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...
Telephone nurse triage at the 9-1-1 dispatch point is relatively new in the United States despite its ability to significantly reduce expensive and scarce Emergency Medical Services (EMS) resource use and emergency department visits. A previous study investigated the distribution of 9-1-1-triaged call incident types within the Emergency Communications Nurse System (ECNS) and found that 9-1-1 triage systems yielded a variety of low acuity complaints that were handled by the Emergency Communications Nurse (ECN). This study explored the current and potential utilization...
Research has shown that two-thirds of emergency visits occur after business hours (weekdays 9am – 5pm). Therefore, identifying primary healthcare providers available after business hours is one strategy for improving appropriate access to healthcare services. Previous studies have also shown a high and steady volume of secondary triage-eligible calls throughout the day and into the evening. However, because the Emergency Communication Nurse (ECN) performing the secondary triage has some discretion on selecting the Recommended Care Level (RCL) based on resource...
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...
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...
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...
This study examined the distribution of the MPDS® Chief Complaint protocols and determinant codes assigned by the EMD as eligible for nurse triage, as well as the distribution of the Chief Complaint protocols contained in the Emergency Communications Nurse System™ (ECNS™) secondary nurse triage process, as determined by the emergency communications nurse (ECN). Protocol distribution was also examined by patient gender. This study characterized protocol and gender distributions to provide a better understanding of the types of patients and their associated...
BACKGROUND As a premier body of EMS professionals, The National Association of EMS Physicians (NAEMSP) appoints, through its Standards and Practice (S & P) Committee, interested members who are experts, or want to develop expertise in related aspects of EMS. These members are designated to develop position statements on EMS topics of interest to them and of importance to the field. These draft position statements are then critiqued by the members of the S & P Committee, and alterations made in response to concerns and subsequent recommendations of the Committee members. The chair...
