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...
The International Academies of Emergency Dispatch® (IAED™) is a nonprofit standard-setting organization promoting safe and effective emergency dispatch services worldwide. IAED supports first responder-related research, unified protocol application, and strengthening the emergency dispatch community through education, certification, and accreditation. As an organization that serves both emergency dispatchers and the public calling them for help, IAED's mission reflects a commitment to build strong relationships with both groups. To this end, IAED began cultivating a relationship with...
Emergency Medical Services (EMS) systems often utilize a structured approach to 911 call-taking and emergency medical dispatch (EMD). One such system, Medical Priority Dispatch System (MPDS®), categorizes 9-1-1 calls into EMD codes based on problem and severity. Response priorities and resources dispatched are determined at the local level through a predetermined response matrix, which is often determined without utilizing outcome-based criteria. The primary objective was to use historical clinical data to develop a methodology to increase the number of patients with time-sensitive critical...
Chief Complaint selection is one of the most important skills for an emergency dispatcher to develop—and one of the most critical moments in any emergency call for help. Selecting the correct Chief Complaint at the opening of the call helps ensure that the correct information will be gathered, the most appropriate response sent, and the most life-critical instructions provided. For many emergency medical dispatchers (EMDs), the selection of Protocol 26 – Sick Person (Specific Diagnosis) is among the most challenging. This is due to the complexity of the protocol, since this requires...
Opioid overdoses have reached critical proportions in the United States of America (USA or US) and worldwide. The US Centers for Disease Control and Prevention report that more than 90 Americans die every day from opioid overdose, and the epidemic was recently declared a national public health emergency. One response to the crisis has been to increase the availability of naloxone HCl (commonly referred to by the brand name NARCAN), a treatment that reverses the effects of opioid overdose when injected or inhaled. The Medical Priority Dispatch System (MPDS®) version 13.0 includes instructions...
In medical emergencies involving out-of-hospital cardiac arrests (OHCAs), bystanders reasonably, but sometimes incorrectly, expect that a call to 911 will result in a dispatcher guiding the caller through the steps of cardiopulmonary resuscitation (CPR). The primary objective of this research is to investigate the role of the dispatcher and dispatcher-assisted telephone-CPR (TCPR) in survival rates of OHCAs. This naturally led to an evaluation of the data collection practices of public safety answering points (PSAPs), emergency medical service (EMS) and fire departments, and hospitals for...
Opioid overdose is the leading cause of accidental death in the US. To respond to this public health crisis, public health and safety agencies are attempting to optimize their use of data sets that can identify opioid overdoses cases early in the continuum of emergency medical care. In this study, we are developing and validating a novel approach to identifying opioid overdose cases using a set of indicators from pre-hospital data, including the electronic patient care record (ePCR), call taking, and dispatch data. We queried all medical emergency calls in calendar year (CY) 2016 for a single...
Extrication activities at the scene of motor vehicle accidents (MVA) result in extended scene times, and increase morbidity and mortality. Identifying the need for extrication-capable resources during the 9-1-1 call-taking process, and dispatching them without delay, is crucial to delivering the required response and patient care. Determining the need for extrication using this protocol currently relies on the 9-1-1 caller's answer to a single key question in the protocol: "Is anyone pinned (trapped)?" The aims of this study were to determine the predictive value of the single key question...
The manner in which calls are handled at the emergency telecommunication center has a significant role in effective management of assistance on the scene. The main information needed to start a response is the location of the incident, which usually means the complete address. The Genova 118 Center has recently modified its standard greeting from "Genova 118" (STD1) to "Genova 118, where do I send the ambulance?" (STD2). The aim of this study is to verify whether the new standard reduces the time needed to acquire a complete address during an emergency call. The prospective, randomized study...
The main objective of this study was to compare emergency medical dispatch (EMD) stroke identification with hospital-confirmed stroke. The secondary objective was to compare the results of stroke diagnostic tool (SDxT) of Medical Priority Dispatch System™ (MPDS®) with National Institutes of Health Stroke Scale (NIHSS) used in hospital by neurologists. Data utilized for the observational study were taken from a preliminary stroke dataset collected at San Martino Hospital (Genova) between January 2016 and June 2017. All cases of suspected stroke arrived at First Aid began part of the study...
