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Mark Conrad Fivaz, MD

EMERGENCY COMMUNICATION NURSES’ ABILITY TO CORRECTLY SELECT ABDOMINAL PAIN AS THE APPROPRIATE PROTOCOL IN TELEPHONIC NURSE TRIAGE SYSTEM

Mark Conrad Fivaz, MD, Jeff J. Clawson, MD, Christopher Olola, PhD, Greg Scott, MBA, EMD-QI, Matt Zavadsky, MS, Gigi Marshall, MSN, Elaine Messerli, BSN, RN

Aug 04, 2021|Research Posters

The primary objective of this study was to determine the ability of an Emergency Communication Nurse (ECN) to appropriately identify the Abdominal Pain Chief Complaint Protocol to use to triage patients in low-acuity cases. The secondary objectives were to establish the most frequently used primary triage code (Medical Priority Dispatch System™ (MPDS®) Determinant Codes), triggering the use of the Abdominal Pain Chief Complaint Protocol in the Emergency Communication Nurse System™ (ECNS™), as well as the percentage of these calls resulting in a Recommended Care Level (RCL) of “emergency a

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ABILITY OF LAYPERSON CALLERS TO APPLY A TOURNIQUET FOLLOWING PROTOCOL-BASED INSTRUCTIONS FROM AN EMERGENCY MEDICAL DISPATCHER

Greg Scott, MBA, EMD-QI, Christopher Olola, PhD, Isabel Gardett, PhD, Daniel Ashwood, PhD, Meghan Broadbent, MS, Srilakshmi Sangaraju, MS, Paul Stiegler, MD, Mark Conrad Fivaz, MD, Jeff J. Clawson, MD

Aug 04, 2021|Research Posters

The overall objective of the study was to determine whether layperson callers can effectively stop simulated bleeding using an improvised or a commercial tourniquet, when provided with scripted instructions via phone from a trained protocol-aided EMD.

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Emergency Communication Nurses' Ability to Correctly Select Abdominal Pain as the Appropriate Protocol in Telephonic Nurse Triage System

Mark Conrad Fivaz, MD, Jeff J. Clawson, MD, Christopher Olola, PhD, Greg Scott, MBA, EMD-QI, Matt Zavadsky, MS, Gigi Marshall, MSN, Elaine Messerli, BSN, RN

Oct 01, 2020|AEDR 2020 Vol. 8 Issue 2|Original Research

Abdominal pain is the most common symptom with which patients present to the emergency department (ED), and overall visits to EDs in the U.S. are growing twice as fast as the overall population. Interventions that can safely mitigate such a high usage of ED resources would be a great asset in the delivery of effective and efficient ED care. One such intervention is a secondary triage of patients calling 911 for an ambulance who were subsequently triaged as a non-urgent low-acuity caller. Emergency medical services (EMS) using secondary...

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You Said It Was Quite Green This Morning...

Kim Mcfarlane, MD, Mark Conrad Fivaz, MD

Mar 15, 2016|AEDR 2016 Vol. 4 Issue 1|Case Study

The Health Contact Centre (HCC) in Brisbane Australia is one of the Health Support Queensland's services that provides clinical support, either directly to the community (4.7 million Queenslanders) or in support of Hospital and Health Services (HHS) and the Department of Health. Registered nurses (RNs) use the Emergency Communication Nurse System™ (ECNS™) as Clinical Decision Software System (CDSS) to triage callers who access this service via telephone. The RN uses a set of symptom-based protocols in the ECNS to telephonically triage the caller/patient and recommends the most...

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Assessing Call Demand and Utilization of a Secondary Triage Emergency Communication Nurse System for Low Acuity Calls Transferred from an Emergency Dispatch System

Mark Conrad Fivaz, MD, Greg Scott, MBA, EMD-QI, Jeff J. Clawson, MD, Corike Toxopeus, PhD, Matt Zavadsky, MS, Kristen Miller, JD, Neal Richmond, MD, FACEP, Christopher Olola, PhD

Aug 01, 2015|AEDR 2015 Vol. 3 Issue 2|Original Research

Telephone nurse triage at the 9-1-1 dispatch point is relatively new in the United States despite its ability to significantly reduce expensive and scarce Emergency Medical Services (EMS) resource use and emergency department visits. A previous study investigated the distribution of 9-1-1-triaged call incident types within the Emergency Communications Nurse System (ECNS) and found that 9-1-1 triage systems yielded a variety of low acuity complaints that were handled by the Emergency Communications Nurse (ECN). This study explored the current and potential utilization...

