Equipment & Gear, Mass Casualty Incidents, Training

Tablet Devices Have Many Benefits for EMS Providers

Issue 1 and Volume 38.

When Hurricane Sandy was bearing down on the East Coast, New Jersey EMS Task Force planner Henry Cortacans was never far from his iPad.

Before, during and after the massive storm, Cortacans, one of the key forces in the statewide EMS organization, was plotting the positions of key assets that would be used to render help throughout New Jersey.

“This is the best piece of technology to come along since I’ve been an EMT or paramedic,” says Cortacans. “They’re simple, easy to use and provide a great deal of functionality.”

Cortacans says the iPad is “critical” to his work during the storm response and has been a useful tool in past deployments as well.

The N.J. EMS Task Force is a statewide organization of more than 250 career and volunteer professionals that responds to man-made and natural disasters. Using Intermedix’s Fleeteyes application on his iPad, Cortacans was able to instantly see where each piece of equipment was positioned and where it may be better incorporated into a response plan. Moreover, the application and his iPad were key in assigning additional ambulance strike teams brought in from as far away as Indiana to help with the storm response.

“For situational awareness, there’s nothing better,” Cortacans says.

Cortacans is not alone. The digital age has transformed the EMS industry in many ways, for sure. At the forefront of that change has been the boom in tablet computing devices, led by the iPad. Apple released the first version of the iPad in 2010, and the device quickly changed the world as everyone knows it.

Other large suppliers, such as Samsung and now Microsoft, followed with a tablet device that allows users easy access to applications for tracking data, creating reports and storing information in ways that were unimaginable a decade ago.

Essential Apps
Tablet penetration is expected to reach 29.1% of the country’s Internet users by the end of 2012, according to Moreover, it’s projected that the tablet user base will go from 55 million people in 2012 to 90 million in the next two years.

The fire and EMS communities have responded to that growth with a plethora of applications that run on a variety of tablets that are geared toward making emergency operations more efficient. From BLS protocols and guidebooks to incident command system tools, more applications targeted to EMS providers are launching every day.

“I think it’s going to be revolutionary,” says Bruce Evans, interim fire chief at the Upper Pine River (Colo.) Fire Protection District and a JEMS Editorial Board member. “I’ve seen some things [recently] that tell me even more is on the horizon.”

Evans notes seeing a new series of pulse oximetry and cardiac diagnostic tools that work with iPhones and iPads at a recent EMS conference. “That was a seminal event for me,” he says, adding that he thinks these new technologies could have a huge affect on the EMS world.

For example, Masimo Corporation has developed an application that allows a special sensor to turn an iPhone into a pulse oximeter. Once it’s approved by the Food and Drug Administration (FDA), it will allow providers to use their iPhones as a primary or backup pulse oximeter and could be especially useful when multiple patients are involved at the same incident or at mass casualty incidents. And, VectraCor has introduced an application that runs advanced 12-lead ECGs (with additional views of the heart added) from an inexpensive tablet or laptop simply by attaching cables to a USB port.

Although the VectraplexECG System is currently FDA approved for a specially configured laptop, rapid development of technology in EMS means that it’s only a matter of time until a tablet version is available.

Evans is already a fan of tablet technology. In a wildland fire [or other major emergency] scenario, to have all of that mapping is absolutely critical,” he says.

Enhanced Simulation
Outside of disaster responses, tablets have also found a home in the classroom by helping students access textbooks and take tests. More importantly, the audio and video elements of tablets let students visually experience a learning scenario rather than just read about it.

“They are incredibly useful for all sorts of purposes, educational in particular,” says JEMS Editorial Board member David Page, MS, NREMT-P. “We use them in our classroom today. We have eight of them, and people in class are running around checking each other off on skills.”

Page has been part of a program within the National Registry of Emergency Medical Technicians to revamp the paramedic program and incorporate tablet testing in the practical portion of the process.

“In our case, in education, the use of it seems immediate,” Page says. “We have tons of manikins, but we need to control the manikin and tell it what to do. We can use tablets to do that.”

Cortacans has used his iPad in training scenarios as well. Earlier this year when several agencies gathered for a drill around a railroad tunnel, Cortacans was able to use the video function of his tablet to send real-time images back to command, providing a firsthand look at the incident. Had it been real, Cortacans says he would have been able to give the leadership in the emergency operations center (EOC) a view on the scene they wouldn’t normally have—and one he couldn’t have provided as easily with a laptop.

