Although it makes up only about 1-2% of all emergency calls for help, sudden cardiac arrest (SCA) remains one of the most deadly—and one of the most hotly debated—topics in emergency services. Emergency Medical Dispatchers (EMDs) can play a critical role in improving survival rates for victims of SCA. In order to provide the most timely, effective care, EMDs must first identify that an SCA is occurring, then move quickly to provide instructions for bystander CPR. To support the achievement of these twin goals, the American Heart Association (AHA) has recently released proposed standards for...
The Health Contact Centre (HCC) in Brisbane Australia is one of the Health Support Queensland's services that provides clinical support, either directly to the community (4.7 million Queenslanders) or in support of Hospital and Health Services (HHS) and the Department of Health. Registered nurses (RNs) use the Emergency Communication Nurse System™ (ECNS™) as Clinical Decision Software System (CDSS) to triage callers who access this service via telephone. The RN uses a set of symptom-based protocols in the ECNS to telephonically triage the caller/patient and recommends the most...
Clinical call handlers at a contact center in Queensland Health, Australia, use a clinical decision support system (CDSS) called Priority Solutions Integrated Access Management (PSIAM™) (PSIAM version 3.6.1.1, 2012 release, Priority Solutions Inc., Salt Lake City, USA) to provide community members with telephonic triage, referrals, and health information. The contact center operates 24 hours a day, 7 days a week, and all calls are handled by Registered Nurses (RNs). Callers requiring emergency services, usually an ambulance attendance, are transferred to Emergency Medical...
While teaching a Medical Priority Dispatch System (MPDS®) refresher course in Canton, Illinois, USA, at the Canton County Sheriff's Office Dispatch Center, I was asked an interesting question by a student: "What do you do when a second party caller doesn't know the answer to your questions?" The student's question was inspired by a recent investigation request from the 911 center's local fire department involving a case dispatched as a BRAVO-level response to a fall patient. Emergency medical dispatchers (EMDs) use the MPDS to assign response determinant codes to incidents based...
Addison's disease is a rare, chronic condition brought on by failure of the adrenal glands, affecting people of all ages. It affects the production of cortisol and aldosterone, both essential in the body's functioning. A very low level of cortisol can be life threatening, since cortisol regulates blood pressure and the immune system, balances the effect of insulin, and helps the body respond to stress. Aldosterone helps to control blood pressure and regulate salts in the blood. Symptoms of this disease usually include a general feeling of being unwell, lethargy and fatigue...
Clinical call handlers use a clinical decision support software system (CDSS) called the Emergency Communication Nurse System™ (ECNS™) to further triage calls considered eligible for secondary triage post the interaction the patient or caller had with the Emergency Medical Dispatcher (EMD). EMDs use a primary emergency triage system called Medical Priority Dispatch System (MPDS®) to triage callers accessing 911 services. This call involved a teenage boy calling 999 in England, UK, on behalf of his friend (also a teenage boy) who was stung on the palmar side of his right wrist by...
On June 26th, mid-morning, a 47 year old male patient called into the 911 center with a complaint of being bitten by insects all over his body. Initially the caller wanted an ambulance to take him to the emergency room (ER), but he had advised the emergency medical dispatcher (EMD) that the rash and bites had been going on for a while. In Louisville, all medical 911 calls are triaged at the MetroSafe 911 center by a certified EMD using the Medical Priority Dispatch System™ (MPDS®) software, ProQA®. The end result of the EMD triage is an assigned (alphanumeric) determinant code that...
It was fairly early one day when a young man about 40 years of age called in to the 112 emergency line and asked for an ambulance. The reason was chest pains. He was very calm and "showed" no signs through the phone that he was in pain or any kind of distress. So I asked him if the patient was himself or if he had someone with him that he was calling for. He replied that he was indeed the patient, and when asked about the chest pain, he said that he had had some discomfort since late the night before and then again that morning. He had no history of any kind of heart or lung problems and...
This case study is based on a call handled at the Emergency Services Telecommunications Authority, Victoria. The Authority handles 42,000 emergency ambulance calls per month in an area of 237,629 km2, with a population of 6 million. The third party caller was the mother of a patient who was in labor with her first baby and had an undiagnosed true footling breech presentation. The patient was at home alone in an isolated rural area. This breech case was the call taker's first in six years of ambulance calltaking. He had taken many childbirths calls over the years, but this one was special...
The following case is a medical emergency call handled by a large metropolitan emergency medical service (EMS) agency. This agency handles over 12,000 emergency and non-emergency ambulance calls per month in an area over 270 square miles, with a population of around 500,000.The emergency medical dispatcher (EMD) used the Medical Priority Dispatch System (MPDS®) version 13.3 (NAE) to handle this call.
