PatrickW

In no particular order...

Activated Charcoal

Glucagon

Epi 1:10

Epi 1:1

Atropine

Furosemide

Lidocaine

Procainamide

D50W

Sodium Bicarbonate

Magnesium Sulfate

Dopamine

Amiodarone

Albuterol

Naloxone

Solu-Medrol

Adenosine

Thiamine

Terbutaline

Diphenhydramine

Morphine

Midazolam

Lorazapam

Etomidate

Succinylcholine

NTG Spray

ASA

Oxygen

Normal Saline

D5W

PatrickW, I am not talking about assessing everyone we cross on the streets, but if I am called to a scene I do a refusal save when the local FD/PD disregards me. Anytime I make Pt contact (talk to them) and they don't want to be transported (note I say nothing about treating) I fill out a refusal. Being totally honest, a refusal does not take all that much time. That's a pt interview, assessment, two sets of vitals, treatment (if needed), and education: knowledge needed to make an informed decision. Those are the people I am talking about.

What does your physical assessment involve if the pt has no complaints? Detailed head to toe? What do you tell them the risks of refusing transport are for someone with no complaints? What do you tell them when they ask why you, the healthcare provider, think they should let you transport them?

Since you brought it up: "How do I know that the family member of the full arrest I'm working isn't going to stroke out from the hypertension associated with the event?"

you don't. But according to any of our textbooks (and my personal ethics/morals) they are our pt too(regardless of the current condition). I suppose that is a personal call.

Since they are a pt, what does your treatment and transport of them usually consist of? Do you call for a second ambulance while you work the full arrest?

I agree they need emotional support, however if they do not have a medical complaint or ask for EMS for themselves we aren't going to transport them as a patient.

"I can't police the community for illness and injury, assessing everyone I come across or everyone involved in an event I'm called for. "-PatrickW

Neither do I, not the witnesses, not the by-standers. But the people involved yes I do. Again CYA, how do you know they won't have some pain later? How do you know that they won't go home and get hurt and blame it on the call you did not document? How do you know they won't talk to some slime ball lawyer (or even a damn good lawyer)? Then what? if they push it your career is over. They have you for neglect and abandonment. You were called to the scene for them, and you did not treat them in any way. Your word vs their's, they are hurt and you have money(at least your company does). It was nice to know you.

I don't know that they won't have pain later, and I don't know that they won't contact some lawyer. What I do know is that the person did not request EMS or want EMS, they claimed that they did not need EMS because they were not injured, and I will document that. Is there some case that you can cite where leaving someone with no apparent injury who stated they don't need EMS was considered abandonment, or are you just trying to use scare tactics?

"If I get called to an MVA and a pedestrian jumped out of the way to avoid it, do I need to get a refusal from them if I ask them if they're ok? How about a school bus that brakes quickly, one patient complaining of neck pain. I have to obtain histories, physicals, and refusals from all the other children and their parents? That's ridiculous. " -PatrickW

Ridiculous or not, the point is if you are required to get them do, if its your choice then its your choice. I would do it. Bottom line. No harm can come from me doing it. So it takes time to do an entire school bus full of kids. So what. Lame lame lame excuse. Not to be offensive here, but it sounds like you are just lazy.

I don't know about your system, but taking a truck (or however many it would take to do a whole school bus full of kids) puts a major strain on the entire system and delays response times for true emergencies from people who want EMS. Yes, there is harm done.

Calling a tomato a potato does not change it. If my company came to me and told me my choice, guess what I will still do a PCR (we are stone age pen and paper) and a signed refusal. It only takes a few minutes to do (generally plenty of down time to complete it), and it will only serve to save my company and I from some sue happy "non-pt". I live in the sue captiol of the world. Aside from the legal stand point, if you don't spend at least a few seconds talking to the "non-pt" then how do you know if they truly are ok?

How does a refusal only take a few minutes for you? Do you not take two sets of vital signs? Is the refusal you're obtaining just a signature, or is it an informed refusal following advising the patient of the risks involved with refusing (which I'm not sure what they are for someone who says they aren't hurt or ill and don't need EMS)?

Just a quick question: can you be definitively positive that your pt is not hurt? I mean just because at the scene they don't have any complaints does not mean that will be the case later(after they talk to a shark or not so nefariously the sympathetic nervous system starts to relax). In the case of them talking to a lawyer not only may they have a claim against the other driver, but you and your company are screwed. So where I am concerned the Pts with "no complaint" get the most thorough assessment and documentation I can do, and I make them sign.

Of course I can't be sure that there isn't anything wrong with them, but I can't thoroughly assess everyone that is involved with any call. How do I know that the family member of the full arrest I'm working isn't going to stroke out from the hypertension associated with the event? If they don't ask for us and they don't want us, I'm not going to sit there and do a detailed history and physical, including vital signs, and then suggest that they be taken to the hospital regardless of my findings.

