What Are the Dispatchers Thinking?

[Yarbo]

No, I personally don't think dispatch questions are more important then focusing care on the pt. Espically questions about PMH/allergies. Stuff you prob won't know unless the pt is a family member or friend. Pt status can easily change between the time you gave info to the dispatch and the time the medic gets there. The medic should do their own assessment when they arrive, instead of relying on info that might be reliable from someone who might be in the medical field

So, you're not going to do radio patches anymore or give a patient report to the nurse? They should do they own assessment. Lol

Constant communication is important in the chain of survival.

 

[BF2BC EMT]

So, you're not going to do radio patches anymore or give a patient report to the nurse? They should do they own assessment. Lol

Constant communication is important in the chain of survival.

Dont know where you got that from.

Most of the time when an off duty emergency happens and you happen to be on scene questions about PMH/allergies will be useless as you probably don't even know the pts name. Your time(in a true emergency) would be better helping the pt with the tools you have. All I'm saying, nothing about handing off report, get real.

 

[EMT11KDL]

Dont know where you got that from.

Most of the time when an off duty emergency happens and you happen to be on scene questions about PMH/allergies will be useless as you probably don't even know the pts name. Your time(in a true emergency) would be better helping the pt with the tools you have. All I'm saying, nothing about handing off report, get real.

also, once the medics/emt get there, i usually give a hand off report with 99 percent of the information that they are going to need.

 

[DrParasite]

oh, i can't believe I missed this thread:

Has anyone responding as a Good Samaritan off-duty been asked twenty or more questions by dispatch?

yep, almost every time I have called 911. answered every question, often before they even asked it. and when I forgot to say if the person was conscious and breathing, they called me back to ask it.

What really frustrated me were the inane questions that dispatch wanted to ask me as I was providing care. Normally if I had a qualified partner it would not have been that bad but as I was pretty much running the show and the dispatcher was NEGATIVELY AFFECTING my ability to HELP THIS DYING MAN.

I understand the need to collect pertinant data but if identify yourself an an EMT, Paramendic, Nurse, Doctor and ask for an ambulance shouldn't they send one? If you mention that you are the only one working on an unconscious choking victim does it really make sense to have you STOP to find out the persons exact age or drug allergies?

do you know what to do? does an OB/GYN know what to do? what about a podiatrist? both are doctors. what about an ortho RN. does she know what to do in an emergency? lets say you are on the ambulance, and get the report that a doctor is on scene. will you take orders from him on a critical patient? what if the doctor is a proctologist, than what?

Do your thing, give the dispatcher the information he or she needs, he will get the resources you need. it should take less than 2 minutes. when in doubt, have someone else call 911 and give all the information (some of which will be relayed to the ambulance crew) to the dispatcher, while you save a life. not really rocket science here.

As someone that has been in a slightly similar situation, I don't give a damn. In my case, if I call in and say, "Hi, I'm an EMT on a call with ABC ambulance service and need a paramedic response," I don't care what the computers want. I want paramedics dispatched, an ETA (and, no, "They're responding with lights and sirens" is not an ETA, and I almost ended up requesting to speak to a supervisor due to that and other comments made), and the ability to hang up the phone.

As someone who dispatches now after several years on the ambulance, I can honestly say unless you are on a BLS ambulance, treating the patient, and requesting a paramedic intercept, I will treat your call just like I would treat any other civilian. If you are on the ambulance, I will need nature, location, age, and sex of the patient, and then you will get your paramedic unit.

You won't get an ETA, since I don't know what their ETA is (liability reasons too), as they can get diverted or stuck in traffic, etc. You can speak to my supervisor too, and he will tell you the exact same thing.

Unless I know you personally, you are a random civilian and are screened as such. Even if you are calling from a facility, you still get screened. All too often I get clinics calling for paramedics, and it's the secretary or the tech calling for the Doc, who just want an ambulance transport to the hospital. And yes, I have agency policy backing me on that too.

...and it could mean the difference between me transporting or waiting for paramedics.

never ever ever wait for paramedics. if they are not there when you are ready to go, start going to the hospital, meet the paramedics enroute. that's why ETA's don't matter. They will get there when they get there, and a dispatcher giving you an ETA won't help you. If you are ready to go, meet the paramedics enroute to the ER, or call the ER and let them know what you are bringing in.

Why would an IFT company need portable radios?

how else are you expected to contact dispatch for routine operations?

