Tech Meets Tradition: Wristband Technology and Software Transform Emergency Response

For incident commanders, Pulsara also provides the big-picture view of how many patients have been treated, who they are, what’s been done, and where they’ve gone. That’s a valuable overview when running an MCI or mass gathering.

EMS organizations under Texas’ Brazos Valley Regional Advisory Council (RAC) – one of 22 RACs that manage EMS in the state – have been at the forefront of adopting wristbands and using Pulsara to manage major events. They implemented full use of both the wristbands and Pulsara for ambulance-to-ED communications in October 2022.

While the platform is straightforward and easy to use, there was an adjustment curve for both the EMS and hospital sides.

“For us, the first phase was just getting the paramedics to use and understand Pulsara and start building the muscle memory for it,” said Rice. “We had some pushback from the ERs – it’s change, and change is hard. But now they’ve been completely transformed positively because of it.”

The second phase for St. Joseph Health was to expand Pulsara to “preplanned disasters” – the major events that, like the Texas Renaissance Festival, will produce a certain number of sick and injured attendees even if they proceed optimally. “We know those disasters are coming,” Rice added. “We can plan for them and build a process.”

In spring 2023, St. Joseph Health EMS used the platform to provide care at Chilifest, a two-day music festival that drew over 35,000 people. Typically, it’s hard to track patients in festival situations. Providers are mainly trying to treat and release – avoid transport if possible, and just let overwrought attendees cool down, get sober or patched up, and pause long enough to feel better.

“In years past, it would be very difficult to know how many people you had in the tent, who was being treated, and their acuity level,” said Rice. “We were doing everything on paper and a few laptops. Real-time situational awareness didn’t really exist. I mean, I’d know my people were out there, I could see the trucks, and dispatch would try to keep track, but unless a supervisor came on and said he had a real problem, you’d just kind of let the event run itself. And I think that’s how most large-scale incidents in this country go.”

Using Pulsara, St. Joseph Health captured information for 34 patients at Chilifest – about half of those it saw. Not bad, but leaders felt they could do better. In October, they got the chance.

FESTIVALS PRODUCE BIG NUMBERS

Familiarity and practice with Pulsara meant being called back into action on short notice at the Texas Renaissance Festival was a manageable challenge – although the massive event would require reinforcements. “It’s like putting up another county’s worth of resources,” said Rice. “I don’t have the staff to pull that off alone.”

Photo courtesy of St. Joseph Health EMS

St. Joseph Health arranged for support from medics with the Bryan Fire Department. Because that department also uses Pulsara, they were easily integrated into care scenes and command structures and worked the same way as their St. Joseph Health counterparts. Interoperability was seamless.

Around the same time, another music event occurred in Snook, just outside College Station: the Live at the Station Festival, headlined by country artist Zach Bryan. The event itself was a bit of a debacle – but the EMS management was near-flawless. “This,” said Rice, “is where the use of the Pulsara incident management system transformed my organization. The numbers generated that day took it to the next level.”

At both Live at the Station and the Renaissance Festival, St. Joseph Health placed a dispatcher on site. Patients could access care by calling 911, walking to an EMS station, or asking emergency personnel or event staff. The dispatchers maintained high-altitude views of the cases recorded in Pulsara and functioned as liaisons with local authorities. In the past, those connections weren’t always robust – EMS providers within event grounds were often on an island and might not be called for an incident right outside the festival gates, even if they were closest. The on-site dispatcher allowed resources to be pulled back and forth.

All patients seeking help had their IDs or driver’s licenses scanned – even those with minor complaints. This provided a more complete picture of the event’s medical impact and EMS care required. “We knew who everyone was, and that’s what was amazing about it,” said Rice. “I could have 200 people with headaches or abrasions and know every single person who walked into our medical tent.”

Over October and November, with the Renaissance Festival, Live at the Station, Texas A&M football, and other events, St. Joseph Health providers became extremely proficient at using Pulsara for mass events. Their numbers were notable enough that the Texas Division of Emergency Management (TDEM) took an interest in how they did it. “When those numbers came up – one day it was 151; the Zach Bryan concert was 200 – I think they thought they were fake,” said Rice. “We only had 12 providers on scene. I think they thought we were trialing the system.”

Now TDEM is creating a regional emergency management group that will have Pulsara access when major events happen, track patients, and help drive family reunifications.

NO GOING BACK

For St. Joseph Health, the next stage of Pulsara use will involve unplanned disasters. In November, a supervisor was able to singlehandedly band, scan, and process seven carbon monoxide patients when a second ambulance wasn’t nearby (though, of course, had any been critical, their treatment would have taken priority). But more likely, the organization expects, is that dispatchers will designate MCIs based on predefined criteria and alert field units.

Looking to enhance your EMS team’s ability to coordinate care and communication during Mass Casualty Incidents (MCIs) and preplanned large events? In this webinar, an expert panel of EMS leaders from Texas, Colorado, and California share their strategies for streamlining communication and improving patient outcomes. WATCH: Streamlining Crisis Response: A Deep Dive Into MCIs And Large Events