Miss M.G. Ferguson, Peterborough Street Ambulance Control Room, Christchurch, photograph taken at time of her retirement after 25 years service, November 1975.(photo courtesy of the Christchurch Star and Canterbury Museum)
AMBULANCE COMMUNICATIONS THROUGH THE DECADES – FROM THE 1950S TO NOW
1950s
- Sole ambulance officers would receive their own 111 calls.
- As they left the ambulance station to attend an emergency callout, the ambulance officer would contact their on-call colleague to come in and hold the fort at the ambulance station. If there was another 111 call in the meantime, the telephone operator would advise the caller that the ambulance service was very busy and their call would be passed on as soon as possible.
- Hospitals would receive 111 calls and would contact the duty ambulance officers by telephone.
- Ambulance officers would carry a supply of coins so they could call from phone boxes to keep in touch and receive updates.
1960s
As an example of ambulance communications in the 1960s, the ambulance control room in Christchurch had four telephones in a very small room.
- The room was sound proofed with sawdust
- The phone for 111 emergency ambulance calls was red
- Another line was direct to the local hospital
In another example, all around the Waikato Region local arrangements were in place with emergency calls going to rest homes, hospitals and other establishments in each town. They were passed to ambulance officers who were often on-call at home. Many of the ambulance stations were volunteer stations.
- In Hamilton there was only one officer on duty at a time. As they left the station, the ambulance officer would contact their on-call colleague to come in and hold the fort. If there was another 111 call in the meantime, the Telecom operator would advise the caller that the ambulance service was very busy and their call would be passed on as soon as possible.
In the Southern Region of the South Island, 111 calls for ambulance were transferred to local hospitals, e.g. Lawrence and hospital staff would call ambulance officers.
1970s
In Auckland, dispatch in the 1970s was by phone if ambulance officers were at the ambulance station or by radio if they were in transit. Every station had two phones – one red and one black. The red phone was only for contact with the Auckland region’s communications centre (then called control room) and the black was for other use including routine calls. Tone calling of vehicles was introduced during this period.
111 calls in Hamilton were taken in the St John ambulance station staff room.
In Dunedin in the 1970s, push buttons on the emergency telephone in the ambulance control room showed the status of the ambulance that has been responded to an emergency. The number of the ambulance was in the top row. At each step in the process – e.g. when the ambulance was dispatched, when it arrived at the scene, when it transported the patient etc, the dispatcher would press the button to change the colour of the button as appropriate. The system also recorded the time onto a dot matrix printer tape. At midnight, a switch would reset the job numbers back to 01.
The Christchurch ambulance control room was improved, serving the Greater Christchurch area.
- A telephonist known as Miss M.G. Ferguson received and coordinated the 111 calls for ambulance during the day. Ambulance night crew looked after phones at night.
- A member of the night crew slept in the control room between 11pm and 6am to take calls.
- The phones only worked as far as Papanui. Beyond that, there was a flag system on the Belfast Pub (a red flag was a sign for ambulance crews to go back to the ambulance station).
- There were radios between the ambulance station and ambulances but they were not reliable and did not work well out of town. For instance, they did not work beyond Amberley.
- To reach an ambulance for the next job, the control room would often telephone the hospital to see if the ambulance was there so they could be sent on to the next job.
- Ambulances were dispatched from within the ambulance station by the call taker, who used an intercom into the station. Calls were logged in a manual log book.
- The only information collected by the call taker was the address, telephone number, and if possible some information about what had happened. There was no system for providing information to the ambulance crew about what had happened and what was wrong with the patient before they arrived on scene.
- The hospital was not contacted to be informed that a patient was on his/her way, unless the ambulance crew called the hospital from the patient’s home – using the patient’s phone.
1980s
The then regional Auckland Ambulance communications centre handled calls manually, with calls written onto cards and handed to the dispatcher ready for call out.
- In the early 1980s, in conjunction with a company called ECONZ, the first Computer Aided Dispatch system for ambulance in the Southern hemisphere was introduced. The phone system was upgraded by Telecom into a custom built system labeled by staff at the time as the “Tardis” because it was so large. The phone system was revolutionary for the ambulance service in that it moved away from just being a normal phone to a system that allowed multiple calls to be taken, calls put on hold and integrated handling of the radio as well.
- The computer system introduced was capable of taking details of dispatching and collating information relating to a 111 ambulance callout and of managing the roster for the Ambulance Service. It was, however, only a dispatch system. It had no capability for collecting information. A callout data was deleted at midnight and a new day began.
- At this stage the communication centre was responsible for Ambulance dispatch, rostering, monitoring medical alarms. It also provided a call centre service for after hours doctors.
- The “Tardis” in the Auckland Communications centre was so complex that a Telecom technician spent over 6 months wiring it up (he is now a St John volunteer). The building itself was specially constructed with floor, ceiling and walls being foot thick pre-stressed concrete and sitting on rubber pads for earthquake resistance.
- The first computers used in the room until the early 1990s were Fujitsu brand and the actual computer had the keyboard sitting on top of it on the desk. This meant it was absolutely forbidden to eat or drink at the consoles as a spillage could be disastrous.
The then Waikato Ambulance Service set up a small communications centre and employed full-time communications officers (called control officers) for the first time. Four staff maintained a rotating roster for many years – covering each other’s sick leave and holidays.
- All control officers in the Midland Region held National Certificate qualification which enabled them to make provisional diagnoses, advise callers and to guide road staff at times.
