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Objective: To determine the level of wireless enhanced 911 readiness among New York's primary public safety answering points., Methods: This descriptive study utilized a simple, single-page survey that was distributed in August 2001, with telephone follow-up concluding in January 2002. Surveys were distributed to directors of the primary public safety answering points in each of New York's 62 counties. Information was requested regarding current readiness for providing wireless enhanced 911 service, hardware and software needs for implementing the service, and the estimated costs for obtaining the necessary hardware and software., Results: Two directors did not respond and could not be contacted by telephone; three declined participation; one did not operate an answering point; and seven provided incomplete responses, resulting in usable data from 49 (79%) of the state's public safety answering points. Only 27% of the responding public safety answering points were currently wireless enhanced 911 ready. Specific needs included obtaining or upgrading computer systems (16%), computer-aided dispatch systems (53%), mapping software (71%), telephone systems (27%), and local exchange carrier trunk lines (42%). The total estimated hardware and software costs for achieving wireless enhanced 911 readiness was between 16 million and 20 million dollars., Conclusions: New York's primary public safety answering points are not currently ready to provide wireless enhanced 911 service, and the cost for achieving readiness could be as high as 20 million dollars.

The federal Communications Commission (Commission) adopted a Third Notice of Proposed Rule Making ("Third Notice") contemporaneously with a First Report and Order ("First Report") that is summarized elsewhere in this edition of the Federal Register. By its Third Notice, the Commission makes a range of proposals and seeks comment relating to public safety communications in the 746-806 MHz band ("700 MHz band") and in general. The Commission invites comment on how to license the 8.8 megahertz of 700 MHz band spectrum designated as reserved in the First Report and on whether to directly license each state or use a regional planning process to administer the nationwide interoperability frequencies (2.6 MHz of spectrum designated in the First Report) pursuant to the national interoperability plan to be established by the National Coordination Committee. The Third Notice also discusses protection requirements for the Global Navigation Satellite Systems and offers proposals to facilitate use of nationwide interoperability in public safety bands below 512 MHz. Finally, because many of the automated and intelligent machines and systems on which public safety entities depend for their operations were not designed to take into account the date change that will occur on January 1, 2000, the Commission also seeks comment on how best to ascertain the extent, reach, and effectiveness of Year 2000 compliance initiatives that have been or are being undertaken by public safety entities, to better understand the nature of the Year 2000 problem and the potential risks posed to public safety communications networks. This action addresses an urgent need for additional public safety radio spectrum and the need for nationwide interoperability among local, state, and federal entities. By this action, the Commission also takes additional steps toward achieving its goals of developing a flexible regulatory framework to meet vital current and future public safety communications needs and ensuring that sufficient spectrum to accommodate efficient, effective telecommunications facilities and services will be available to satisfy public safety communications needs into the 21st century.

The Federal Communications Commission (Commission) adopted a First Report and Order ("First Report") contemporaneously with a Third Notice of Proposed Rulemaking that is summarized elsewhere in this edition of the Federal Register. In the First Report, the Commission amends its rules relating to public safety communications in the 764-806 MHz band ("700 MHz band") that the Commission previously reallocated for public safety services and in general. This action commences the process of assigning licenses for frequencies in the 700 MHz band and addresses an urgent need for additional public safety radio spectrum and the need for nationwide interoperability among local, state, and federal entities. By this action, the Commission also takes additional steps toward achieving its goals of developing a flexible regulatory framework to meet vital current and future public safety communications needs and ensuring that sufficient spectrum to accommodate efficient, effective telecommunications facilities and services will be available to satisfy public safety communications needs into the 21st century.

The Commission seeks additional comment in wireless Enhanced 911 (E911) rulemaking proceeding with respect to an ex parte presentation filed by Ad Hoc Alliance for Public Access to 911 (Alliance) on September 17, 1998. In its ex parte filing and its accompanying engineering report, Alliance has presented an approach under which the Commission would require that, if the signal from the user's provider is "inadequate" at the time a 911 call is placed through the use of an analog cellular handset, then the handset must have the capability to select automatically the strongest available compatible channel of communications for purpose of completing the 911 call. Additional comment is sought to assist the Commission in determining whether to adopt the approach presented by the Alliance in its September 17 ex parte filing. The effect of adopting the Alliance approach would be to improve reliability of 911 services to wireless customers.

