search terms: Triage system, fewer lights and siren, cold, Medical priority dispatch system, Weber county, use of lights and siren, medical prioritizing system, information gathered, responses to emergency calls, dispatchers, color-coded cards, miranda cards, on-scene information, Ogden Standard Examiner, March 6 1995, use of paramedics, rescue dispatch, safer approach, emergency medical dispatchers (EMD)

Ogden Standard Examiner, Monday, March 6, 1995
Amy Joi Bryson, Standard Examiner staff

Taking a safer approach to rescue dispatch

You're probably seeing fewer lights and sirens around town. Fire engines still race off to burning buildings and paramedics streak to accidents with serious injuries.

But in many cases, those in the emergency response field in Weber County are going "cold" on runs. Lights are off, speed limits are followed and sirens are noticeably silent.

The difference is the result of an updated Medical Priority Dispatch System being implemented at 911 centers in Weber County.

Ogden Fire Chief Mike Mathieu said the system tries to reduce the number of emergency vehicles responding to incidents, conserve the use of paramedics with advanced lifesaving skills and decrease the use of lights and sirens when not medically prudent.

"It's sort of a triage approach to ensure we send the right thing to the right situation," he said. The same system is used in England and throughout the United States, including Los Angeles and Cleveland, Mathieu said

For example, auto accidents are being affected by the medical prioritizing system, which was adopted earlier this year and will be evaluated at the end of this month.

It used to be that one of three county paramedic units was sent whenever there was an auto accident with injuries, Mathieu said.

"Because the paramedics were busy, we didn't have them available for calls where they may have been more needed," he said.

Paramedic response to injury accidents now is reserved for serious situations, including accidents involving more than one victim, auto-pedestrian collisions and accidents where patients are trapped in cars or thrown from vehicles.

Mathieu said emergency dispatchers decide who to send based largely on information gathered from callers.

Questions they ask are crafted from years of medical research and scrutiny of 911 calls, he said.

Mathieu said it used to be dispatchers routinely asked callers reporting chest pains whether the patient was pale. If paleness was a factor, paramedics were sent, Mathieu said. But because pale is a word that has so many different meanings to different, the chief said a more telling question is to ask whether the patient is sweaty or changing colors.

"The art of question is not to steer callers to responses. The art of the question is to get the callers to provide the most accurate information in layman's terms about the personās condition."

The responses to emergency calls in most cases are divided into four categories depending on the severity of the call.

Mathieu said the priority dispatching that had been used by county 911 systems was developed by a Salt Lake City doctor in 1984. Although it had been upgraded and modified several times over the last 10 years. Mathieu said area dispatch centers had not implemented the changes.

The latest version of the system was purchased with the help of a state Emergency Medical Services grant and was the result of an 18-month effort by the Weber EMS council, Mathieu said.

Much of the input will come from dispatchers working with new cards that are guiding them through questions they ask callers.

Ogden dispatcher Sara Allen said the color-coded cards are easier to read and help in tense situations where callers may be frantic.

"People are not at their best when they are calling 911," she said.

She said callers often get frustrated with dispatchers.

"They don't realize that even as one dispatcher is taking down the information and asking questions, another dispatcher is getting help on the way."

Another aspect of the advanced priority dispatching system is medical Miranda cards Mathieu said will be provided to police.

The cards guide officers in asking specific questions that help a dispatcher determine what level of response is needed.

"Instead of officers just saying paramedics are needed, we can get more on-scene information about the specific injuries and again, it is a matter of sending the right response," Mathieu said.