Alertness is important to assess during many medical emergencies; however, assessing alertness proves difficult in a non-visual emergency dispatch environment. Little is understood about how to best gather an accurate report of patient alertness during an interaction between callers and Emergency Medical Dispatchers (EMDs). The primary objective of the study was to compare two versions of a Key Question (KQ) intended to gain an accurate report of alertness, to determine whether either demonstrates a higher degree of caller...
Opioid overdoses have reached crisis proportions. One response has been to increase the availability of naloxone HCl (commonly referred to by the generic name naloxone), which reverses the effects of opioid overdose. The Medical Priority Dispatch System (MPDS®) includes instructions by which the Emergency Medical Dispatcher (EMD) can prompt the caller to find and use naloxone on overdose victims. However, these instructions are only provided on dispatch Chief Complaint (CC) Protocols on which overdoses are expected to be handled...
Situational awareness (SA, also called situation awareness) is the ability to take in relevant information about an event in order to understand it and take effective action. Maintaining effective SA as an emergency medical dispatcher (EMD) may be more difficult than in other, similarly complex roles because of the remote nature of an emergency call for help. This study attempts to provide insight on one remote SA situation by reporting on a simulation study in which cardiopulmonary resuscitation (CPR) instructions were provided over...
It has long been anecdotally held by emergency responders that non-medical emergency responders were less willing to accept post-incident intervention following a personally disturbing event than their medical counterparts. Aspects of emergency responder stress were studied across multiple disciplines of the emergency services: pre-hospital emergency medical services (EMS), fire protection, law enforcement, and emergency department (ED) or emergency room (ER) personnel. Individual anonymous surveys were administered across the...
The most critical and difficult part of the Emergency Police Dispatcher's (EPD) job may be the gathering of the initial problem description, which uses a scripted Protocol Case Entry Question (CEQ) but also requires interpretation on the part of the EPD. Specifically, at the beginning of the call, the EPD asks the caller the CEQ "Ok, tell me exactly what happened" (TMEWH). Based on the caller's response, the EPD selects a Chief Complaint (CC) Protocol—a specific protocol that provides the prompts to drill down into the caller's situation—the primary reason for calling 911. Selecting the wrong...
Rapid identification of sudden out-of-hospital cardiac arrest (OHCA) and delivery of bystander chest compressions in patients with ventricular fibrillation are key elements in the chain of survival. However, time to bystander compressions can be greatly affected by a wide variety of barriers, some beyond an EMD's control. The aim of this study is to identify and quantify the impact that barriers have on the time taken to achieve bystander compressions for suspected OHCAs. This retrospective, quantitative cohort...
Empirical literature examining the health and wellness of emergency responders has continued to grow over the past decade. Yet there is a relative absence of literature on 911 telecommunicators, who are often the "first, first responders" in an emergency. Examination of work-related factors that enhance risk for stress and adverse outcomes may improve current prevention and intervention efforts in this population. Civilian 911 calltakers and dispatchers from the state of California (N = 833) participated in an online study to...
Public Safety Answering Point (PSAP) quality can have life-or-death implications. The quality of service provided by PSAPs is inconsistent due to the lack of mandatory standards of care at the national, state, and local levels. Public demands and duties placed on PSAPs have grown due to technological changes, civil cases alleging negligence, and the emergence of national recommended standards of care, yet governments at all levels have been slow to create governance structures to reinforce adherence to standards...
In emergency dispatching, pre-alerts are used to send responders to calls prior to getting a final dispatch code. Some studies have showed that pre-alerts can effectively reduce dispatch time for out-of-hospital cardiac arrests, potentially improving overall patient outcome. However, there is also a potential risk in running lights-and-siren on non-fully triaged calls. Although pre-alerts have been used for several years, no research studies have demonstrated its benefit, in general. The goal of this study was to determine...
