The National Association of EMS Physicians and the then National Association of State EMS Directors created a position statement on emergency medical vehicle use of lights and siren in 1994.1 This document updates and replaces this previous statement and is now a joint position statement with the Academy of International Mobile Healthcare Integration, American Ambulance Association, American College of Emergency Physicians, Center for Patient Safety, International Academies of Emergency Dispatch, International Association of EMS Chiefs, International Association of Fire Chiefs, National Association of E
The difficulty of evaluating mental status, particularly alertness, is more pronounced in the medical dispatch context, where the Emergency Medical Dispatcher (EMD) must work through the eyes and ears of the caller, who is most likely a layperson. Determining true non-alertness and the level of its effects on outcome needs to be solved to perfect the interrogation and response-coding processes at dispatch.
The primary objective of this study
was to determine the ability of an
Emergency Communication Nurse (ECN)
to appropriately identify the Abdominal
Pain Chief Complaint Protocol to use to
triage patients in low-acuity cases. The
secondary objectives were to establish
the most frequently used primary triage
code (Medical Priority Dispatch System™
(MPDS®) Determinant Codes), triggering
the use of the Abdominal Pain Chief
Complaint Protocol in the Emergency
Communication Nurse System™ (ECNS™),
as well as the percentage of these
calls resulting in a Recommended Care
Level (RCL) of “emergency a
The overall objective of the study was
to determine whether layperson callers
can effectively stop simulated bleeding
using an improvised or a commercial
tourniquet, when provided with scripted
instructions via phone from a trained
protocol-aided EMD.
Anecdotally, numerous MPDS® (Priority Dispatch Corp., Salt Lake City, Utah, USA)-user agencies in the USA, Canada, UK, and Brazil have reported that the emergency caller has difficulty understanding the key question (KQ) “Is s/he completely alert?”
Sick Person (Specific Diagnosis) is one of the
most commonly used Chief Complaint Protocols
in the Medical Priority Dispatch System (MPDS).
This protocol is often used when a caller does not
report any specific or high-priority symptoms. Of
particular concern is the 26-ALPHA-1 determinant
code, which refers to a person with “No priority
symptoms” and none of the specific symptoms
listed on the ALPHA-code drop-down list (Fig. 1).
Despite long-standing calls for consistent
training practices, very little is known about
the methods used in emergency dispatcher
training, their relative efficacy, or the topics or
competencies addressed.
Cardiovascular disease remains the most common cause
of death worldwide, with ischemic heart disease (IHD)
causing nearly nine million deaths per year. Coronary heart
disease (CHD) is estimated to cause about one-third of
all deaths in people over 35 years old, and the incidence
of CHD is expected to continue to rise. Acute myocardial
infarctions (AMIs)—heart attacks—represent a significant
portion of this overall CHD mortality, with approximately
620,000 Americans suffering a first heart attack, and
295,000 suffering a repeat event, each year.
Identification of persons based on verbal descriptions
is one of the key skills of police work. This includes
identifying suspects, but also locating missing persons,
identifying a person needing help in a public assist call, or
finding and helping a person who is threatening suicide.
Correct identification can lead to reduced loss of life,
reunions of missing persons with their loved ones, and
apprehension of suspects, while incorrect identification
can have terrible unintended consequences for both
officers and civilians.
Traffic incidents (collisions and crashes) are among the
most common call types handled by Emergency
Communication Centers (ECCs). They are also among the
most complex call types because they represent such
a range of possible situations. These can range from
“fender benders” with no injuries and little or no property
damage—in which case a single law enforcement officer
might be an appropriate response—to mass-casualty
events involving trains, buses, or other large, multipassenger vehicles.
