EMD - Is it worth it?

[x648eng119 2]

EMD can be more trouble than it's worth. If anyone's looking for a discussion on this, we can start another thread on the pros and cons of EMD. Let me know if you're interested.  :wink:

Sure - why not!!

In my humble opinion, as long as it's done right, EMD can be a very valuable tool. Especially when used to its full extent. Using the cards allows the dispatcher/calltaker to take control of the call right away, and as long as the dispatcher remains calm, the caller really can't go off on tangent. IT JUST HAS TO BE DONE RIGHT!!!

[Guest]

In my system the we get sent w/o lights and sirens to CVAs, and chest pains but light up for sick people and other crap. The system may work when all the ideal conditions exist but they wont ever in our system.

[x648eng119 2]

In the experience I have with EMD, it doesn't change the type of response, but sometimes it will determine who gets sent on the call.

ie:a call that comes up with a level A or B respnse may not get FD first response, or a medic, depending on the area, whereas C, D, and E (Possibly O) would get everything.

[EJS1810 7]

I feel EMD will work if done right. That means you have to have sufficient personnell in dispatch to have 1 person stay on the line with the caller and run th ecards. The other Staff can do the dispatch. We will be starting with the Medical Priorites Pro-QA EMD at the new Putnam 911 in March. I am worried if we will have the staffing to do it properly

[LCFD994 8]

Like just about everyone I feel if its done right then it is a good idea. I have never been " officially" in dispatch, but I get to see the end result of what difference a dispatcher has made using the EMD.

[chazEMT 5]

I feel EMD will work if done right.  That means you have to have sufficient personnell in dispatch to have 1 person stay on the line with the caller and run th ecards. The other Staff can do the dispatch. We will be starting with the Medical Priorites Pro-QA EMD at the new Putnam 911 in March.  I am worried if we will have the staffing to do it properly

EMD is a great system from the standpoint of getting care to the patient early! But as EJS mentioned in the above quote, the system has to be set up properly for it to work (sufficient personnel, etc.)

Dispatchers also need to be TRAINED to the point where they feel comfortable and competent working the cards...trust me, it AIN'T like you see on TV, where the dispatcher is giving a calm, compliant caller instructions on how to revive their 6 year-old! And if there isn't a comfort level on the part of the EMD, the system encounters a glitch at the "get-go!"

Well, as always, I've rambled on...in a nutshell, EMD WORKS-but make sure you have your system adapted for it at the dispatch level!!

[JBE 328]

I will echo these comments(although I have little exposure to EMD). If it is done properly, it will benefit those inneed.

[Remember585 815]

One word sums up if EMD is "worth it."

YES!

[mikeinet 37]

One word answer: yes.

Further answer: In a place like westchester where there is no "priority" system or no determination of "level" of responce (light-sirens/automatic als/non-emergency responce) then unfortunetly the only real gain that EMD has is being able to give CPR instructions, FBAO instructions, and how to control bleeding.

In a system that runs on priorities then EMD is a must, it determines the real level of an emergency and how a responce should be based.

[Remember585 815]

I disagree.

EMD gives you the capability to deliver a baby over the phone, it gives you the chance to acquire information that may be vital for the responding EMS units, and, from personal experience, I have found that the original problem the caller stated is far more complex by my "interrogating."

How you choose to respond is up to each responder. 60 Control may get a call from a local PD saying "unknown medical" and the bus and medic go "no lights, no sirens." This "unknown medical" could be a major emergency, that if someone took the time to EMD, they may have known more information.

Believe me, I hated EMD even when I worked in Somers. But it does work, and it has many benefits that too many communities in Westchester are robbing their public of!

[calhobs 110]

from what i remeber is that you are suppose to respond to all calls lights and sirens (actually thats what you have them for) WHat happens if you respond to and unknowen and it has turned into a shooting and you didnt respond lights and sirens????? Try and explain that one to the jury. UM yes SIr your Honor it was an unwoen so we figured to take it easy and see the sights.

[JBE 328]

from what i remeber is that you are suppose to respond to all calls lights and sirens (actually thats what you have them for) WHat happens if you respond to and unknowen and it has turned into a shooting and you didnt respond lights and sirens????? Try and explain that one to the jury. UM yes SIr your Honor it was an unwoen so we figured to take it easy and see the sights.

OK wait a second here, there are jurisdictions out there who have silent dispatch protocols. If an unknown medical emergency is dispatched, there is the possibility that it's a silent dispatch protocol. If someone(PD or EMS Boss) arrives on scene prior to EMS arrival and confirms a shooting or some other type of urgent response, common sense would dictate that they would crank up the aforementioned electronic warning devices. There are other times when you have a shooting with a hostage situation,(rare but possible) where the EMS unit is advised to respond without either, as so not to agitate the bad guy. Something to keep in mind.

[mikeinet 37]

calhobs - why would you respond to every call with lights and sirens? In today's day and age, 911 is the phone number to call when anything goes wrong... so why do you respond lights and sirens, possibly putting people's lives at risk, for someone who's throwing up and doesn't feel well? (general illness w/ no priority symptoms) that's just silly.

[WAS967 97]

At my full time job I always respond with L&S because 1) It's our protocol to and 2) If I didn't people would complain. At my part time job I work a night shift and more often than not I respond with no lights and sirens. At the part time job we are dispatched to everything so a lot of times the situation doesn't call for a "hot" response, but even if it did, I find that I can get there (again, at night) just as quickly without as with. Sure, if I run into an obstacle, (traffic [rare], red light, etc) I'll light up.