I'll do you one better, if you are picking up a patient on room 321 of a SNF, called in as a BLS fever who needs to go to the hospital/Doctor's office, and you get there to find them 80 years old, grossly diaphoretic, AMS, with the nurse saying he was fine 10 minutes ago, wouldn't you want to contact your dispatch center and request ALS? or to ask for a 2nd truck for the 400lb patient? you expected to run back to the truck to call for help?

Radio/nextel/agency provided cell phone, doesn't matter, as long as you have a company issued device to contact your dispatch center

I think the biggest difference that's going on here is 911 vs. IFT dispatching. I never have worked IFT so I don't know how exactly it works. We are required to do 12 hours in dispatch annually so I'm pretty familiar, although not proficient by any means, with our 911/EMD dispatching system.

with all due respect, unless you have actually sat in the chair, and dealt with some of the callers over the phone, trying to pry accurate information out of them, you don't know squat. You might see it done, might even think you know how to do it all, but sitting in the dispatch center for 12 hours watching is a lot different than spending 12 hours answering phones.

I dispatch at times, we don't EMD calls if a medical provider is on scene. EMD is designed to instruct bystanders. If you tell me your a nurse or an EMT that should remove you from any liability, they have identified themselves as a medical provider on scene, it isn't a dispatchers job to determine if the caller is or isn't what they say they are.

should, but doesn't, because you don't know if the person is really a medical provider. Ever had a "nurse" call, but when the crew got there, it was a nurse assistant? or a medical professional call, but they turned out to be a lifeguard with CPR training? That's why everyone gets treated the same, just like they are a civilian (until some reputable person gets on scene and confirms what is going on).

Usually due to cartain dispatchers acting (intentionally or not) like field crews de facto supervisor, when in fact, they are support staff.

umm, that's because they sorta are (kinda but not really).

who tells the unit where to go? dispatch. who is responsible for making sure the unit makes it to the scene, and on time? dispatch. if a unit is on scene for an extended period of time, who is responsible for making sure they are ok, and keeping abreast on what the situation is? dispatch. for IFT who handles scheduling of runs? dispatch.

are dispatchers support staff? absolutely. they are an essential part of the EMS operation. they are also responsible for resource management, keeping track of all the units, making sure everyone is safe, and coordinating additional resources with other agencies on major scenes. Sound like another job description you know?

 

[JPINFV]

As someone who dispatches now after several years on the ambulance, I can honestly say unless you are on a BLS ambulance, treating the patient, and requesting a paramedic intercept, I will treat your call just like I would treat any other civilian. If you are on the ambulance, I will need nature, location, age, and sex of the patient, and then you will get your paramedic unit.

Strange, because I was on a BLS ambulance at a facility, treating a patient, and requesting a paramedic intercept. I have no problem giving nature, location, age, and sex of the patient. What I don't want is to run through various EMD questions like, "Is the patient breathing?" The patient may have been breathing when I left the room (and in this case it was, stand in the door way and go, "Ok... we need to go now. Approach patient with shortnes of breath, tripoding, and accessory muscle use to initiate care, patient adamantly refusing nearest hospital in the hope that she wouldn't be sent back to current facility), but if something changed then me getting back and helping my partner is infinitely more important than answering questions that should have no bearing on whether paramedics are dispatched or not.

You won't get an ETA, since I don't know what their ETA is (liability reasons too), as they can get diverted or stuck in traffic, etc. You can speak to my supervisor too, and he will tell you the exact same thing.

Then it seems to reason that no one should ever get an ETA. Transporting to a facility? Nope, can't give an ETA because I might hit traffic while transporting. That sounds like a complete cop out from someone who should know where the closest unit is. Now, if that was my only problem, then I wouldn't have cared. However I was initially refused paramedics ("Hi, this is ABC Ambulance requesting a paramedic escort [the term "paramedic escort" is specifically used in the protocol and policy book to describe a patient being transported with paramedics]." [in a somewhat snotty voice] "We don't do those"). Now add on EMDing a BLS ambulance AND refusing an ETA...

Unless I know you personally, you are a random civilian and are screened as such. Even if you are calling from a facility, you still get screened. All too often I get clinics calling for paramedics, and it's the secretary or the tech calling for the Doc, who just want an ambulance transport to the hospital. And yes, I have agency policy backing me on that too.

Wow, so a dispatcher is allowed to overrule a medical crew on a treatment decision despite never seeing the patient (including an ambulance crew), but you don't want the liability of giving out an ETA? Want to take a guess at which one I think has more liability, refusing to dispatch or refusing an ETA?

never ever ever wait for paramedics. if they are not there when you are ready to go, start going to the hospital, meet the paramedics enroute. that's why ETA's don't matter. They will get there when they get there, and a dispatcher giving you an ETA won't help you. If you are ready to go, meet the paramedics enroute to the ER, or call the ER and let them know what you are bringing in.

