Welcome to the third issue of the Annals of Emergency Dispatch and Response (AEDR) since its inauguration in March-April 2013. To better serve our readers, the main focus in this AEDR issue is case studies.
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...
One of my former mentors, Deputy Chief (Ret.) Jim Graham of the Chesterfield County (VA) Fire and EMS Department, was a huge proponent of the use of information, whether on a fireground operation, developing a new training program, or addressing budget reductions. One of his favorite sayings—one that stays with me to this day—was "We must constantly strive to become better at data-driven decision making, instead of following the 'I think, I feel, or I believe' model." However, he usually followed that up with the caveat that we should strive to ensure that we had good...
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...
Mountain users in the UK range from super-fit athletes to children and older people. Search & Rescue (SAR) personnel are regularly called upon to rescue and treat casualties with pre-existing medical conditions who have become unwell in mountain locations unaccessible by road. In the event of an emergency arising in a remote mountain setting, help is likely to be much slower arriving, compared to an urban environment. For example, in Snowdonia (North Wales), the minimum time for help to arrive is typically in the area of 45 minutes (RAF SAR helicopter from...