They speed through the city of Paris in their distinctive red vehicles, sirens wailing, bringing emergency medical assistance to persons in need. Providing urgent medical care is an important function of the Firefighters Brigade for the City of Paris. Their well-equipped aid vehicles, referred to as 'ambulances for resusitation' provide medical assistance for persons enroute to being hospitalized. A medical doctor and trained medical assistants are onboard to provide lifesaving help. This function is similar to the medical services provided by the SAMU, another emergency aid service for the public. The urgent care sector of the Firefighters Brigade handles about 9,000 medical emergency calls per year.

For every aid call, a medical case report needs to be created and printed.

For every emergency aid call, the firefighter-medic must complete a report that contains all pertinent information about the patient: where and under what circumstances the patient was contacted, the nature of the injuries, the medical assistance provided, etc. This report is given to the attending physician at the time of arrival at the hospital. The Firefighters Bridge of Paris uses an A3 format report form to record this vital information enroute to the hospital. A copy is retained for administrative purposes, to provide statistical details, and as documentation in case of possible legal action. These reports must be filed and indexed.

Over time, the Brigade found it increasingly important to manage and store this information in an electronic format. A clerical assistant extracted pertinent details from the incident reports and entered this information in a coded format into a database. The new method enabled efficient tracking and recovery of statistical information and individual cases from the over 9,000 assistance calls made each year.

The Brigade used this archival process for ten years, but the system began to show its limitations. The data coding and entry process was time-intensive and the original report was handwritten by the attending doctor. Often the writing was difficult to read or decipher accurately.

REANIME: the solution for digital information exchange.

The Brigade chose to invest in a completely new system called REANIME, (Réseau d'Accès Numérique aux Informations Médicales Extra-hospitalières) a network-based solution to digitally collect and transmit medical information. The concept is to replace handwritten reports by entering info via a terminal and using a printer. There are two key advantages : the information is conveniently stored in data terminal and a concise, easy to read report can be printed out as needed.

The REANIME system was first installed in 2002 in two emergency aid vehicles. In January 2003, it was installed in 11 more ambulances. " The doctor enters the information into the terminal, which is installed on a special support within the aid vehicle, and connected to a printer, " explained Dr. Patrick Hertgen. " Upon returning to the Brigade facility, the data is transmitted via Wi-Fi to a central computer. The electronic file offers a number of advantages, but can also be perceived as a constraint. Certain doctors considered the data entry to be an added chore and needed to become used to a new way of working. To successfully integrate REANIME, we had to position it as a 'plus' or added-value for the medical teams. Therefore, we integrated useful documentation into the system such as quick references for medical treatments, or the medicines on-hand in the aid vehicle, " he concluded.

Thanks to the digital data entry, there is an accurate and accessible database of statistical information readily available. By phoning the emergency dispatch operator, a doctor can immediately know if a patient has previously been treated and for what specific medical problems.

Pentax PocketJet offers full advantages of thermal printing.

The Brigade's printer requirements were demanding : easy to use, durable construction, rapid print speed, compact size and easy integration with the data terminal.

The beta version of REANIME had been used with an inkjet printer. After considerable problems were encountered with the usage and print quality, the Brigade made the decision to switch to the Pentax PocketJet. They were assisted by Mégatron, the Pentax distributor in France. " There were a number of factors that led us to choose the Pentax PocketJet, " explained Lieutenant Jean-Marc Lecomte, project manager. " Above all, the speed factor. The PocketJet 200 is extremely fast compared to the previous inkjet printer- we're talking about one minute, versus three minutes. Previously, we inserted letterhead paper for each report and this took extra time. But with the PocketJet, we can just print one time, without any extra effort."

The cost of ink supplies and the related print quality was another important factor in the Brigade's decision to go with the PocketJet. Their high volume printing needs meant ongoing replacement of the ink cartridges in the inkjet printer. Given the demanding and often stressful working conditions in a moving emergency vehicle, the last thing a medic needed was the hassle of trying to change an ink cartridge. Additionally, the ink was sensitive to weather (sun or rain) and heat conditions, and created runny, illegible copies.

The thermal printing capabilities of the PocketJet were seen as highly positive, yet initially a concern in the evaluation process. Lieutenant Jean-Marc Lecomte explained " When we saw that it was a thermal printer, we were reticent because of concerns that the print would not last over time. But this wasn't true anymore, we learned that thermal printing is well preserved by using a special paper. Pentax's paper is guaranteed for 7-10 years if it is saved under proper conditions. Therefore, we could find no more disadvantages due to rain or sun !

Another major benefit was that the PocketJet 200 prints from a single roll of paper. The doctors can include graphics or pictures in the report and on A4 format paper, the images often get cut off on the page breaks. The convenient roll format equals about 100 A4 pages.

The practical design and functionality of the PocketJet was another important consideration for the high-energy work environment inside an aid vehicle. The PocketJet has no moving parts and is solidly built. The printer is installed within a support base and connected to the data entry terminal by a cable.

The Brigade is very satisfied with the REANIME system and the Pentax PocketJet printer. We have found a complementary combination of technical solutions and we look forward to making full use of them, " Jean-Marc Lecomte concluded. " From the perspective of the hospital personnel, who receive a clean, printed report instead of a hastily handwritten document, we have had nothing but positive response.

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