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Mark Conrad Fivaz, MD

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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Emergency Communication Nurse System Outcomes of Advanced Medical Priority Dispatch Codes in a UK ambulance service: A descriptive analysis.

Mike Brady, PhD, Mark Conrad Fivaz, MD, Peter Noblett, Christoper Olola, PhD, Greg Scott, MBA, EMD-QI

Feb 13, 2024|AEDR 2024 Vol. 12 Issue 1|Original Research

Most United Kingdom (UK) ambulance services undertake remote clinical consultation of 999 emergency calls, often using computerised decision support systems, such as the Emergency Communication Nurse System (ECNS). In 2021 the Welsh Ambulance Services NHS Trust implemented ECNS in a novel way. Both nurses and paramedics used the tool to assess the full range of Advanced Medical Priority Dispatch System (AMPDS) codes and acuities. This study reports the ECNS outcomes of the full range of AMPDS codes, aiming to inform future discussion, protocol evolution, and clinical models internationally.

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Proposed use of the Emergency Communication Nurse System in Welsh Ambulance Service 999 Secondary Triage with Paramedic and Nurse Users

Mike Brady, PhD, Susan Tucket, RN, Michelle Perry, Brian Jarvis, Peter Brown, Mark Conrad Fivaz, MD, Gigi Marshall, MSN

Sep 07, 2021|AEDR 2021 Vol. 9 Issue 2|Original Research

The Welsh Ambulance Service NHS Trust (WAST) manages more than 500,000 calls every year, with its emergency ambulance staff attending more than 250,000 of these calls. WAST currently uses the Medical Priority Dispatch System to process its 999 emergency calls and is an accredited centre of excellence. WAST employs experienced nurses and paramedics to undertake 999 secondary telephone triages of 1) low acuity patients, 2) patients awaiting an ambulance response, and 3) patients whose condition may be managed effectively by an alternative to an ambulance...

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