Pre-hospital and retrieval medicine, with its high acuity patients, high adrenaline environment, noise levels, geographical challenges, and the unexpected nature of what each individual job can bring, creates an environment in which communication is critical; both in terms of communicating within our team, with partner organisations and the Aeromedical Control Centre, as well as with patients and their families.
Here’s a brief look at the different equipment we use for our day-to-day comms, as well as the less commonly used communication devices we have access to when needed.
Inside the aircraft
The AW139 comms box – this is the panel you’ll see beside the doctor’s seat:
Delving a little deeper
Air traffic control: Com1 and Com2 allow the aircraft to interact with the Sydney air traffic control tower and regional control towers when we’re landing elsewhere, including Bankstown. On this system, you often hear discussion between air traffic control and individual aircraft, planning approaches and runway management as well as aircraft identifying themselves to each other.
Com 3 – Wulfsberg Multi frequency radio: This is set to Eso Air 1 during complex missions which allows communication with agencies on scene. This would include hopsital security, marine radio and surf life saving.
Com 4 – GRN: Government Radio Network. This is a statewide two-way radio system that uses a digital control channel to automatically assign frequency channels to groups of users. This is the main system we use to communicate with ACC from our ground and air vehicles, as well as how we communicate with crews on scene and get updates en route.
During complex missions, Com4 becomes our simplex Helicopter channel allowing us to communicate down the wire. During a winch procedure we can turn off all lines to keep focus on the members of the team on the wire and avoid distraction.
Com 5: Com 5 allows us to make and receive phone calls via the aircraft mobile. Most often this will be used for clinical updates between our team and either the Retrieval consultants or receiving teams. In order to be able to use the mobile, we need to ensure the comms button on the overhead panel beside the comms lead connector is set to Radio not ICS.
So what about inside base and our road vehicles?
The Batphone: All primary taskings via RLTC (Rapid launch trauma coordinator) will come via this phone. Each base has one by the CADLink screens and status boards, and they ring out across the whole base, including outside areas. The batphone must ring 4 times and there must be a paramedic present to take the call. No jobs can be accepted until either the road paramedic confirms it is accessible or the pilot confirms they can complete this mission.
Top tips for Batphone etiquette:
-If not directly involved in the mission please stand back from the desk.
-Receiving a call should generate a sterile environment. Keep background chat appropriate and to a minimum; it’s all recorded by ACC.
-If the phone has rung 4 times and there is still no Paramedic present, answer the call “Sydney base: please standby for a paramedic” until they are present.
-Keep a clear passage/line of sight between the paramedic and pilot/ACM taking the job so communication is not impeded.
-Do not scroll on the CADLink screen whilst a tasking is being discussed, once the job has been identified and the detail screen opened.
GRN Radios: At all our bases there are free standing GRN radios. These can be left on State 1 or set on to local channel if we are monitoring specific jobs. Generally these will be situated beside or below the CADLink and status screens and beside the bat phones
Inside our road ambulance vehicles, each one has a handheld GRN radio. At the start of missions this will be set to the State 1 channel and allows us to speak to ACC. When tasked, the tasking details should tell us which local channel the job is being run on. Once we have radioed in to let ACC know we are on our way to scene, they will confirm the local zone and channel (for example, Sydney North). At this point we let them know we are now going to local channel in case they wish to speak to us further. Road ambulance, police and coordinators will all be on this line and you can ascertain valuable information about the job you’re heading to.
The MDT – Mobile Data Terminal: This refers to the computer device inside each of our cars. This is the system that all NSW ambulance cars are equipped with. Timings, addresses and mission details are all on this system. The big red button in the top left is the distress bell. If you press this, police immediately get notified and many people will suddenly appear! Don’t push it unless you fear for the safety of your team. There is a second duress button in the back of the car below the flexible light. It can be easily confused for the light switch but all those lights turn on by pressing on the head of the light.