[Guest]

That's a good policy - one thing i don't understand are these guys who go around at 2:30 in the morning, areas where there is no traffic, the Q pinned on on the airhorn. WTF? have some courtesy. If you are coming up to an intersection, sure, make a little noise, but be consderate. I can't stand the idea - "i'm up, everybody is up"

[calhobs 110]

first of all you would be told by distpatch if there is for exapmle a hostage taken and then of course you would not use lights and sirens and as far as just the person throwing up well there is a resopn why that person is throwing up. I mean come on people i have been doing this for over 15 years and our protocal in The FDNY is you go to all calls lights and sirens, which does not mean you blast your Q or air horn at 3am in the moringn when htere is not traffic to tell you the truth i dont use a siren much only when i have too.

[mikeinet 37]

calhobs: yes, there is a "reason" why they are throwing up... but is it life threatning?

I personally see no reason to "respond" to a general illness... can you justify killing someone (say an accident at an intersection) for someone who has no apparent life threat? I know I can't.

[JBE 328]

That's a good policy - one thing i don't understand are these guys who go around at 2:30 in the morning, areas where there is no traffic, the Q pinned on on the airhorn. WTF? have some courtesy. If you are coming up to an intersection, sure, make a little noise, but be consderate. I can't stand the idea - "i'm up, everybody is up"

Well, you can look at this in two different ways. One way is the psychological warfare standpoint. Think of the comfort someone in need has when they hear that siren. They know help is coming. Then you get the people who pi$$ and moan about "I don't want a whole fleet of fire trucks and ambulances and NO SIRENS" Then the vindictiveness of certain people comes into play. :twisted:

[x648eng119 2]

This is true, so - maybe the 1st due can give a little tap on the siren while approahing the house. But would you want to be woken up at 3:30 in the morning by some "nozzle nut" when you have to be up at 6?

[JBE 328]

Someone asked me that question once. What would I do if I got woken up by a siren. One of two things. Either turn the scanner on and find out what's up, or just roll over and go back to bed.

[x648eng119 2]

But the average Joe Citizen - not fire buffs like you and me. Put yourself in their shoes. (or slippers)

[JBE 328]

I would probably roll over and go back to sleep.

[Oswegowind 17]

EMD works period

I personally have delivered a baby following the cards and initiated CPR...If you are alone you can always send the bus and then continue...If it originally was relayed by the pd then you can do a call back and get more info...I believe it is important...

and from a legal perspective it gives you a backing to give them instructions and be protected...if you are EMD qualified and give instructions you can be sued...if you are trained than you are covered by a world reknowned system that works and has been proven to work...even in the UK and the Philippines...

[Guest WCDES636]

EMD works great for Pre arrival instructions. It would work great for priority Dispatching as well. But local BLS agencies are too Medic Dependent. They want an ALS response on all calls. I have had BLS units asking for ETA's for a medic long before getting on the scene. It's sad to see EMT's basically becomming DRIVERS. I came up in a BLS only system, where EMT's treated patients. Not sat around and waited for a medic to tell us it was going BLS.

[x635 4,066]

Most important part (and not used at all in this county) is the whole Priority Dispatch part.

Priority Dispatch is used to determine level of response, such as ALS, BLS, PD, FD etc, and the mode of response (Code 1,2,3)

This would help, so you're not sending a medic unit on an ankle injury, etc...but sending them to a chest pain or syncope.......or not sending a unit code 3 to a minor injury or incident.

[mikerabbit 2]

Not to knock BLS but I believe it is a true waist of resorces to send a medic to a hand laceration, especially when the dispatcher knows it is a 5-10 min ETA for a fly car.

The problem is that alot of people are afraid to use EMD because they dont want to be blamed for not sending a medic.

[chazEMT 5]

Not to knock BLS but I believe it is a true waist of resorces to send a medic to a hand laceration, especially when the dispatcher knows it is a 5-10 min ETA for a fly car.

The problem is that alot of people are afraid to use EMD because they dont want to be blamed for not sending a medic.

I agree with the first part of your post Mike...especially in a two-tiered system, it makes no sense to tie up a medic on BLS jobs when the need for ALS may arise on another job!

As for your last statement--bear in mind that EMD, as with most things, is "garbage in-garbage out!" EMDs can only process and act upon the info they're given during the brief duration of the call. It's often impossible to make a definite determination of ALS vs BLS from the info a caller gives. And when one of those "grey areas" arises, the judgement is usually to send ALS, with the understanding that the medic can either "BLS" the call, or be cancelled by the BLS crew en route. (Of course, this leads us to a whole other can of worms regarding response times of the BLS crews, and the competence of the EMTs....but that's a whole different bottle of tylenol!!)

Sorry I've rambled on....AGAIN!

[WAS967 97]

Dont stress there Chaz....you can only do so much in an EMT class. I always tell the new people that half of what you learn (if not more) is learned on the street and from experience. Yup, there are a few special people in every bunch that you just want to strangle. But hopefully in the end, most can be taught to be excellent EMTs.

[LCFD994 8]

I see that EMD worked very well for a gentleman in Putnam County as the dispatcher used it to instruct a person to perform the Heimlich manuver on a choking victim.The Heimlich was performed successfully...

GOOD JOB =D> =D> =D> =D>

[Oswegowind 17]

I haven't seen one post that put down EMD so far even if it is used at a minimum...anybody want to partake in negating these positives or is it unanimous(?) that EMD does work????