What Are the Dispatchers Thinking?

[MrSalty]

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

I had a situation at a wedding where I was asked to help with a 74 year old non-responsive choking victim that was cyanotic.

Long story short, I was able to clear the mans airway and was able to restore his breathing.

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?

I'm just saying.

Has anyone else encountered this and if so what is the best way to handle it?

Thanks

 

[EMT11KDL]

Double Post

 

[EMT11KDL]

what has happened in the past is that the dispatchers have been burned on that exactly thing, by people claiming to be someone that they truly are not.

I am lucky in my county if i call dispatch we have direct line to them that ONLY EMS and FIRE have. Also, with the e911 system, my cell number shows up and it already has my name and information which included my fire dept and my fire id number.

Also, if you are the responding unit, wouldnt u like to know information, like is the patient breathing, loc, what exactly they are responding too...

If you cannot talk to the dispatcher hand your phone off to someone else, and have that person relay the information. If there is no one around call the dispatcher, identify yourself, tell them you have a man down, chocking or code, or trauma or whatever it is, (very quick and precise). and tell them location, and ur the only one on scene.. and if you can put ur phone on speaker phone...

 

[Handsome Robb]

Have you ever sat in dispatch? The system they use spits out the questions at them to give the crew information and to determine the priority of call. They ask the questions for a reason.

Dispatching sucks, I have a lot of respect for the people that do it, they deal with stupid, rude, angry, upset people all day long.

The only time our dispatch center will disregard the questions is if the EMT/Paramedic calling it in works for our company and IDs themselves with their name and employee number.

I'd personally give someone else the cell phone or put it on speaker and set it down.

 

[fast65]

It helps to answer their questions instead of double guessing the importance of them, helps the process go a little, I don't know, quicker?

They ask the questions because it helps them determine the priority of the call as others have said. The information you're providing helps EMS have a least a vague idea of what they may be walking into, so the more information available, the better.

I can count the number of times I've been told there was a healthcare provider of some sort on scene and had there actually be one when we got there...once...and he was drunk. I don't work in dispatch, so I can't say that I'm in anyway correct, but I would wager that dispatch doesn't take too much stake into someone telling them that they're an EMT/paramedic/nurse/doctor/superhero/yellow spotted kangaroo.

Question, if you're at a wedding, why are you the one calling 911? How did you clear his airway?

 

[Shishkabob]

It's called Emergency Medical Dispatch and they have cards they have to read from in order to dispatch the appropriate resources at the appropriate priority. (Atleast, that's the intent)


If things were that time sensitive, you could have either put someone else on the phone, or just given a brief description, state your certification, then hang up. Obviously giving someone else the phone is a much more viable and correct way of doing things, but still.

 

[Aprz]

I've made this same mistake at my previous non-EMS job. I agree with everyone else assessment on this; You should've given the phone to somebody else, or if you're the only one then use speaker phone.

 

[medicdan]

As Linuss said, this is EMD... it not only provides you as the responder more information about the scene you are walking into, but also provides pre-arrival instructions to the caller-- both medical, such as to begin chest compressions, but also preparations, such as turning on the porch light, moving pets from the door, etc.

The dispatchers still need this information for responding crews...

 

[abckidsmom]

Yeah, give the phone to someone else, but I will say that *any* time a dispatcher is asking what meds he's taking, or what he's allergic to, it's idiotic meddling.

Quality EMD work relies on succinct gathering of as much information as possible, without asking so many questions that it tweaks the caller. In my experience as a dispatcher in a medium-busy system (taking >150 calls/shift), callers just don't answer questions that they think are stupid. I was so thankful that we used MPDS EMD, with constant QA and feedback on the system. In just the 2 years I was dispatching, we went through at least 3 versions of the cardset. I liked it a lot.

If I was ever presented with a situation like yours, I would just pass the phone to someone or set the phone down and just leave it open to the room.

 

[LucidResq]

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.

As a dispatcher, when you don't cooperate with me you are negatively affecting my ability to send this dying man an ambulance, with on-duty paramedics who have the equipment to treat him more effectively and take him to a hospital. If you haven't worked as a dispatcher you don't know everything about what is pertinent and what is not.

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?

