The best possible response time for any emergency is immediate. This is no simple theoretical goal, but a physical reality everywhere that a Public Safety Dispatcher, using standard Emergency Medical Dispatch protocols, can be reached by phone. These calm “voices of hope” quickly perform an initial triage to determine the type of medical or trauma situation being reported, dispatch appropriate emergency services as necessary, and provide quality instruction to the caller before any additional help arrives on scene.
The Navigator conference in Baltimore this week, sponsored by the National Academies of Emergency Dispatch, celebrated the efforts made in the last 33 years since Dr. Jeff Clawson developed a set of protocols in an attempt to reduce the number of Code 3 medical runs through proper resourcing and to promote dispatching as a profession. Now there are 65 million emergency calls for service each year to just over 3,500 Public Safety Answering Points (PSAPs) worldwide where the best are recognized as Accredited Centers of Excellence (ACE).
But not all calls requesting service are equal. Using the Medical Priority Dispatch System (MPDS) protocols, automated through software like ProQA, the initial triage phase is automated to provide a standardized format for carrying out the practice of priority dispatching. The acuity of the call is determined to categorize the dispatch response. Increasingly that response may include the possibility of alternative service endpoints in certain systems reforming the traditional “you call, we haul” strategy where each call ends with a transport to the hospital. For systems authorized to use it, like many in Europe, PSIAM provides a secondary level of triage, commonly performed by nurses, for any lower acuity incidents that should not require an ED visit. This is a dramatic departure from the norm in the US and one that will require vertical integration of healthcare providers starting with EMS, the practical gatekeepers to a significant amount of healthcare in the community. Recognizing EMS as healthcare providers is also a shift in thinking from the prevalent public safety mindset and one not taken in current healthcare reform.
The first link in the chain of the emergency response system, however, is the Emergency Medical Dispatcher. These are the true First Responders who are immediately present at the scene providing care even though they cannot see or physically be present with the patient.