- The control officers would set off the appropriate pager for each officer using a tone-calling device. The officers would then phone in for job information.
- An example of a heavy workload in that time: 72 ambulance callouts in 24 hours (largely due to the Edgecumbe earthquake). A control officer of the time remembers thinking they were “pretty busy” at a time when the daily average was around 60 callouts in 24 hrs.
- A simple ECONZ computer system was used from the 1980s through to 1998. At midnight it provided a printed daily log of each job on multifold paper using a noisy dot matrix printer.
- Contacting ambulance officers moved to the Telecom tone-paging system during this decade.
- A robust custom built telephone system that took us into 1998 was built and maintained by Concord Technology of Hamilton.
- In the late 1980s air ambulances made an appearance in Hamilton and Taupo. The role of the control officer changed to include new skills related to determination of air ambulance need against ACC criteria and the dispatch and flight-following of helicopters.
- Within a few more years, helicopters enhanced ambulance operations at Gisborne, Rotorua and Tauranga.
An ambulance officer tells of his experience with 111 calls in Whangamata from 1985 to 1988:
- “In Whangamata at that time we answered our own 111 calls locally. This duty was shared between 3 or 4 locals. The calls were transferred to people’s home or business phones. At that time, I owned a takeaway bar and we would quite often answer the phone there not knowing if the caller would want fish and chips or an ambulance! The crews were alerted by a portable radio which triggered a transmitter installed in a local’s attic up on a hill.
- “This set off tone-only pagers and the crew would phone in for details. At that time there were no radio communications at all on the Eastern side of the Coromandel Peninsula. You would travel for at least 45 minutes with no communications at all until you got to Kopu, ten minutes from Thames Hospital.”
The Wellington Free Ambulance Communications Centre, then called the control room, was a small room in Cable Street
- Calls received included 111 calls for ambulance, routine and administration calls
- The control room had direct lines to Police, Fire and Wellington Hospital
- Three radio channels were linked together
- There were no portable radios; vehicle radios could be ‘tone called’ i.e. air horns would be blasted if they went unanswered
- The control room was crewed by one person, with a manager on duty Monday-Friday 8am-5pm. The Ambulance Operations manager could take a call if required
- The Control Room also housed the Manager, who issued medical supplies and other supplies, and collected case records.
Radio telephones between the Christchurch ambulance control centre and ambulances improved
- The control centre had a large radio with different channels on it, e.g. one for North Canterbury, one for Mid Canterbury and one for South Canterbury).
- The control centre and ambulances had to switch between channels and you had to hope that the ambulance remembered to switch channels if they went from one channel’s ‘zone’ into another.
- There was no training for control centre staff in this early period, because there was no division between the work of ambulance crews and control centre work, with the exception of the telephonist.
In Invercargill / Oamaru, 111 calls were received by the hospital telephonist and ambulance crews were paged.
- Paged crews phoned the Operator and were then connected to the 111 call
- Crews on call at home at night had 111 calls transferred to their home phones.
1990s
In the 1990s a system known as VisiCAD was installed in the then regional Auckland Ambulance communications centre. This was a big change for ambulance communications as it provided electronic mapping and data storage. The centre itself was upgraded in the late 1990s to provide for expansion.
In the Waikato number of stations that formed the Waikato then Midland Region grew throughout the 1980s and 1990s.
- The workload of the sole charge control officer grew proportionately. The role became a very specialised task with broad operational and procedural knowledge a necessity with the control officer often acting as the regional "watch manager" during the night and weekend hours.
- Sepac units were used – they had a push button for each stage of an ambulance callout and a modulated tone was sent back to the control room where a simple device interpreted the ambulance status by a numeric code. Experienced control officers came to recognise the modulated tones for each stage and did not need to read the output screen to know what the ambulance was doing.
- A strange skill that experienced control officers developed was the ability to “know” when an ambulance was about to call – a canny combination of unconscious time calculation and institutional knowledge. Just as the control officer would think “Where is ambulance x?”, the officer would report in.
- Improvement in telecommunications saw more stations able to page ambulance officers as time went by, reducing the number of telephone calls required.
- Tone pagers became more reliable in remote areas and it was still reassuring for the volunteer officers to be able to phone in to discuss job details and strategies.
- In 1997 the increasingly shaky old computer system was dismantled in favour of specialist despatch software by a San Diego company, Tritech – the software called VisiCAD was designed for emergency service use in the United States and promised significant improvements in mapping and data recording / retrieval.
- The VisiCAD system was in use in Midland Region up until the Regional Operations Centre closed on 22 February 2007.
In Wellington during the 1990s, there was initially only phone and radio dispatch. There were no pagers and the communications centre was single-manned after midnight.
In Otago, until 1992 calls came into the ambulance station through a phone switchboard. All information was handwritten onto cards and then copied in to a log book.
- In 1992, ambulance communications changed to Computer Aided Dispatch (CAD). The call taker then entered the information into a computer system rather than handwriting.
- In 1994, the Otago Ambulance service merged with Invercargill / Southland.
- Two crews in Invercargill worked at night and, if both crews had to go out, they had to divert calls to the hospital because one of the crews was also the call-takers.
- In 1994, Tait 20/20 radios were introduced so that crews could push a button to indicate at what stage they were at with a callout.
- The modern Ambulance Communications Centre came into effect in November 2006 and the Dunedin Communications Centre closed.