1) People lie.
2) I have talked to some idiot EMTs and nurses. LPNs who want to put salt in lacerations and EMTs who want to stick spoons in seizing patient's mouths. Sorry, the only people who don't get my full shpiel are RNs and Physicians who sound like they are competent.
3) It sounds like you are falling into the trap a lot of panicked citizens fall into by thinking the questions are delaying response. Policies vary, but I have them en route the second you give me an address and tell me you need EMS. All the answers you give me are given to them while they're on the road. I was hired because I can multitask like no one's business. Don't underestimate me and think I'm not sending help just because I'm talking to you.
4) We have a medical director just like you, but our protocols are much stricter because we are not medical professionals (even if we are, we are not working in that role). I have a list of questions I am REQUIRED to ask on every call and a list of things I am REQUIRED to tell you verbatim. Please humor me, answer the simple questions, and listen to the directions because arguing with me wastes both of our time and I'm not getting fired because you have a superiority complex. Thanks.

Has anyone else encountered this and if so what is the best way to handle it?

If you feel you are so important to this patient, give the phone to someone else and let them talk to the dispatcher. Otherwise, cooperate or drive him to the hospital himself if you don't want to help me get you help.

 

[JPINFV]

Have you ever sat in dispatch? The system they use spits out the questions at them to give the crew information and to determine the priority of call. They ask the questions for a reason.

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.

 

[Handsome Robb]

Dispatchers have a job, they can lose said job. They deal with :censored::censored::censored::censored::censored::censored::censored:s all day, as a provider who has worked in the field I would think you would be a little more understanding to their situation.

Now I understand if your calling while working on an IFT truck how the EMD questions would be frustrating.

ETA could be twisted back on the dispatcher and service. I can see it now "Dispatcher said ambulance would arrive in 5 minutes, it turned out to be a 7 minute response and the patient died." Yea 2 minutes probably wont make a difference most of the time but a lawyer could use that to his advantage, thats why 911 dispatchers don't give ETAs.

Edit: also as someone who has worked in the field I would assume that you would appreciate the help the responding crew gets from the answers of these questions.

 

[JPINFV]

Now I understand if your calling while working on an IFT truck how the EMD questions would be frustrating.

Which, in my case I was. Of course this was also after being told that they "don't do [paramedic escorts]" when "paramedic escort" is exactly the term used in the county EMS policy book. That was followed by EMD questions (again, IFT ambulance. I'm calling because I have a patient in rather severe respiratory distress who has used her 2 words a breath to flatly refuse the closest), which was followed by a refusal to give me an ETA. Sorry, I have better things to do than answer a bunch of question that provides zero additional help.

The dispatcher is sending paramedics because an EMT ambulance requested paramedics for respiratory distress. That is all that matters. This isn't a choice about lights and sirens vs cold. This isn't a choice between EMT ambulance and paramedic ambulance. This isn't a case where phone instructions are needed.

ETA could be twisted back on the dispatcher and service. I can see it now "Dispatcher said ambulance would arrive in 5 minutes, it turned out to be a 7 minute response and the patient died." Yea 2 minutes probably wont make a difference most of the time but a lawyer could use that to his advantage, thats why 911 dispatchers don't give ETAs.

...and it could mean the difference between me transporting or waiting for paramedics. On another situation I was given a 2 minute ETA that was more towards the 7 minute mark. Considering I was on the second floor and I call 911 as soon as I realize I needed paramedics or emergency transport, then that 2 minutes is easily the time needed to package, give a once over, and move to the ambulance... in that case to wait for several minutes for fire. Personally, I'd rather have a wrong ETA when calling in as prehospital provider than abject refusal to do, quite frankly, what I consider part of the dispatchers job.

I wonder if the fire department has this problem with their dispatchers when requesting an ETA for another apparatus. Wouldn't want to give a wrong ETA now, would we?

 

[Handsome Robb]

Not trying to derail the thread but if your working for an ambulance company, as an EMT, with a dispatch center, why do you need to call 911 to request paramedics? Why is there no policy for this? Notify dispatch your request with a quick blurb about what and why then go back to providing patient care and packaging. Rather than having the provider call 911 and get cycled through the dispatch system and have a provider get upset.

Now as a paramedic responding to a BLS trucks request I'd still like to know more than a general complaint. Do I need to be ready to intubate right off the bat? To push drugs for an allergic reaction? Go straight to CPAP on a CHFer? So on and so forth.

Just my thoughts.

 

[MrSalty]

All good Posts!

I appreciate ther feedback, both positive and negative to my comments.

I did, in fact, hand the phone to someone else. The problem I was having is that dispatch kept wanting to speak to me directly and as such it was a bit distracting.

Now - I am not going to say that there may not have been someone on the other end that may have been more qualified. That all the questions asked were not pertinant.

I made a point NOT to be rude to the diapatcher. I also made a point to answer their questions as time permitted.