One of the main features of the French emergency medical services (EMS) system as it has been developed during the last 40 years is the participation of a physician in each stage of the EMS organization. Thus, in the 100 French emergency medical dispatch centres, all calls received on 15, the national medical emergency phone number, are medically dispatched. The main advantages are: (i) better security for the caller; (ii) proper adaptation of the response to the emergency; (iii) a quicker and more efficient intervention time; (iv) the hospital is informed of the arrival of an emergency; (v) the respect of medical secrecy; (vi) a good cost-efficiency ratio in the use of intervention means. The main limitations are connected with: (i) the inaccuracy of certain calls and problems of dialogue with the caller; (ii) the poor acceptance of the system's obligations by some of the callers, patients, physicians or any other partners of the EMS organization. In the future the implementation of the multi-purpose European emergency number 112 will probably require the system's adaptation to it.

Introduction: Although general discussion of legal claims against emergency medical services (EMS) have been published, there is no literature that examines legal claims that specifically have involved base-station contact for direct medical control., Methods: A review of case law through July 1994 was conducted to identify cases that involved radio communications between a prehospital provider and a physician or nurse under the direction of a physician., Results: Only eight cases could be identified. Each case is described in terms of the event, selected pertinent legal issues, and the opinions rendered by the court., Conclusions: These few cases illustrate some important observations that indicate that there will occur an increase in the detail, role delineation, and clarification of the prehospital providers, medical directors, base-station physicians, and others who provide direct medical control to prehospital EMS providers. These findings have important implications for EMS medical directors.

This article presents an overview of several major legal issues in contemporary prehospital health care delivery and emergency medical services. It includes review and analysis of medical-legal issues in medical control; patient consent and treatment; modern emergency medical services communications; discussion of medical-legal concerns in regard to patient destination choice, diversion, and transfer; and an analysis of theories of recovery including a review of selected case histories.

The EMS community should commend the FCC for attempting to help relieve some of the frequency-congestion problems by adopting the EMRS. EMS users, however, should continue to advocate cost-effective solutions to EMS frequency-congestion problems.

The Commission has adopted rules that create the Emergency Medical Radio Service. This action was taken to redress the adverse consequences on public health and safety resulting from current crowding on emergency medical channels. The rule changes will establish a discrete radio service category dedicated strictly to eligibles providing basic or advanced life support services on an ongoing basis and thereby ensure the reliability of emergency medical communications.

This action modifies 90.38 of the Commission's Rules by expanding the eligibility of end users to which special emergency paging licensees can provide service. Hospital paging systems could not be used to inform participants in an organ donor program of the availability of a suitable organ. The Commission has decided that patients actively awaiting an organ transplant should be eligible under the Special Emergency Radio Service to receive paging service.

In sum, advocates for ERS have not made an overwhelmingly compelling case for ERS, on cost or human terms--why is it necessary that government explicitly cover ERS? Moreover, it is essential that advocates mobilize in the states and build allies, particularly in the LTC community.

In response to a petition, the Commission proposes the reallocation of forty-eight 25 kHz channels in the 928-929 and 952-960 MHz band segments to the Private Operational-Fixed Microwave Service and the Domestic Public Land Mobile Radio Service for distribution automation and wide-area control and repeater operations, respectively. The spectrum from 928 to 929 MHz is presently reserved for Land Mobile. The 952-950 MHz band is currently allocated to the Private Operational-Fixed Microwave Service and the International Control Services.

Radio communication problems in EMS run the spectrum from annoying to deadly. Dedicated radio frequencies for EMS, much like those exclusive to police and fire departments, are long overdue.

This document amends 2, 90, and 99 to allocate high frequency (HF) frequencies to be used by the States, Territories, and Possessions in meeting disaster communications needs. This action is necessary to provide these entities with frequency resources needed to fulfill disaster communications requirements.

This action changes rules in the Special Emergency Radio Service to permit the limited use of bio-medical telemetry systems on certain medical services VHF frequencies. The operation is to be allowed only beyond fifty miles from the center of urbanized areas of 600,000 or more population (U.S. Census of 1970). The bio-medical telemetry system is used to send electrocardiograms from patients to hospitals.