Questions We Ask You
If you've ever called 9-1-1 you may wonder why the call taker seems insistent upon asking you a series of questions instead of dispatching help. Rest assured, they are doing both! Cambridge uses a specialized system (Computer Aided Dispatch or CAD) that allows the call taker to instantly transfer information electronically and automatically to the dispatchers. You don't hear them telling someone where to go, because there is nothing to be heard! This computer system greatly increases response time and accuracy and is considered the critical computer system in the Police, Fire, and Emergency Communication Department.
So why answer all those questions? It helps us to provide the appropriate equipment and manpower response to your specific emergency and it helps us to immediately begin giving the proper life saving instructions - if they are required. "He's bleeding badly" does not mean the same thing to every person. To one person this may mean that they have severed a major artery and to another person this may indicate a supercial cut that is bleeding but that may or may not need stiches.
In April of 1998 Emergency Communications began a special program to improve response to emergency medical calls. Under the leadership of Dispatcher Ron Richard, the ECD had previously adopted the Medical Priority Dispatch System (MPDS) protocol for handling and classifying EMS calls. Every ECD staff member was certified in MPDS (a rigorous 3-day course) and a set of MPDS cards was obtained and placed at each position that could take a 911 or other emergency call. In April, all dispatchers began to use the cards, not just for those calls that needed pre-arrival instructions (e.g., baby choking, person needing CPR instructions, etc.) but for all EMS calls. The cards help dispatchers ask a carefully selected but brief set of questions which help insure that the dispatcher understands the exact nature of the medical emergency and better organizes the correct response. In 2006, the cards were replaced by a computerized version of the cards which offered greater functionality; for example a callers answers to their specific questions are captured, organized and presented on the laptops of many responder vehicles as they are enroute to the emergency.
Over 240 different codes match caller needs to a highly tailored set of responses. For example, previously the classification "BLEEDING/HEMORRHAGE" was used for all calls where persons were bleeding. Under the EMD system there are seven different types of such calls from a cut on the finger that only needs an ambulance all the way up to a major arterial bleeding that gets a full tiered response of the closest Engine company (to arrive fast and start the workup), the closest Fire Squad ALS paramedic unit (to provide advanced life support/paramedic level functions), to a transporting contract ALS unit from Professionbal Ambulance (to assist in all ALS functions as well as in transport to and entry into the hospital ER).
More finely detailed classifications help get the right equipment to the right call, avoid unnecessary over-response, better prepare en-route responders, and help dispatchers guide the pre-arrival actions of persons helping the patient. The EMD program is a collaborative effort among the Fire Department and its highly respected Squad and Rescue service, the city's contract ambulance and ALS company (Professional Ambulance), the Police Department, and the ECD.
A Steering Committee sets policies, oversees the classifications, and deals with general EMS issues. Supervisors use call review, call scoring, and feedback sheets to insure quality control. In addition, there is a pay incentive and re-certification program to promote and insure EMD skills development by dispatcher.
Why is DLS good?
Dispatch Life Support is the body of information and methods used by EMDs to help callers deal with a wide range of patient and scene circumstances. The scripted protocols enabling this crucial exchange of information lead the EMD through a verifiable, comprehensive process that eliminates the chance of inadvertent omissions of vital information. By giving instructions over the phone the dispatcher is able to give aid to the victim through the caller or bystander until medical help arrives.