I worked yesterday with an EMT with extensive dispatch experience, and as always, it was interesting to hear his perspective on the dispatcher’s job. Sometimes there is a natural antagonism between road crews and dispatchers because the dispatcher is the bear of bad news, but should not neccessarily be shot for it.
(Oddly, while working together dispatch sent us to a quiet location where we sat for the last six hours of our shift without a call).
I didn’t mean to be totally trashing EMD in recent posts. I recognize while I may get frustrated with the overtriage of lights and sirens, EMD and the EMD dispatchers are a valuable part of our EMS system. I’d like to post a great comment I got on a recent post from a dispatcher:
As an EMD dispatcher, it is safe to acknowlege that EMD is not only to slow units responding down for the non-emergent calls. EMD also provides callers with post dispatch instructions and this ranges from CPR, Choking, Maternity, bleeding control and much more. In a sense the 911 call taker is the virtual first responder. As we are unable to see the patient, as we are trained to treat a patient as an EMT-B & EMT-P, we rely on the callers information. Getting an out-of-control caller to calm down is difficult even for the experienced dispatchers, but non-the-less needs to happen in order to improve the quality of life for the patient. EMD provides a set of protocols that allows the call taker to reduce the agitation or excitment of a caller much easier. Yes, in the past it was “winged” but as Medics & EMT’s alike know it is risky to provide pre-hospital instructions to a caller with out being able to see the patient. Also, in the excitment of the call and reducing the callers “freaking” a call taker, even medically trained, may miss important questions that is nessecary to assit that patient. A caller may give information that the patient is not breathing. A call taker, not using protocols may get tunnel vision and start working the patient over the phone, but fail to ask the pertinent questions that EMD will make you ask. Now you find out, using EMD, the patient fell down a flight of stairs and is not breathing. There is instructions for the caller to use jaw thrust to protect the patients c-spine. In the delivery of a baby over the phone, as a call taker even trained medically, you do not want to miss ANYTHING. One missed step could mean life or death for the infant or mother. As EMD may not work for the response level of the responding units all the time, in my view I have seen a reduction in the amount of calls that are being sent on a priority one. It also does not help when a company deviates from the response algirthym such as making all “E”, “D”, “C”, “B” responses priority responses, when EMD protocol states that only “E” & “D” are Hot responses all the time. The protocol states that “C” response is BLS “Hot” with ALS “Cold” (The just in-case needed factor) and “B” is BLS “Hot” no ALS and “A” is BLS “Cold”. But, “C” and “B” are reduced in priority based on local protocols or medical control which every EMD has to have to operate. It is safe to say that EMD has it’s purposes and can work in most situations, especially in pre-hospital instructions to callers on the phone with the calltaker. Also, keep in mind, the EMD is increasingly usefull and benificial to response grids and regions that are not anywhere near a hospital or the nearest emergency responder is possibly 20 minutes out.
For more on the dispatch perspective check out Nee Naw a blog by an EMS dispatcher in London that is great reading.