I can't police the community for illness and injury, assessing everyone I come across or everyone involved in an event I'm called for.

If I get called to an MVA and a pedestrian jumped out of the way to avoid it, do I need to get a refusal from them if I ask them if they're ok? How about a school bus that brakes quickly, one patient complaining of neck pain. I have to obtain histories, physicals, and refusals from all the other children and their parents? That's ridiculous.

The 911 service I work for does have a transport policy, and we are able to treat and release some patients if they do not meet our transport criteria and both crew members are comfortable doing so. "You call, we haul" is ridiculous.

The replies here really puzzle me.

In the hypothetical situation of an MVA with no injuries, what would the people with no injuries be refusing? Transport for no injuries? Is that implying that you, as the healthcare provider, are suggesting that these people be transported to an ER, even though they have no complaints?

In my system, a refusal means that the patient meets transport criteria and the patient should be transported to an ER. To obtain a refusal, we have to inform the patient of the possible consequences of refusing transport (for example, for neck pain we would warn them that if they have a spinal injury and refuse transport, they could become paralyzed and die), and by signing the refusal they acknowledge that they accept these possible consequences to refuse. I can't imagine doing a refusal on someone who has no complaints. What would I tell them the refusal means?

With few exceptions, anyone who denies injuries on an MVA is not a patient. They are a person involved in an MVA who isn't hurt and doesn't need EMS. There would have to be extenuating circumstances for me to assess someone who claims they aren't hurt and don't need an ambulance, and tell them that they need to go to the hospital.

I would not have used my personal cell phone. There is no recording of your conversation to the ER Staff.

Most dispatch centers record all phone calls (obviously), so if your dispatch center has the ability to forward phone calls, you can call the dispatch center and ask to be put through to the hospital. If anything comes up, the recording can be pulled.

9.. The acid in your stomach is strong enough to dissolve razor blades.

Well, that's a relief!

The electrode placement ONLY comment was directed to the tangent that you spun of working WITH ALS. I would never endorse this for a BLS crew as again there is nothing they can do about it.

Sorry you got confused while reading, as so often happens here because one takes immediate offense and types a response instead of stepping back and fully comprehending what was just said.

Please do not confuse the two entirely different scenarios of BLS only on scene and a mixed crew of ALS/BLS.

I guess I should never had entertatined your tangent whereas to limit the confusion and address the original issue.

Now these are your words, forgive the improper quoting:

Gave her some orange juice (or oral glucose) and suddenly she feels fine and has no complaints. With a BLS crew that didn't have the option of checking BGL, their options would have been: Transport while twiddling thumbs saying "I don't know what's going on!", or request ALS so that ALS can do the exact same thing BLS would have done on scene if they had a glucometer. Is that really what's best for the patient?

In this very statement where you said give OJ and all is well, that would indicate or imply the thought process of "everything is dandy and all it was is a low BGL, lets get a refusal now. Did anyone else here not think the same thing?

Secondly, you stated ALS would do the exact same thing on scene as BLS. Hmmm, interesting theory but I beg to differ. I will allow you a chance to further support that ludicrous claim with something more tangible, fact related other than you just saying so.

Also, you said BLS would be transporting, twiddling their thumbs saying "geez I dont know whats going on"? Once again, this implies that IF you knew this magic number, that you would know exactly what is going on and that is all there it is to it. Which as I and Ruff stated previously is incorrect, there could be so much more going on, yet once again the lack of knowledge is what prevents one from realizing that.

So, in closing, I toss back at you sir, that it was you who implied the things you accused me of.

You don't know how much you don't know...

Well, I don't think there are different scopes of practice for EMT-Bs on a BLS-only truck vs. EMT-Bs working with EMT-Ps, and I didn't know you were arguing for one.

If you'll notice, in the scenario I posted, I stated only objective criteria. That scenario is from a call I was on, and all I stated was the facts of what happened. BGL low, symptoms, BGL brought up, no symptoms. Make of that what you will, but no where did I state that the low BGL was the only issue and no where did I state that the patient should not be transported.

With such a condescending, holier-than-thou attitude I don't understand how you can expect people to not be offended by your posts. I understand you're passionate, however I don't think too many adults would agree that name-calling, insulting intelligence, and a general condescending attitude are helpful in anyway to proving your point.

Really, you're qualified to tell me that "I don't know how much I don't know" from a few posts of mine with a differing viewpoint on BLS use of glucometers. Seems somewhat hypocritical, even.

Thanks for "entertatining my tangent", though.

