WREMSCO EMD Deadline

[WAS967 97]

And for those who have more experience with the "cards" than I do (never seen em):

shall be responsible to dispatch an ambulance to every call for

emergency medical assistance in the Westchester Region unless it is determined by

EMD protocol that ambulance response is unnecessary.

Is there any part of the EMD protocol that actually says you can tell the caller that they don't require an ambulance???

[firedude 985]

I guess this really aims at the agencies like Harrison, PCRVAC?, Eastchester, MEMS?, WPEMS, MVEMS, OVAC, YVAC, MVAC etc who are (or maybe - some I dunno honestly) dispatched by PDs.

The Town of Mamaroeck Ambulance District (LVAC + MEMS) switched from the PDs dispatching to 60 Control in July. Eastchester VAC is also dispatched by 60 Control. just FYI

Edited October 18, 2012 by firedude

[Goose 188]

I doubt anyone would want to take on the liability of not sending a bus. Could be wrong, though.

Just seems like more and more this is an "in name only" situation. Is there going to be a metric attached to this in terms of what % of calls must recieve EMD based triage? From where i sit, i just don't see this changing the reality of EMS operations in this county. Agencies that staff ALS ambulances probably won't change the way they operate as long as their communities will continue to support that level of care - reguardless of the situation EMD/no EMD you're still getting a bus, an EMT and a medic. The real issue is when it comes to fly cars that serve multiple jurisdictions, but again because a paramedic fly car is the only guarenteed thing i can't see them not being sent. For those of us dispatched by 60 Control, will this open the door for redirection by the ECC operator - during times of heavy call volume - to higher priority and holding jobs / sending lower priority jobs mutual aid? When it gets busy i find myself and my collegues self triaging calls - asking what 60 has then figuring out what sounds more serious and going to those jobs. Problem is, the ECC operators have access to more information than field personelle do during dispatch.....which is why an MDT would be nice. But, i digress.

I just can't help but be skeptical on how this will play out or what this means for those of us still in the field. Saying you have or enforce EMD is great, but taking full advatnage of all its benifits is another.

[theofdmv 1]

Mount Vernon Fire Dispatch, currently have 2 EMD's and the rest of the 8 members assigned will be EMD certified by the middle of November. They are all currently taking the APCO EMD class.

[v85 212]

Yes, there are certain parts of the protocol that allow for, with the consent of the local medical director, not dispatching an ambulance.

These sections are known as Omega responses.

Another interesting fact is that the computerized version of EMD that everyone thinks of is only one product in the EMD field. Its company: the National Academy of Emergency Medical Dispatch is a dba name of Priority Dispatch which is a FOR-PROFIT company that makes good money ($500 per terminal license) on its computerized EMD system (called ProQA). There are other versions of EMD in existence like APCO's and some states like NJ have their own EMD made up by the state health department and ems office

Edited October 18, 2012 by v85

[WAS967 97]

Goose brought up another issue that drives me nuts. Only half of the EMD system is really being used by 60 Control. Why does WCDES not use the priority dispatch system?

[Sailr322 88]

While I think that EMD is a fantastic and invaluable tool, I have noticed of late fewer calls seem to be getting EMDed. I'm not sure if this is just me or if it is something that other people are noticing, if anyone else wants to share what they have noticed that would be greatly appreciated. If we are already seeing fewer calls with an EMD with just the addition of those agencies that Firedude mentioned switching to 60 over the summer, what is going to happen when the deadline comes in January? Even fewer calls being EMDed? I think that 60 dispatchers do an amazing job and am in no way attacking them, rather I am trying to ask if others have noticed a decline in the ability to EMD a call because of an already increased call volume.

[WAS967 97]

One of the BIGGEST reasons I've seen in the recent past for calls not being EMD'd is the improper transfer of the call from the PD operated PSAP to 60 Control. Usually if 60 is unable to EMD due to call volume they make a note in the CAD saying such. I'd imagine that would come into play with the whole required QA/QI part of the EMD plan and can be used as a tool/ammunition for the powers that be at WCDES to argue for more dispatchers. Nobody can argue against the need for a few more chairs in there. What are they running, one supervisor and three or four dispatchers? Two good incidents and the rest are answering phones with their feet.

[Sailr322 88]

That makes much more sense. Thanks for clarifying. Yes, as far as I am aware they have four dispatchers and ones supervisor on at any given time. If someone is able to confirm or deny thhis that would be very helpful.

[x129K 1,393]

Having been an EMD since 1996, I can say, with experience, that EMD is NOT all it is cracked up to be.

In cases of arrest/choking/hemmorage control/childbirth - YES, pre arrival instructions are vital....but IMEO, the rest is just fluff.

Paramedic is, and should be the standard of care..I think in the next few years, BLS transporting units will be obsolete.

I am not a fan of the Priority response plan.

I find the majority of callers actually beleive that the dispatcher they are talking to is the one who will be responding. I can not even begin to count the times I have initiated EMD, only to hear, "Just send the Mofo'ing Amalance!" Click...................

NOT bashing my, or any other agency, just real world experience.

[x129K 1,393]

Oh.

And I also find, that those MOST critical of dispatching, and dispatchers, are those who have never spent a millisecond in "the chair".

EVERYONE has ideals, Dispatchers have protocols.

[Goose 188]

One of the BIGGEST reasons I've seen in the recent past for calls not being EMD'd is the improper transfer of the call from the PD operated PSAP to 60 Control. Usually if 60 is unable to EMD due to call volume they make a note in the CAD saying such. I'd imagine that would come into play with the whole required QA/QI part of the EMD plan and can be used as a tool/ammunition for the powers that be at WCDES to argue for more dispatchers. Nobody can argue against the need for a few more chairs in there. What are they running, one supervisor and three or four dispatchers? Two good incidents and the rest are answering phones with their feet.

It's something very close to that. It's ridiculous. But again, it's an "in name only" thing - lets make a county dispatching center and staff it at the bare minimum just to say we have it.

I wonder what authority the REMAC would have in drafting protocols in terms of dispatching of resources ( ie : x, y, & z are BLS calls with no ALS dispatched). Also curious if FDNY worked with their REMAC to establish how they triage calls or if they operate solely off whatever software program they use tells them.

[v85 212]

The actual responses are defined by the local agency. The software or flip cards only gives it the codes. So agencies can have Charlie and Delta ("ALS Level calls") handled as BLS based on what the local system and medical control wants.

A good example is that in NYC any trauma call is BLS unless the person is unconcious. That is a local decision, not one made by the software

[firedude 985]

Now that the deadline has passed, has there been any changes in dispatching agencies?