Emergency Medical Dispatchers (EMDs), at emergency communication centers that have implemented the Medical Priority Dispatch System® (MPDS) protocols, use scripted questions to interrogate people calling 9-1-1. Based on this interrogation, case determinant codes are assigned– to identify the specific patient condition and enable optimal allocation and deployment of resources to ensure appropriate field responses. MPDS determinant codes for both OBVIOUS and EXPECTED DEATH exist for patients that are clearly and irreversibly dead, or have a terminal illness accompanied...
Evidence-based medicine (sometimes called scientific medicine) has existed in some form since at least the 16th century, when Andreus Vesalius, the "father of human anatomy," published diagrams of the human body actually based on anatomical investigation. William Harvey's publication of the first accurate description of the cardiovascular system, the 1665 discovery of the cell by Robert Hooke, and the 19th-century revelation of the neuron as the basic unit of the brain were also critical milestones. In the 1960s, the push toward evidence-based medicine became stronger, and basic science research began..
Recent estimates indicate that more than half of all Emergency Department (ED) visits could be avoided, reducing patient costs and increasing satisfaction with care. Since 911 is increasingly the first point of contact for many patients entering the health care system—even those with non-emergency conditions—one potential approach to decreasing emergency costs and ED overcrowding is to reinvent the 911 dispatch center as a clearinghouse for directing patients to alternative care providers. This study presents a cost avoidance analysis of two 911 dispatch centers that...
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...
This study represents a first attempt to classify a subset of time-to-dispatch in a 911 center – the call prioritization time. This time is defined as the time required to gather critical case information, after the address is obtained, and prior to notifying responder units of the call. This study characterizes call prioritization time in nine different 911 centers, all using the Fire Priority Dispatch System (FPDS). Times were examined by individual agency, overall. This was a retrospective, non-controlled, descriptive study involving nine 911 and by FPDS...
Emergency dispatchers are exposed to potentially traumatic events at rates that likely exceed that of emergency first responders. Although not physically present at the time of the incident, it is likely that this repeated exposure in concert with highly stressful work conditions could lead to potentially negative emotional and physical outcomes. To date few studies have examined rates of stress related pathology and subsequent impairment in emergency dispatchers. The following study takes an initial step to investigate rates of Acute Stress Disorder, Secondary Traumatic Stress and...
Two of the most prominent trends in healthcare right now—paradoxically— are diversification and mergers. Many larger healthcare entities are swallowing smaller ones, creating central hubs that offer huge varieties of services and smaller, outlying branded clinics that feed into the hubs. What this means for patient care remains to be seen. What it means for diversification within each organization, though, is already becoming apparent. Larger, merged entities can offer more varied continuums of care, including for example emergency services that lead directly into on-site rehabilitation and affiliated h
The extent of fire emergencies in our communities is of great concern, not only to the public, but to the nation's fire departments, whose role is not only to respond to them, but to mitigate and, even earlier, to prevent them. The variety of types of fire-related emergencies reported to 911 is of significant interest to this ongoing mandate. The aim of this study was to characterize the distribution of calls handled using a Fire Priority Dispatch System (FPDS™) in the studied agencies. This was a retrospective and non-controlled descriptive study...
Welcome to the fourth issue of the Annals of Emergency Dispatch & Response. We have reached our second birthday going strong: this issue contains the most overall papers, the broadest scope of topics, the most diverse group of authors, and the most peer-reviewed research of any issue so far. Perhaps even more importantly, putting out our fourth issue makes us eligible for listing in online research databases. We’ll be more visible, more accessible, and more citable than ever.
Time-to-dispatch in a 911 center continues to be a topic of much discussion in public safety. This study represents a first attempt to classify a subset of time-todispatch, call prioritization time, the time required to gather critical information prior to dispatching the call. The study characterizes call prioritization time in two Police dispatching agencies by determining overall median call prioritization time for all Chief Complaints (CCs) in the agencies studied, then by determining specific call prioritization times for the top five most commonly-used CCs...
