The most critical and difficult part of the Emergency Police Dispatcher's (EPD) job may be the gathering of the initial problem description, which uses a scripted Protocol Case Entry Question (CEQ) but also requires interpretation on the part of the EPD. Specifically, at the beginning of the call, the EPD asks the caller the CEQ "Ok, tell me exactly what happened" (TMEWH). Based on the caller's response, the EPD selects a Chief Complaint (CC) Protocol—a specific protocol that provides the prompts to drill down into the caller's situation—the primary reason for calling 911. Selecting the wrong...
Historically, emergency medical dispatchers (EMDs) do not normally have the opportunity to learn about the outcomes of the patients who they have impacted. More often than not, ST-Elevation Myocardial Infarction (STEMI) cases are urgently transported and triaged within the hospital system, and dispatchers are not afforded the opportunity to learn "the rest of the story" about the patient's outcomes. This leaves the EMDs wondering about the patient, not only from a survival standpoint, but also as to whether or not their pre-arrival instructions (PAIs) made an impact on the patient's condition...
For years, rising EMS call volumes have taxed resources in EMS jurisdictions. A significant problem of utilization by frequent 911 callers has contributed to transports and ED utilization, some of which may be unnecessary. Solutions to this have been limited for field providers. Purpose: We wished to both pilot a new EMS partnership with our county's Health and Human Services Agency (HHS) that could intervene with services for these "super-users," and study the scope of the problem, with the goal being appropriate alternate dispositions besides EMS activation. Intervention through referrals...
Northwell Health Center for Emergency Medical Services (CEMS) strives to provide the best prehospital care in the Northeast Region. CEMS Communications, an Accredited Center of Excellence with the IAED, continually monitors the effect of its MPDS system as it applies to our EMS response through Clinical and Communication Quality Assurance and Quality Improvement. The objective of this study was to evaluate MPDS cases handled on Protocol 26 Sick Person (Specific Diagnosis) and compare these with our paramedics' Provider Impressions. The evaluation of this data will look to validate the use of...
Today's wireless 911 location technology is not always precise. As people move away from using landline phones, more and more calls to 911 are being placed from mobile phones, even indoors. In fact, over 70% of 911 calls today are made from mobile phones according, to the FCC. As such, the need exists to improve location accuracy for mobile 911 calls in order to provide fast and reliable 911 response. The objective of this study was to evaluate a potential improvement in wireless 911 location technology by performing a pilot test comparing an existing wireless Phase 2 system to a device-based...
Lee County, Florida, has 108 golf courses. Snowbird season packs the golf courses with many who are older. Medical emergencies: stroke; cardiac arrest; fractures; back injuries; stings; and heat exhaustion are common. Access to patients on golf courses is challenging. Golfers can only see the lanais and back of houses—not street addresses. To design a Graphic Information System (GIS) and Computer Aided Dispatch (CAD) solution to identify patient locations using common place names and verified addresses. GIS produced maps of all 108 courses were labeled with possible access points to...
Sudden cardiac arrest (SCA) is one of the most common causes of death in western industrialized countries. More than 12,000 people in Austria suffer SCA every year. Survival is strongly influenced by bystander cardiopulmonary resuscitation (CPR) and early defibrillation. The hospital discharge rate after out-of-hospital cardiac arrest was 11% in 2011. The bystander CPR rate was 42%, and in only 4% of cases was an automatic defibrillator (AED) used by laypeople. CPR guidelines have emphasized the importance of Public Access Defibrillation (PAD) programs since 2001. To...
Adequate chest compression (CC) depth is crucial for optimal resuscitation outcomes. Lightweight rescuers, particularly women, are often unable to achieve the required 5-6 cm CC depth. This non-randomized cohort study investigated new strategies to improve CC performance. The objective of the study was to evaluate the effects of a 5-second instructor's intervention on the depth of CCs performed by female rescuers during standard video selfinstruction (VSI) basic life support (BLS) training. Methods: Data were prospectively collected from January 2011 to January 2012...
In telephone assisted, advanced medical priority dispatch system (AMPDS) driven, lay-rescuer, compression-only cardiopulmonary resuscitation (COCPR) it remains unclear whether the instruction "push as hard as you can" improves compression depth. This was a prospective, experimental, double-blinded, randomized, controlled, parallel group study to compare the depth of chest compressions achieved following the instruction "push as hard as you can" and the recommended guidelines. Primary outcome was defined as compression depth. Secondary outcomes were defined as...
The Yorkshire Ambulance Service (YAS) moved to Performance Standards 9 in November 2012. As a Trust aspiring for Accreditation, the Quality Audit Team (consisting of Emergency Dispatch Quality Assurance ED-Q specialists) wanted to ensure that compliance was suitably above the targets set by the International Academies of Emergency Dispatch (IAED). The goal of this study was to improve and track improvement of current compliance performance to the Medical Priority Dispatch System (MPDS) utilizing Continuous Dispatch Education (CDE) in YAS. To achieve this goal, YAS...