What was of concern was after I cleared the patients airway of excess partially chewed organic matter, I was in the middle of attempting resuce breathing when I was told that the dispatcher wanted to talk to me as the bystander could not answer many of the questions that the dispatcher had.

In fairness to an earlier comment, perhaps I was a little stressed. I had a 74 year old in respiratory arrest who was also cyanotic. I REALLY was focused on the airway.

What would have helped me feel a little more confident/better would have been the following:

1. Acknowledgement of my assessment that the patient did indeed need an ambulance.

2. Approximate ETA when I could expect help. (something, anything as I had family members that wanted to throw grandpa in their sub-compact and get him to the hospital. Some information would have gone a long way to help me help them as I really thought this was not a good course of action.)


Everything turned out fine in the end. I saved the patient, the ambulance showed up, life went on.

I have nothing against diapatchers and in reference to people jamming spoons into other peoples mouths I guess I could not comment as I have never seen or heard of this behavior. All I am saying is that there may be a better way to respond to people that identify themselves as EMS professionals on the other end of the line.

 

[JPINFV]

Not trying to derail the thread but if your working for an ambulance company, as an EMT, with a dispatch center, why do you need to call 911 to request paramedics? Why is there no policy for this? Notify dispatch your request with a quick blurb about what and why then go back to providing patient care and packaging. Rather than having the provider call 911 and get cycled through the dispatch system and have a provider get upset.

Because Orange County, CA only licensed the fire departments to provide paramedic service, so if paramedics are needed either the dispatcher is going to contact 911 (and we didn't carry portable radios, so this means someone going back to the truck or going and picking up a phone anyways). Calling 911 directly also removes a link in the chain. Ever play the game telephone as a kid?

Additionally, it also removes the potential that the private company dispatcher wants to play medical control and tell the EMTs to just transport.

Now as a paramedic responding to a BLS trucks request I'd still like to know more than a general complaint. Do I need to be ready to intubate right off the bat? To push drugs for an allergic reaction? Go straight to CPAP on a CHFer? So on and so forth.

Just my thoughts.

...but you'd rather have a dispatcher, who has much less information, call 911 to request paramedics?

 

[MrSalty]

Response

Not trying to derail the thread but if your working for an ambulance company, as an EMT, with a dispatch center, why do you need to call 911 to request paramedics? Why is there no policy for this? Notify dispatch your request with a quick blurb about what and why then go back to providing patient care and packaging. Rather than having the provider call 911 and get cycled through the dispatch system and have a provider get upset.

Now as a paramedic responding to a BLS trucks request I'd still like to know more than a general complaint. Do I need to be ready to intubate right off the bat? To push drugs for an allergic reaction? Go straight to CPAP on a CHFer? So on and so forth.

Just my thoughts.

Good question.

I was 200 miles out of my area and not in the county that I am registered as an EMT.

I was at a wedding.

I was not working.

I was acting as a good samaritan.

 

[Shishkabob]

2. Approximate ETA when I could expect help.

Urban area? Probably around 9 minutes.

Rural area? Depending on coverage, up to 30+.




You wont ever get a more precise answer from dispatch.

 

[Handsome Robb]

Yea JP, I have played telephone. It's not hard to tell a dispatcher "Unit XX requesting ALS to my location. Pt in respiratory distress secondary to FBAO/Anaphylaxis/Unresponsive pending respiratory arrest. If the dispatcher messes that up they need to find a new job. If they are playing OMD and telling you to transport they need to be removed from their position.

Thats asinine that crew members of an IFT truck don't carry portable radios.

The dispatcher shouldn't be calling 911 either, they should have a direct line to the 911 dispatch center operator rather than being shuffled through the 911 system.

 

[Akulahawk]

Because Orange County, CA only licensed the fire departments to provide paramedic service, so if paramedics are needed either the dispatcher is going to contact 911 (and we didn't carry portable radios, so this means someone going back to the truck or going and picking up a phone anyways). Calling 911 directly also removes a link in the chain. Ever play the game telephone as a kid?

Additionally, it also removes the potential that the private company dispatcher wants to play medical control and tell the EMTs to just transport.



...but you'd rather have a dispatcher, who has much less information, call 911 to request paramedics?

I don't ever have my dispatcher call 911... I do it myself. If I have a non-public, direct number, I'll use that instead. Dispatchers tend to notice things like that. If a person knows the back number, they're probably not the average citizen. The times I've used those numbers, I've gotten what I need faster and easier, with less formality than by calling 911. They've taken what I say generally at face value. Then again that could be a Santa Clara/Sacramento EMS system only kind of thing...