How, pray tell, do you plan on arranging a mid transport meet up in an area not set up at all to arrange a mid transport meet up? Should I call the fire ambulance on my fire dispatch radio that I don't have? Call 911 on my cell phone after getting off the phone at the facility? The area that I worked in for most of my time did not operate in that fashion, for good, bad, or indifferent.

how else are you expected to contact dispatch for routine operations?

If out of the ambulance, cell phone and 1-800 number or land line at the facility.

 

[JPINFV]

who tells the unit where to go? dispatch. who is responsible for making sure the unit makes it to the scene, and on time? dispatch. if a unit is on scene for an extended period of time, who is responsible for making sure they are ok, and keeping abreast on what the situation is? dispatch. for IFT who handles scheduling of runs? dispatch.

are dispatchers support staff? absolutely. they are an essential part of the EMS operation. they are also responsible for resource management, keeping track of all the units, making sure everyone is safe, and coordinating additional resources with other agencies on major scenes. Sound like another job description you know?

Oh, can't believe I missed this one.

If I'm calling 911 for a paramedic response, than the 911 dispatch is certainly not my supervisor. It's not even support staff. It's someone who's going to push a few buttons, speak into a different microphone, and start paramedics to my location because a member of the EMS system is saying, "We need paramedics at this location for our patient."

 

[Nervegas]

Older thread, but ill toss in my views. I have only needed to call in off-duty a handful of times, every time I have just told someone else to call 911 and gone off to do my own thing. Usually there are enough gawkers to just get someone else to handle the phone call thing.

And with EMD dispatching that the OP was referring to, the box is already on its way before they start asking all of the EMD questions. On our dispatch youll hear "Medic XXX need you en-route to XX for a priority 1/2 whatever the caller stated or unknown medical." While we are on the way, they will update us with further information, and alter the priority accordingly.

 

[DrParasite]

Strange, because I was on a BLS ambulance at a facility, treating a patient, and requesting a paramedic intercept.

Ahh, I see, you were on the the IFT ambulance, and instead of contacting your dispatch center to call for ALS, you called 911. IDK if that's your company's policy or standard practice, but it might have led to some confusion.

Typically, if we receive requests for ALS, they come from the IFT's dispatch center, not from a private 911 cell phone. In fact, I think I have received only one such call and we sent a paramedic unit to meet up with them (once I figured out what they wanted)

Then it seems to reason that no one should ever get an ETA. Transporting to a facility? Nope, can't give an ETA because I might hit traffic while transporting.

pretty much while when I'm on the truck, I either give a longer than I need ETA (when 2 minutes away, gave dispatch a 5-7 min ETA), or didn't give an ETA, just my present location. They can guess my ETA, but that's on the other person, not me. but when you are on an IFT, you are on a schedule, so ETAs are important because other runs need to be scheduled around them.

That sounds like a complete cop out from someone who should know where the closest unit is.

Not a cop out at all, just reality. I know what unit should be closest. but if i'm working as a calltaker, I might not know what else is going on in the city/county, as the dispatchers handle it. not only that, but if you need an ALS unit, and next door to you a person has just been shot 3 times, the medic unit might end up getting diverted to them.

plus I can give you a 4 minute ETA, but when they get delayed by a train, or get flagged down for an MVA, or can't start the truck when they try to respond and a next due station needs to be sent, who are you going to yell at? that's right, the dispatcher who gave you the 4 minute ETA.

Now, if that was my only problem, then I wouldn't have cared. However I was initially refused paramedics ("Hi, this is ABC Ambulance requesting a paramedic escort [the term "paramedic escort" is specifically used in the protocol and policy book to describe a patient being transported with paramedics]." [in a somewhat snotty voice] "We don't do those"). Now add on EMDing a BLS ambulance AND refusing an ETA...

sounds like you had a bad day, maybe you should get a job in dispatch and show them how it's done?

Wow, so a dispatcher is allowed to overrule a medical crew on a treatment decision despite never seeing the patient (including an ambulance crew), but you don't want the liability of giving out an ETA? Want to take a guess at which one I think has more liability, refusing to dispatch or refusing an ETA?

you can't be sued for refusing to give an ETA. and yes, a dispatcher can overrule a civilian on the phone. an EMT on an ambulance is a little shady (and no, I have never EMDed an ambulance on scene, usually get the info asked for above + call back number, agency name and ambulance number), but then again, most ambulances go through dispatch to request paramedics, they don't call 911.

