as 40 percent — that’s new roads, closed roads, lane changes, you name it [source: Tele Atlas].

To correct mapping problems such as an incorrect address, or to request a change to the address for a business or home, or to add an address, please submit your corrections to these websites: http://mapinsight.teleatlas.com/mapfeedback/index.php and https://mapreporter.navteq.com/ .