You just demonstrated one major problem. You are assuming because all the signs are there for low BGL, that is all that is involved. You have no other tools or KNOWLEDGE to determine otherwise. Again this is "protocol learnin" or" rote checksheet mentality". WHY is her BGL low? Isn't she controlled? I would be very uncomfortable with a BLS crew making this diagnosis and giving the OJ treatment, then getting a refusal on my grandmother. Sorry, its just the way I feel and it is not what is best for the patient.

As for freeing up the medic, again it is another lame argument. Most medics can handle everything in a systematic order for any call by prioritizing what is best and what is needed. By this statement, I do not mean to imply all medics are stellar and godlike, I am implying that most tasks are simple, easy and require minimal skill and time. No one has ever said skills are difficult (IV's intubating,etc); anyone can be taught to do these.

As for you getting a BGL while I do an IV, guess what? I will have done an intial BGL myself while you get a BP and pulse, or on known diabteics that I have treated before, I may do an IV and BGL at the same time. Then while you are placing the electrodes (provided I have trained you and trust you know proper placement) I will be inserting an IV. Any subsequent BGLs will be done by me while you are driving me to the ER or while I am assessing whether or not to get a refusal for this particular patient.

There are so many other ways you can assist as an EMT than worrying about a BGL. You can work on your assessment skills, interview the patient up to a certain point, set up for IV, monitor lead placement, prepare stretcher and give a smooth ride. You doing all of those are way more important and valuable to me than you being able to prick a finger.

Ok, now can we leave the tangent of "what if" an EMT is working with a medic, cause that was not the point of this thread. The point was referencing BLS crews and what/how they should handle the knowledge of a number on a machine.

First off, you are the first one to bring up the possibility of a low BGL being all that is involved, and you are the first one mentioning an EMS diagnosis and refusal. I did not say anything about either in my post, and it is in fact you who is making that assumption.

Second, monitor placement is another skill that Basics are not allowed to perform (at least here). I'm not saying it never happens, but it's not in our scope. But let me get this straight, you're suggesting Basics should be forbidden to perform dextrosticks as part of their assessment because it only provides a BGL of which Basics can do little about, but instead we should be placing limb leads as part of an assessment even though we can do nothing with a rhythm strip?

As for the point of this thread, the question posed at the end of the OP was "Who can offer reasons for and against this diagnostic tool for BLS providers?" You'll have to excuse me for pointing out how it is useful for me everyday I work.

Scenario: 60yo F complains of bilateral leg weakness. Gradual onset, it's 3AM now, she woke up to go to the bathroom and noticed her legs were very weak. No other complaints. History of IDDM and HTN. Good strong PMS. BGL turned out to be 48 mg/dl. Gave her some orange juice (or oral glucose) and suddenly she feels fine and has no complaints. With a BLS crew that didn't have the option of checking BGL, their options would have been: Transport while twiddling thumbs saying "I don't know what's going on!", or request ALS so that ALS can do the exact same thing BLS would have done on scene if they had a glucometer. Is that really what's best for the patient?

It's also important to remember that not all BLS providers are part of BLS-only crews. I work with a paramedic and being able to check someone's glucose is a valuable tool for me as a Basic or Intermediate to have. When we have an unconscious patient, for example, it's nice for my partner to accomplish the "more ALS" aspects like starting a line, hooking up the monitor, etc. while I check the BGL (among other things, of course). It's just one less thing the medic has to worry about and one more thing the basic can accomplish for the good of the patient.

You misread my intention(not hard to do) but if you read it again I said that the RN would not appreciate being called an LPN but they are both considered Nurses. I never said that the rn would be upset about being called a Nurse. I specifically said a RN would dislike being called a LPN or compared to an LPN.

I understood that, my point was that referring to an RN as an LPN is not like referring to a Paramedic as an EMT, because the latter is accurate. EMT is an all-encompassing umbrella for the different certifications, so being a paramedic and being called an EMT should not be considered offensive or inaccurate. Sure, "paramedic" is a more accurate term, just as "RN" is a more accurate term for an RN than "nurse", but that's just the way it goes. Now, if someone referred to you as an EMT-Basic, then you'd have a complaint.

Its a matter of pride, not just title.

I worked dang hard to get my medic and being referred to as a EMT is not what I expect to be referred to.

Just as a nurse works hard to get her RN she isn't going to be happy being compared to an LPN, of which both are referred to as nurses. But the RN isn't going to be happy when someone says Oh, you are a lpn then.

You're comparing apples to oranges.

"Nurse" is a general umbrella including LPNs and RNs. "EMT" is a general umbrella including Basics, Intermediates, and Paramedics. Calling an RN a nurse is not an insult, and calling a Paramedic an EMT should not be considered an insult either. You're operating under the assumption that EMT means EMT-Basic (or Intermediate), which simply isn't the case.