How, pray tell, do you plan on arranging a mid transport meet up in an area not set up at all to arrange a mid transport meet up? Should I call the fire ambulance on my fire dispatch radio that I don't have? Call 911 on my cell phone after getting off the phone at the facility? The area that I worked in for most of my time did not operate in that fashion, for good, bad, or indifferent.

sounds like you worked for a :censored::censored::censored::censored:ty service who didn't believe in giving you the tools needed to do your job properly. sucks for you, I wouldn't work there.

If out of the ambulance, cell phone and 1-800 number or land line at the facility.

see previous statement.

If I'm calling 911 for a paramedic response, than the 911 dispatch is certainly not my supervisor. It's not even support staff. It's someone who's going to push a few buttons, speak into a different microphone, and start paramedics to my location because a member of the EMS system is saying, "We need paramedics at this location for our patient."

if you are an IFT service, than the 911 dispatcher isn't your semi-supervisor, your IFT dispatcher is. the 911 dispatcher is responsible for all the 911 vehicles, not the private vehicles that aren't in his or her system.

and if you are an IFT truck, you aren't IN the EMS system, you are in the Interfaciliy transport system. You have your own policies, your own dispatcher, your own supervisor, and your own priorities, completely separate from the 911 system.

But I stand by my original statement, if med school doesn't work out for you (and I honestly hope you become an MD and don't have to deal with IFT ever again, especially private IFT companies because they generally suck), you should get a job in dispatch, to show them how it's done. it's a little more complicated than pushing buttons and speaking into microphones, but without ever having to do the job, you wouldn't know that.

 

[JPINFV]

Ahh, I see, you were on the the IFT ambulance, and instead of contacting your dispatch center to call for ALS, you called 911. IDK if that's your company's policy or standard practice, but it might have led to some confusion.

Standard practice for that area. Never had an issue with it outside of that one time.

plus I can give you a 4 minute ETA, but when they get delayed by a train, or get flagged down for an MVA, or can't start the truck when they try to respond and a next due station needs to be sent, who are you going to yell at? that's right, the dispatcher who gave you the 4 minute ETA.

That's a "stuff happens." On the other hand, I guess the take away message is to say, "BLS ambulance needs paramedics at _____ for a __ y/o male/female for ____," and hang up after confirming that that information has been received. After all, why stay on the phone if dispatch isn't going to tell me anything useful. It will also prevent me from "having a bad day" when the dispatcher can't figure out how to do her job.

sounds like you had a bad day, maybe you should get a job in dispatch and show them how it's done?

Yes, I'm having a bad day because a dispatcher didn't know how to do her job. That's my fault that apparently the dispatcher has a stick up her butt.

you can't be sued for refusing to give an ETA. and yes, a dispatcher can overrule a civilian on the phone. an EMT on an ambulance is a little shady (and no, I have never EMDed an ambulance on scene, usually get the info asked for above + call back number, agency name and ambulance number), but then again, most ambulances go through dispatch to request paramedics, they don't call 911.

Yes, because playing telephone with dispatch instead of calling 911 directly makes a whole ton of sense. If I've gotta talk to someone in order to get paramedics, I might as well talk to someone who can actually get me the resources I need instead of calling someone else to get me the resources I need.

sounds like you worked for a :censored::censored::censored::censored:ty service who didn't believe in giving you the tools needed to do your job properly. sucks for you, I wouldn't work there.

It's the county rules, not the service. Of course aren't you from the state that still lets ambulances respond without even an EMT on board? Pot, meet kettle. After all, who would work in a state with such asinine and archaic rules like that?

see previous statement.if you are an IFT service, than the 911 dispatcher isn't your semi-supervisor, your IFT dispatcher is. the 911 dispatcher is responsible for all the 911 vehicles, not the private vehicles that aren't in his or her system.

and if you are an IFT truck, you aren't IN the EMS system, you are in the Interfaciliy transport system. You have your own policies, your own dispatcher, your own supervisor, and your own priorities, completely separate from the 911 system.

But I stand by my original statement, if med school doesn't work out for you (and I honestly hope you become an MD and don't have to deal with IFT ever again, especially private IFT companies because they generally suck), you should get a job in dispatch, to show them how it's done. it's a little more complicated than pushing buttons and speaking into microphones, but without ever having to do the job, you wouldn't know that.

