The Dispatcher Thread

EMDispatch

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With a long night ahead, I decided to start a dispatcher thread. Hopefully it can provide some insight into what and why we do certain things.

Public Safety Answering Points PSAP Overview
PSAPs (911) centers across the US have different structures. In some locations all 911 calls are handled by a single PSAP. Other jurisdictions have a center receiving PSAP which triage calls and transfer them to appropriate secondary PSAPs for FD/EMS/PD. There a numerous variations on these 2 structures.
Depending on the size of the PSAP, they may also divide responsibilities into calltaking and radio dispatching. Smaller agencies often assign the personnel both tasks. Agencies may also handle specific FD, EMS, or PD only, or divide responsibilities among employees. Obviously smaller agencies do not have that luxury.

Emergency Medical Dispatchers
In the late 1970's agency began attempting to streamline their 911 system by introducing trained EMS personnel into their PSAPs. The goal was to effectively prioritize calls. This concept developed into training specific personnel as Emergency Medical Dispatchers (EMDs). Modern EMDs through the use of a standardized interrogation process, and specially developed instructions are able to attempt to determine the nature and severity of a call, as well as guide the caller through immediate life saving interventions.

Education/Training
The education requirements for EMDs and 911 telecommunicators very from state to state. State's generally require an approved Emergency Medical Dispatcher course. These courses are offered from the National Academy of Emergency Dispatch (NAED), and the Association of Public Saftey Communications Officers (APCO). The NAED and APCO course teach how to effectively utilize their unique designed interrogation system. These programs are taught and used internationally, the system developed by the NAED is used in 23 countries.
EMDs are also required to maintain their licensure through continuing education hours and re-certification both by the accrediting agency and their state or local agency.

EMD Interrogation
The standardized interrogation procedures utilized in EMD are based on best practices and QA validation since the systems were first developed nearly 30 years ago. The aim of the interrogation is to ensure that the EMD is able to obtain critical information ( location, and contact number),identify any potential priority symptoms ( loss of consciousness, respiratory distress,etc.), obtain a chief complaint, and provide any instructions for critical interventions.
The questions asked in the process follows an algorithm in attempt to achieve an appropriate triage level for the call. The systems err on the side of caution which often results in over-triaging of calls. It also relies solely on the information provided by callers, which may not be complete. Ideally, the system is structured to elicit all critical information.
Depending on the agency, the results of the interrogation can be used to determine the priority, type, and even if a response is necessary. Most agencies do not utilize the system fully, particularly the option to deny a response.

Interventions/Diagnostic Tools
EMDs are able to provide instructions for specific interventions. In the system from the NAED, MPDS, EMDs are able to provide:AED support, CPR, childbirth assistance, tracheostomy airway and breathing, the Heimlich maneuver, asprin administration (if allowed), bleeding control, and underwater vehicle escape.
In MPDS, dispatchers also able to track respiration, pulse, and utilize Cincinnati Pre-Hospital Stroke Scale so they can better triage calls.
Some states and agencies also allow EMDs the ability to pre-empt HEMS.

References
If you want to learn more about the justification behind EMD process etc, check out the following links:
National Academy of Emergency Dispatch:
http://www.emergencydispatch.org/
APCO:
http://www.apco911.org/

Any other questions about dispatching, EMDs, etc...ask below
 
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