“You’re giving them the best picture possible,” he says. “There’s nothing like them seeing it with their own eyes.”

The N.J. EMS Task Force planner also used his iPad to log the position of equipment responding to a recent call at a port, where the initial report was that upwards of 50 stowaways were in a container aboard a ship. Within a short period of time on the scene, he was able to locate each ambulance that responded and report back to the EOC.

In addition, the use of Dropbox, a common cloud storage application, enables Cortacans to distribute response plans for ports, train lines and other potential disaster sites to members of the Task Force in an instant, so they can also access the plans via their mobile devices.

In many areas, EMS agencies have transitioned into doing electronic patient care reports on tablets, rather than paper or laptops used in the past. And, using a tablet device, EMS folks in the field can now gain instant access to all kinds of digital information, like weather forecasts, TV news and even direct video feeds from news helicopters—things only achievable via landline or satellite feeds five years ago.

Tablets are being used to transmit real-time images and video of patients to doctors in hospitals who can make advanced preparations on care decisions before the patient arrives in the emergency department.

There are other factors involved with the rapid adaption of tablets in EMS, too. Some of that can be attributed to the changing demographics of the employee base.

Younger employees tend to come into the EMS field already adapted to new technologies, rather than having to adapt to new ways of doing things. Moreover, they’re more likely to have already made the transition to smartphones—phones that allow access to the Internet and the use of applications. All of this makes the incorporation of tablets into field EMS work that much easier.

To that end, another aspect of tablets to be considered is the ease of use and near-immediate access to the Internet and to social media.

Putting tablets with instant Internet access in the hands of EMS providers in the field does create some additional policy work for EMS managers. Although many agencies already have programs in place to advise employees about taking and using photos in the field, the tablets change the game a bit. To be successful in this area, they’ll need to have solid social media and Internet use policies in place before handing a tablet to a provider heading out to an EMS post in the field.

The flipside of that, of course, is that consumers are now relying on social media (e.g., Facebook and Twitter) to communicate during disasters and expect emergency responders to do so as well. In fact, four in 10 respondents to an American Red Cross survey said they would use social media to let loved ones know they are safe during a disaster. Likewise, a third of the general public would expect emergency help to arrive within an hour after they posted a message on social media, and 76% said they expected help to arrive within three hours after posting on social media, according to the survey. Also, 70% of the general public felt emergency response organizations should regularly monitor their websites for emergency requests.(1)

All of these functions can now be accomplished easily from the field using tablets, Internet access and appropriate software applications.

Page believes pricing and durability of tablets may be one factor holding up more widespread adaptation of the tools in field EMS today. “Once prices decline and they get more rugged, laptops used today will fade away,” he says. In fact, many of the largest manufacturers of rugged laptops have already released tablet versions such as Panasonic’s Toughbook and GammaTech’s Durabook.

What’s Next?
“Imagine, in an ambulance, you step in, there’s an iPad on the wall [that] is accumulating information via Bluetooth and Wi-Fi,” Page says. “Then imagine being able to hit a button to Skype over to the hospital and talk directly to the doctor.”

The idea isn’t so far off.

As Evans notes, organizations can buy three tablets for the cost of one durable laptop. So they’re already economical. Likewise, proven tough cases are already on the market to protect the sometimes delicate tablets, transforming them into even more powerful devices that are dirt, dust and waterproof.

“These [devices] can do any number of things,” says Evans. “It really opens up the whole world of diagnostics in emergency services and gets it down into a small hand-held device.”

“Fact is, the future of tablets in EMS is limited only by the imagination of those using them,” says Cortacans.

“All you need is someone with a little innovation and creativity, and they’ll find many ways to use them,” Cortacans says. “Once you show it to someone, not only are they going to be shown the capabilities, but in their minds they can come up with 10 other reasons to use them.”

1. American Red Cross. (Aug. 31, 2012). More Americans using mobile apps in emergencies. In American Red Cross. Retrieved Nov. 7, 2012, from

Editor’s Note: Although this article focuses on Apple devices and mobile applications, it’s important to note that the pages of JEMS and its associated websites, Product Connect pages and Buyer’s Guides show dozens of other tablet, PC and mobile devices that are enhancing the way EMS documents, researches, reviews, revises, enhances and reports on our work in the field. For more visit