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The Distribution of Recommended Care Level Classification by Time of Day within the Emergency Communication Nurse System

Mark Conrad Fivaz, MD, Greg Scott, MBA, EMD-QI, Jeff J. Clawson, MD, Corike Toxopeus, PhD, Matt Zavadsky, MS, Kristen Miller, JD, Neal Richmond, MD, FACEP, Christopher Olola, PhD

Aug 01, 2015|AEDR 2015 Vol. 3 Issue 2|Original Research

Research has shown that two-thirds of emergency visits occur after business hours (weekdays 9am – 5pm). Therefore, identifying primary healthcare providers available after business hours is one strategy for improving appropriate access to healthcare services. Previous studies have also shown a high and steady volume of secondary triage-eligible calls throughout the day and into the evening. However, because the Emergency Communication Nurse (ECN) performing the secondary triage has some discretion on selecting the Recommended Care Level (RCL) based on resource...

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The Distribution of Recommended Care Levels by Age, Gender, and Trauma vs Medical Classification within the Emergency Communication Nurse System

Mark Conrad Fivaz, MD, Jennie McQueen, RN, Tracey Barron, BS, Jeff J. Clawson, MD, Greg Scott, MBA, EMD-QI, Isabel Gardett, PhD, Brett Patterson, Matt Zavadsky, MS, Neal Richmond, MD, FACEP, Christopher Olola, PhD

Mar 22, 2015|AEDR 2015 Vol. 3 Issue 1|Original Research

An examination of the Emergency Communications Nurse-determined Recommended Care Levels (RCLs), for calls transferred for secondary nurse-triage has not been performed. The outcome of such an investigation would help to gain a more complete picture of the type of care ultimately recommended for these patients. The Emergency Communications Nurse System (ECNS) studied contained 22 RCLs, ranging from urgent levels, including a country-specific 3-digit number Emergency response (911), and Emergency care as soon as possible to less time-dependent, low priority levels, such...

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The Distribution of 911 Triaged Call Incident Types within the Emergency Communication Nurse System™

Greg Scott, MBA, EMD-QI, Jennie McQueen, RN, Mark Conrad Fivaz, MD, Isabel Gardett, PhD, Matt Zavadsky, MS, Neal Richmond, MD, FACEP, Jeff J. Clawson, MD, Christopher Olola, PhD

Aug 07, 2014|AEDR 2014 Vol. 2 Issue 2|Original Research

This study examined the distribution of the MPDS® Chief Complaint protocols and determinant codes assigned by the EMD as eligible for nurse triage, as well as the distribution of the Chief Complaint protocols contained in the Emergency Communications Nurse System™ (ECNS™) secondary nurse triage process, as determined by the emergency communications nurse (ECN). Protocol distribution was also examined by patient gender. This study characterized protocol and gender distributions to provide a better understanding of the types of patients and their associated...

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A Case with a Sting in the Tail

Mark Conrad Fivaz, MD

Aug 01, 2014|AEDR 2014 Vol. 2 Issue 2|Case Study

Clinical call handlers use a clinical decision support software system (CDSS) called the Emergency Communication Nurse System™ (ECNS™) to further triage calls considered eligible for secondary triage post the interaction the patient or caller had with the Emergency Medical Dispatcher (EMD). EMDs use a primary emergency triage system called Medical Priority Dispatch System (MPDS®) to triage callers accessing 911 services. This call involved a teenage boy calling 999 in England, UK, on behalf of his friend (also a teenage boy) who was stung on the palmar side of his right wrist by...

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Triage Nurse in a 911 Center Effectively Handles Case of Insect Bites

Rick Roller, Mark Conrad Fivaz, MD

Mar 01, 2014|AEDR 2014 Vol. 2 Issue 1|Case Study

On June 26th, mid-morning, a 47 year old male patient called into the 911 center with a complaint of being bitten by insects all over his body. Initially the caller wanted an ambulance to take him to the emergency room (ER), but he had advised the emergency medical dispatcher (EMD) that the rash and bites had been going on for a while. In Louisville, all medical 911 calls are triaged at the MetroSafe 911 center by a certified EMD using the Medical Priority Dispatch System™ (MPDS®) software, ProQA®. The end result of the EMD triage is an assigned (alphanumeric) determinant code that...

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