What’s next for the First, First Responder? Since that term was first coined decades ago by Dr. Jeff Clawson in the nascent years of emergency medical dispatch development, much has changed. One of the biggest changes is the expanded role of the emergency telecommunicator in general—not simply the role of the emergency medical dispatcher (EMD), who was the subject of the earliest efforts to professionalize emergency telecommunicators with formal training and continuing education. In today’s technology-rich world, there is a greater-than-ever need for case prioritization, caller instructions, and better remote care for distressed persons contacting emergency services for any type of event, be it law enforcement related, a fire emergency, medical, or public health issue. These expanding needs create opportunities for both our longstanding challenges and possible new frontiers in the emergency dispatch profession.
Within emergency medical services (EMS) there is a renewed emphasis on the still-present challenge of reducing the risks of response by using smart dispatch practices to send fewer vehicles in a lights-and-siren mode, thus helping to keep our streets and highways safer from emergency vehicle crashes. And a newer concept gaining momentum is that of secondary telephone triage and care. This practice combines the skills of the EMD, using an evidence-based triage protocol, with those of a clinical specialist who can assess patients with the benefit of advanced clinical training and rigorous protocols.
This issue of AEDR contains research articles that explore those practices. Two large EMS systems, one in Texas, USA, and one in Wales, U.K., provide us with extremely useful research on potential EMS system improvements that rely on consistent use of robust remote medical triage protocols. The U.S. study explains how one system demonstrated a reduction in high-priority responses by matching patient acuity as measured by the paramedics, to specific dispatch codes assigned using a version of the Medical Priority Dispatch System™ (MPDS®). In the second EMS system study, researchers at the Welsh Ambulance Service have developed a system design that involves using experienced paramedics who receive a degree, to work at a level consistent with that of a nurse in the U.K., within the Emergency Communication Nurse System™ (ECNS™), that may potentially improve the efficiency of the system while maintaining high clinical practice standards.
A third article examines our own efforts at the International Academies of Emergency Dispatch® (IAED™) to involve more emergency dispatchers in doing research. Through structured interviews with dispatch personnel interested in research, this study identified some of the barriers to getting involved in emergency dispatch research, as well as practices that provided motivation. It turns out that emergency dispatchers can do good research, with the right incentives and encouragement.
Finally, we spotlight someone who has championed the cause of research and protocol development in EMS, emergency dispatch, and public health for decades—our own IAED President and Chair of its Institutional Review Board, Jerry Overton. Jerry’s wealth of experience and knowledge is only surpassed by his positive attitude and congenial manner. Whatever new challenges lie ahead, I can think of no better person to give us the inspiration to embrace our research efforts, as well as the future of the First, First Responder.