I never said dispatch was easy, but I don't have to be in dispatch to know that telling a crew, "Sorry, we don't do that" when using a term verbatim out of the protocol/policy manual (that is county wide, not company specific) is... well... stupid. Especially when the meaning is clear. You don't need to be in dispatch to realize that asking an ambulance crew, "Is the patient turning blue" is stupid.

...and yes, the dispatcher is responsible for the 911 units. When the county (not the company) decides to limit paramedics only to the fire departments, then a patient requiring paramedics becomes a 911 system problem.

 

[DrParasite]

Standard practice for that area. Never had an issue with it outside of that one time.

weird practice. but I guess Cali has some weird practices.

That's a "stuff happens." On the other hand, I guess the take away message is to say, "BLS ambulance needs paramedics at _____ for a __ y/o male/female for ____," and hang up after confirming that that information has been received. After all, why stay on the phone if dispatch isn't going to tell me anything useful. It will also prevent me from "having a bad day" when the dispatcher can't figure out how to do her job.

sure. and you might get a paramedic unit. or you might have the dispatcher calling you back at the call back number you gave and until he or she is able to properly follow dispatch protocol and ask all those questions, not send a paramedic. I don't know, I would have just answered all the questions that were asked, it seems like wasting a minute is much better answering questions than being argumentative.

Yes, I'm having a bad day because a dispatcher didn't know how to do her job. That's my fault that apparently the dispatcher has a stick up her butt.

again, without ever being a dispatcher, how do you know what their job is? in fact, unless you have done their job, I am pretty sure you aren't qualified to say they don't know how to do their job. Just like I can't tell a doctor they don't know how to do their job without MD after my name.

Yes, because playing telephone with dispatch instead of calling 911 directly makes a whole ton of sense. If I've gotta talk to someone in order to get paramedics, I might as well talk to someone who can actually get me the resources I need instead of calling someone else to get me the resources I need.

it might be playing telephone, but that's standard practice on the east coast. but again, your protocols might vary.

It's the county rules, not the service. Of course aren't you from the state that still lets ambulances respond without even an EMT on board? Pot, meet kettle. After all, who would work in a state with such asinine and archaic rules like that?

because they pay me 18 an hour? and that whole "ambulance responding without an EMT on board" happens much less frequently than you think, and it's usually only in the rural volunteer covered areas, or areas that are covered by a volunteer FF ambulance. Scary, yes, correct, absolutely not, and when I was told this was happening I couldn't believe it, because NO agency near me would permit something like that to happen.

but we are talking about your issue dealing with dispatch, not the actions of unlicensed and unaligned ambulances that are permitted to do what they want without any oversight.

I never said dispatch was easy, but I don't have to be in dispatch to know that telling a crew, "Sorry, we don't do that" when using a term verbatim out of the protocol/policy manual (that is county wide, not company specific) is... well... stupid. Especially when the meaning is clear. You don't need to be in dispatch to realize that asking an ambulance crew, "Is the patient turning blue" is stupid.

...and yes, the dispatcher is responsible for the 911 units. When the county (not the company) decides to limit paramedics only to the fire departments, then a patient requiring paramedics becomes a 911 system problem.

maybe they can't do that, especially if it's a protocol/policy violation? You can quote terms from the policy manual all you want, but if what you want them to do something that dispatch policy doesn't allow, than quote all the terms you want, it's not going to happen. I don't know what the rules are, or what their policies are, and neither do you, so I can't say for sure.

I'll end with this: follow your company and county rules. if your county says to get ALS, you need to play telephone and go through your IFT dispatch center, do it. if your county lets private ambulances call 911 to request ambulances, do it. If you decide to deviate from the standard practice and policy, because you think it will work better, and find out it doesn't work as smoothly as you expect, don't blame the dispatcher; follow the rules that are applied to everyone else. And then if you are doing everything correct, following the policies, than you have your boss call their boss, file a complaint, and get someone fired. But that will only happen if your right and they were wrong, which may not be the case.

 

[WuLabsWuTecH]

Around here, when I ask for an engine or a medic over a land line, i'll generally get it. But we also don't have a tiered response system. If i'm on scene and someone is sick/hurt, a medic will come. The only determination is if the engine also comes with it for manpower. Generally if I say it's ALS and give indicators for such, they'll send me an engine. It's only happened a handful of times though.

And yes, sometimes dispatchers ask for some really unnecessary info. The dispatcher at a college campus once ased me for both my student ID number and that of the student I was trying to help. I later learned that she had already dispatched the police and first response unit, and was just trying to gather information for the CAD so the officer wouldn't have to do it all later, but it was certainly a good thing I wasn't trying to do CPR while answering these questions!