madwis911@yahoo.com

Hey man... this is what having an open forum is all about! Glad to be part of the team! Since I am no longer in the field I almost didn't respond... but then that just wouldn't have been in character!!

The EMD system actually empowers the EMD to ask more, better questions by giving a base line of questions to ask on every call, the EMD can ALWAYS ask a clarifying question to help get the BEST information to the responders... Remember, the whole point of an EMD system is to allow dispatchers to send the MOST APPROPRIATE response to calls... as I mentioned previously, since we implemented EMD our services respond COLD to ALPHA and some BRAVO calls AND we send the NEAREST (base d on AVL/GPS locations of all ambulances in the county) ALS unit to the most serious calls... regardless of jurisdiction. This has been huge, and saves lives! Our system works pretty well and has been a model for other systems in out state. I guess I'd like to know if your dispatch agency uses any of the commercially available systems, there are several!

Thats why we ask the CASE ENTRY question - "What's the problem, tell me what happened?" - This allows the EMD to ask clarifying questions; EMD = whats the problem, tell me what happened? caller - "I think I brok my leg" EMD - "tell me what happened?" caller - "it was dark, i was going to the bathroom and hit my little toe on the bedframe" EMD - "ok, so you stubbed your toe?" caller - 'yes' a call like this would likely code out as a 30A1 - Traumaitc Inury - NOT DANGEROUS BODY AREA - all of the ambulances in our county have MDC's so the crew can read exactly what comments the dispatcher see's... Make sense?

No, it's like I said. We have a close working relationship with our field users, all of the medical directors compare notes, we have quartly 'grand rounds' where medics, EMTs, dispatchers, medical directors, ER staff get together and review cases, even the minor ones... ...yes, we have a dedicated 9-1-1 center medcial director (yes, he is an MD!) and trust me, when things DON't match up we hear about it. Our user agenices call us for times or they complete a 'field feedback' report in the ER when they are doing their run reports and they get a special review. Obviuosly I'm not going to win you over, I know every system is just a little different...what can I say, our system works well for us! So, if you ever find yourself in the land of beer, brats and cheese, give me a call and you can come see for yourself!

OK! Good luck!

spenac, Maybe my remarks related to being accurate 95% of the time need some clarification - our system, working towards strict protocol compliance, means that our CHIEF COMAPLAINTS & ACCUITY LEVELS (priorities) match what the EMTs/Medics find upon arrival between 90-95% of the time. The 5-10% of the times where the responders find something TOTALY different mean the caller either lied completely or the EMD failed to follow the protocol, skipped questions, made a data entry error (our system is PC based) otherwise 'screwed up', yes, it happens! As a point of reference, this year my center will answer in excess of 700,000 calls and dispatch in the neighborhood of 40,000 EMS calls. Having been on your side of the radio for nearly 20 years, I underastand that not every call is as it would appear!!

spenac - Here is the answer to your question about seizures - Here in Dane County (WI) we use the National Academy of Emergency Dispatch, Medical Priority Dispatch System; We ask EVERY caller the same CASE ENTRY QUESTIONS; What is the address of the THE emergency? What is the phone number you are calling from? What's the problem, tell me what happened? Are you with the patient now? How old is he/she? Is S/he conscious? Is s/he breathing? Then, depending on the answer to 'whats the problem...', the EMD will choose one of 34 CHIEF COMPLAINTS, in the case of a seizure I would go to CC 12 & ask the following; 1. Has s/he had more than 1 seizure in a row? 2. (female) Is she pregnant? 3. Is s/he a diabetic? 4. Does s/he have a history of heart problems? 5. Is s/he an epileptic or ever had a seizure before? 6. Has the jerking stopped yet? (You go check and tell me what you find?) 6A - If Yes - Is s/he breathing now? 6B - Is s/he breathing regularly? Now, depending on the answers to these questions this call would be coded somewhere between; DELTA - 1 - NOT breathing 2 - continuous or mulitple seizures 3 - irregular breathing 4 - breathing regularly NOT verified pt is >35YO CHARLIE - 1 - pregnant 2 - diabetic 3 - cardiac history BRAVO - 1 - breathing regularly NOT verified, pt is <35YO ALPHA 1 - NOT seizing now AND breathing regularly verified In our system, EMS units run COLD (no L&S) to ALPHA and some BRAVO calls - alternately, we send AUTOMATIC ALS to ALL ECHO LEVEL (the most serious) and some DELTA level calls. I know it's not as easy to explain, but I'd be happy to go into more detail with anyone who is interested. Email me at madwis911@gmail.com. Paul

The thing is in both systems 90%+ what we find does not match what we were told. So neither system is that great and as much as I pick on dispatchers it sucks trying to get people to calm down and answer questions. Thank you dispatchers but never forget I will continue to bash you.