The CAD and CADLink screen: Computer Aided Dispatch. This refers to the system used to manage all 000 calls that come through to NSW ambulance. The CADLink screen is the list of jobs on the computers beside the bat phones and allows us to see all 000 calls as they come through in real time, state-wide. When tasked to a primary, we identify the job, by time in the queue or location, and print or rapidly review the details as we head out. Please do not ‘surf the CAD’ whilst a job is being discussed. The large CADlink monitor is screen shared with those on the Pilots desks. If you scroll whilst a mission is being planned, their screen will also change and vital details for the flight plan may be missed and hard to relocate.
Outside our vehicles:
Aboard our aircraft, we carry various other means of communication for use in rural areas or when the medical team are separated from the aviation team and may need to communicate.
Satellite phone: The Satellite phone battery is checked every day as part of our checks and well worth taking the time to familiarise yourself with. Satellite phones have coverage over most of the earths surface and the sat phone we carry essentially works exactly as per a mobile phone with the crucial difference that you will need a clear view of the sky for it to operate. Remember, if you’re using the Sat phone on board any of the fixed wing aircraft, the number you’re calling may need to be dialled without the first zero. Allow plenty of time when using the sat phone – the delay can be similar to that when using radio communication.
GPS: Each aircraft is also stocked with a Garmin GPS (global positioning device). Initially developed by the military, GPS is now utilised in many of our own personal devices day to day but the purpose of our handheld GPS is for tracking and locating teams if they leave the aircraft and later need to rendezvous with different services or at a different location.
Down the wire: Every HEMS doctor on a helicopter shift checks their own personal handheld GRN radio each morning- checking battery levels, zone and channel. A helmet radio comms check with the paramedic should also be carried out at the start of each shift. When tasked on winch jobs, this radio becomes critical for communicating with the aircraft and air crewman. This radio is used for “down the wire comms” when winching, and in direct line of sight of the aircraft. While they can set to any channel and zone, this radio will be set to Admin zone and the Helicopter simplex channel during these jobs. Pre-winch as we disconnect our helmet headsets from the aircraft, we connect to our individual GRN radios and do a brief radio check to ensure it is working, that we can be heard clearly and understood. After winch insertion to a scene, we can use the radio to contact the aircrew and to arrange our extrication via direct communication with the crewman in the aircraft above us, and with our paramedic on the ground. While any winching is in progress, the aircraft Com3 will be set to ESOAir1 or Surf1, as per the comms plan. These will be deselected when not needed.
Extra acronyms and terms you may hear across the radio systems
ATC: Air traffic control
Visibility and cloud ceiling will determine whether pilots can use a visual or instrument approach to land (IFR or VFR).
“Cleared for….”: ATC authorisation to proceed.
SQUAWK: A squawk code is a discrete transponder code assigned, during take-off, by ATC to allow identification of individual aircraft. The name squawk refers to a historical nickname for the system first used to identify aircraft during World War II.
Traffic: As part of the crew, it’s important to always keep an eye for any approaching traffic- aka other aircraft, in your vicinity. If no one has mentioned it, speak up in case it hasn’t been seen yet. Use left or right, high or low. Often a clock face is used to identify the angle of the other aircraft relative to our position.
Mayday: The aircraft and its occupants are in immediate danger and require assistance.
Pan Pan: An urgent message regarding aircraft safety but no immediate need for assistance.
SARtime: Search and rescue time – the pilot will notify ATC of anticipated times of contact outside of which, if they don’t hear from the aircraft, they would initiate search and rescue proceedings. You might also hear the paramedic relaying a SARtime to ACC.
SARwatch: This is the generic term relating to aircraft safety and monitoring. The pilot will cancel SARwatch once safely landed to notify ATC they no longer need to be aware of them.
QNH: Air pressure at sea level.
MET: Meteorological advisory.
NOTAM: Notice to airmen.
VHF: Very high frequency radio.
Many thanks to our amazing Aircrewmen and Paramedics for their guidance in putting this article together.