Region II Communication System

What is CMED?

CMED (Central Medical Emergency Direction) relies on a network of radio towers set up strategically throughout Central Massachusetts (EMS Region II). Through these towers (see map) an ambulance can contact CMED via radio and request entry notification to a hospital of destination. This provides physician access and ensures that the emergency department is aware of the patient's pending arrival. CMED also plays an important role in coordinating EMS response to Mass Casualty Incidents and patient distribution from the scene to the hospital. CMED is crucial to the coordination of communications between ambulances and hospitals and ultimately contributes to optimal patient care.

Region II CMED Operations Continuing Education Program, View Details...

Technical design

The Central Massachusetts EMS communications system consists of radio base stations (towers) and dedicated telephone lines controlled by computer operated consoles at the CMED operations facility. This system was designed to provide communications over a wide and varied geographic region while minimizing radio frequency congestion.

A standard ambulance radio and antenna operating on the UHF/VHF medical channels can access the system within the entire region with adequate communications quality. It's important to know the design limits of the system, and use appropriate equipment with the system in order to ensure satisfactory communications.

The CMED Operator

The CMED console is controlled by EMT operators who are responsible for professional and accurate coordination of medical communications in the Region. They record data for call tracking, database and quality assurance purposes. In a multiple agency response situation or a disaster, the CMED operator is a critical link in the communications chain, facilitating interagency and regional communications.				Tina Dixson, EMT-I CMED Supervisor
Asa Buck, EMT-B, CMED Operator (M-F 7 am-3 pm)	Derek Marois, EMT‑B CMED Operator (M-F 3-11pm)	Sue Anderson, EMT-B, CMED Operator (M-F, 11pm-7am)	Brian Bardell, EMT-B CMED Operator (per diem)	Mairead Colemen, EMT-B CMED Operator (per diem)
Ashley Falvery, EMT-B CMED Operator (per diem)	Lisa Florio, EMT-B CMED Operator (per diem)	Terri Gough, EMT-B CMED Operator (per diem)	Kim Seymour, EMT-B CMED Operator, (per diem)	Sarah Plant, EMT-B CMED Operator (per diem)
Samantha Howe, EMT-B CMED Operator (per diem)

Entry Notifications

No emergency patient should arrive by ambulance at a hospital without notification through CMED. Entry notifications should be early and brief, indicating an estimated time of arrival (ETA), the patient's age, sex and chief complaint. Only essential information needed for appropriate patient preparation should be relayed. A full patient report should be given to staff upon transfer of patient care at the hospital.

Medical Direction

On-line Medical Direction refers to direct radio or telephone communication with a medical control physician for patient management consultation. EMTs at all levels may request CMED facilitated medical control when indicated per protocol or when medical advice is needed. Medical control contact must be documented on the patient care report and the physician's signature must be obtained.

Responsibilities of EMS Providers

• The proper use of communications equipment is essential to effective system operation.
• EMTs have an obligation to understand the regional EMS system.
• They are also encouraged to contribute to the success and advancement of the system. Participation in regional committees and suggestions as to how to improve patient care is second only to the delivery of patient care.
• Once medical control and direction has been established with an appropriate physician, the EMT may request a change in medical control only if technical difficulties prohibit further contact with that physician.
• Questions about medical control on a specific call should first be discussed privately with the physician involved. EMTs may also wish to consult their own service medical director.
• Unresolved issues may be directed to the regional medical director.

Responsibilities of Hospital Personnel

Hospital personnel who utilize the CMED system have an obligation to understand the EMS system and the skills and capabilities of the EMTs with whom they are communicating. Medical orders must be given directly by a physician who is identified as the medical control physician. All physicians providing medical direction should receive formal training in radio communications from the hospital, including the importance of concise, confidential transmissions. Medical Control Physicians are expected to have thorough knowledge of the most current Massachusetts Pre-Hospital Treatment Protocols and be willing to participate in case reviews.

Priority Call Guidelines

PRIORITY ONE (Immediate Life Threatening)

Cardiac Arrest	Acute Pulmonary Edema
Unstable Cardiac	Respiratory Arrest
Major Head Injuries	Airway Obstruction
Multiple Trauma	Anaphylaxis
Unstable GI Bleed

PRIORITY TWO (Life Threatening)

Suspected Cardiac	Unstable Medical (e.g., hypoglycemia)
CVA	Symptomatic Cervical Injuries
Coma (unknown etiology)	Suspected Fractures/Dislocations of Joints
Unstable Trauma

PRIORITY THREE (Non-Life Threatening)

• Stable trauma:
  • Minor Lacerations and Soft Tissue Injuries
  • Suspected Minor Fracture without Circulatory or Nervous System Compromise
• Other Non-Acute Medical Complaints

PRIORITY FOUR (Stable)

• Interagency Transfers
• Direct Admissions

Tower Map

                      Region 2 CMED Radio Tower Locations

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