Emergency medical dispatch (EMD)

What is EMD?

the primary and initial point of contact for callers seeking medical assistance

What are the responsibilities of the EMD?

receives and processes calls for emergency medical services assistance, determines the nature and severity of the medical incident without diagnosing the problem or condition, coordinates and dispatches EMS resources based on the predetermined response configurations found in the locally approved EMD guidecards, provides emergency medical care using the locally approved guidecards and software, and maintains contact with the caller

what are the characteristics of a successful EMD?

maintains confidentiality, handles the emotional stress involved in caller/patient crisis situations effectively and guides callers, is clear and concise and uses accurate speech

what is required by APCO to become a telecommunicator?

CPR certification, and 40 hour training course

regardless of the resource, your agency should always have the following:

basic and special capabilities of each resource, resource location and status, and procedures for request and activation

What is tier 1?

first responders provide immediate response to events that are determined to be urgent

what is tier 2?

basic life support ambulances staffed by EMT personnel

Tier 3

Advanced life support(ALS) units are staffed by an advanced emergency medical technician

Myth or fact: using the EMD guidecards increases the amount of time and resources required to process a call

Myth

What are hot responses?

going lights and sirens

what are cold responses?

a normal traffic response

BLS cold

basic life support responding in normal response mode

BLS hot

basic life support responding with lights and sirens

ALS hot

advanced life support responding lights and sirens

What are four factors are required for proper resource allocation?

the nature and severity of the emergency, the EMS resources available, proper use of the EMD guidecards, and determining the need for specialized resources

What is liability?

liability means that you are ultimately response for your actions

what is negligence?

defined as failure to act or perform in a particular situation as any other reasonable, prudent telecommunicator would under the same or similar circumstances

four ways that the court proves negligence?

duty, breach of duty, injury/damage, and proximate cause/causation

what is simple negligence?

conduct that was not purposeful or caused by malicious intent (human error)

what is Gross negligence?

a negligent action that was undertaken with malicious intent

what is foreseeability?

refers to the fact that you must rely solely on the information you get from callers

what is the standard of care?

the standard of care for an area can be defined at ay level of government local, state, or federal. usually the standard used in a court case is the standard that the local community uses.

what is used for establishing standard of care

the EMD’s behavior and conduct are judged in comparison to professional standards published by organizations involved in the development of EMS standards, such as the national association of EMS physicians (NAEMSP) and ASTM international

The APCO institute EMD program is based on:

The National Standard Curriculum for Emergency Medical Dispatch designed by the National Highway Traffic administration (NHTSA) and guidelines set by NHTSA and ASTM International

what is one way in personal risk management to reduce liability?

actively participate in QA/QI and continuing education programs

what is a dangerous or negligent EMD practices?

providing medical instruction without using locally approved EMD guidecards

what are the three guidecard types?

All callers interrogation, individual chief complaints, scripted medical instructions

What are the chief complaint guidecards?

used to obtain information form the caller regarding the type and severity of the specific medical emergency being reported.

how many criterias are needed to send a call over?

only one criterion is necessary to determine a dispatch response

What are scripted medical instructions?

these guidecards give specific medical instructions to be provided when patients need immediate care to save their lives. these cards must be read directly to the caller word for word

although proper call handling relies on your ability to gather information about chief complaint,

it also requires you to gather information about the safety of the scene and other important factors that may require you to dispatch support agencies and resources

What are the phases of dispatch?

Phase one: call-receiving activities (collect), Phase two: dispatch activities (dispatch), Phase three: Post-dispatch activities (provide)

what is the most effective way to break through a caller’s hysteria?

repetitive persistence

what is acute?

sharp, severe, or rapid onset

what is chronic?

long duration or frequent recurrence

out of hospital chain of survival:

recognition and activation of emergency response, high-quality cpr, defibrillation, advanced resucitation, post-cardiac arrest care, and recovery

providing chest compressions to a person who is not in cardiac arrest…

is unlikely to cause any harm and the alternative will result in a worse outcome

What is an AED?

an electric device that uses a computer within the machine to analyze and detect certain heart rhythms that can be corrected through the delivery of an electrical shock to the heart

What is PAD

public access defibrillation program designed to make AEDs available

the terms left and right always…

refer to the patients left or right side not the caller’s

what is respiration?

breathing is automatic

what is agonal respirations?

are breaths that are ineffective in gathering oxygen for the body. weak, heavy, gasping, snoring, gurgling, moaning, or occasional

how many bones does the spinal column have?

33 bones

tendons connect to what?

muscles to bones

ligaments connect to what?

bones to other bones

what is the epidermis?

thin outer layer of skin

what is dermis?

is the inner thicker layer of skin

What are the vital points

pulse, blood pressure, respiration, temperature, skin

What is a sign?

something that can be seen or heard (objective)

what is a symptom?

is something that a patient reports cannot be observed (subjective)

what is anaphylactic shock

accompanies the ingestion, inhalation, injection or absorption of a substance to which a patient is severely allergic

cardiogenic shock

when the heart can no longer pump blood effectively

hemorrhagic shock

when the body loses large amount of blood through internal or external bleeding

hypovolemic shock

when the body loses larges amount of body fluids through vomiting, diarrhea or perspiration

neurogenic shock

can occur after damage to the spinal column and results in paralysis

septic shock

caused by severe infections

what is a form of respiratory distress?

choking

how many chief complaint types are required by the national highway traffic safety administration national standard curriculum for EMD?

32

one person’s distress could be?

another persons chronic breathing problem

any male patient, 35 or older or female patient 40 or older, complaining of abdominal pain should be considered…

a possible cardiac patient. any patient over the age of 35 complaining of chest pain should be considered a cardiac patient

when diabetics fail to take their insulin, they will have a gradual rise in their blood sugar levels. this is known as what?

slow onset results in diabetic ketoacidosis

how long do seizures last?

45 to 60 seconds

what additional information is needed when a moto vehicle accident occurs?

Was there anyone thrown from the vehicle and if a chemical spill is involved

what is an imminent childbirth?

when labor contractions are less than two minutes apart

what percentage of calls are reviewed?

7-10%

the CDE program must be organized around the standards of care of the EMD with these specific objectives:

maintain and develop the EMD’s understanding of medical conditions, incident types, and priorities necessary when performing patient assessment and prioritization of medical calls, maintain and improve the EMDs ability to use APCO EMD guidecards, and maintain knowledge of seldom used technical aspects of the system

all APCO-certified EMDs must:

provide 24 hours of CDE for every two-year certification period

How can you lose APCO certification

habitual or excessive use of narcotics, conviction of DUI, violation of laws pertaining to medical practice and drugs, and conviction of felony (moral turpitude)

what is burnout?

a state of mental and physical exhaustion (cumulative stress)

stages of burnout

stress arousal phase, energy conservation phase, exhaustion phase

how to reduce stress

eat a healthy meal before going to work, leave work problems behind when you go home, talk it out and understand tertiary patient syndrome and how to deal with it (became emotionally involved in the outcome)

What is CISM

critical incident stress management

what are the common signs or symptoms associated with excessive stress

cognitive, physical, emotional, behavioral