Look at the site you're on now. EMT City. Who is the "national governing body" of this profession? The national registry of EMTs. I just don't understand why there's stigma attached to the "EMT" title...despite popular belief, "EMT" is not a level of certification. It is many, including paramedic.

That's nothing when it comes to noticing small spelling/grammar/punctuation errors.

I even notice that in the page title, "EMTs" is spelled with an unnecessary apostrophe!

I don't rely on machines for anything. I use all of my senses. For example, when checking someone's BGL, I don't use a silly high-tech machine. I taste their capillary blood.

Mmm, hyperglycemia.

Regardless of what you believe why and/or how...... Your faith should be first. If not- do you really have any faith at all?!!!!!

So if I'm a doctor and believe that I would be harming my patients by giving them blood transfusions (damning them to hell), I should be able to refuse to administer blood products to dying patients because of my own beliefs? Who's to say my beliefs are wrong? That's a huge taboo. You can't question other people's beliefs. Why? Because you can't.

People are free to make all the stupid decisions they want about their own life, but when their beliefs start infringing on others' lives by withholding potentially life-saving procedures from someone else (like in the OP's case), that is negligent homicide. And really, I'd even go as far as to say that attempting to teach an impressionable child beliefs that may later cause their death is shameful abuse of power. There would be a lot less problems these days if kids weren't presented beliefs as fact at an early age and brought up to just accept it.

Our trouble was the ambulance got stuck behind a train

To be fair, you really shouldn't have been driving the ambulance on the tracks in the first place.

I've had a few.

The one that immediately comes to mind is when we had two shark bites in the same town, about two hours apart. That was an interesting shift

Now I could see it being higher than I have experienced with a broad statement like you give. My dispatch calls in like the caller does. If caller says fell and broke toe that is what we get told. In your system bad gas could still count as chest pain. Stubbed toe traumatic injury. So with that broad based dispatch I could see it matching. Does dispatch still say what caller said was the problem in other words - EMS XZ you are being dispatched to traumatic injury caller states they have a broken leg?

It depends on the dispatcher, really, but it's always qualified with a "possible". "Per the caller, possible open ankle fracture", "per the caller, possible dislocated shoulder", "per the caller, possible MI". I imagine the latter is only transmitted to us if the dispatcher thinks the caller really knows what they're talking about. For example, if they've had previous MIs or if there's a transferring physician.

I am not trying to argue just no way in hell that 90% of how you dispatch is what is found. You dispatch as broken leg we find stubbed toe, you dispatch as heart attack we find bad gas, you dispatch as stroke we find diabetic emergency, etc. That means information was wrong, not dispatchers fault very often but callers fault. Your little flip book does not stop the errors it builds on the error. Also do you actually have access to what the paramedics find on arrival? So you sent me out for a seizure do you follow up and record that I found a person that was sneezing not seizing? That or actually matching each run report to it's dispatch record would be only way to prove correct dispatch. Or are your stats actually for getting us to correct location?

I don't know about how your dispatch works, but we never get dispatched to a "broken leg" or "heart attack". We may get dispatched to a traumatic injury/leg injury, or chest pain. 90% accuracy seems about right to me with that system in place. Maybe a little high, but not unheard of.

So then you only hear half of what they say, not knowing you missed something, and then blame dispatch for their screw up, even though it wasnt theirs to begin with, and even possibly harming the paitent because you are convinced on what you thought they said.

Right, because the fact that someone could improperly use a tool causing a minor inconvenience is a good reason to withhold it.

I really can't think of an example of how you could mishear a 911 call causing poor pt care that would be any more likely than mishearing dispatch info. At least if you got to listen to the 911 call you would probably catch your mistake if you do mishear dispatch. But I think that's such an improbability that it doesn't really need to be worried about. We wouldn't be relying on the 911 call 100% either, it is just an extra tool. More info. It would be a good thing. We'd still listen to dispatch. Nothing would change except for a little extra info at our disposal.

This is where you have to get involved. You need to step up to the plate, and make documentation of what your dispatch has screwed up on or not told you. Pull tapes, copy run narratives, show where it has or potentially could have harmed patient care. Show it to your supervisors. Make sure it gets passed on.

What do you want more, a better dispatch center, or another toy you can use to wreck the ambulance responding emergent to pick grandma off the potty.

I guess I don't really feel like I have a right to complain about not getting every bit of info from dispatch for a few reasons.

1: I don't want to be "telling dispatch how to do their jobs".

B: I've been on ride-alongs in neighboring counties, and the only info they get is age, whether the pt is conscious and alert, whether they are breathing "ok", and the address. What we have is far better than that.

3: I'm very new to EMS.

The last thing I want from a ground unit running L&S in route to a scene is for the crew to be paying attention to whats coming over a computer in the line of a 911 call-- When instead they should be concentrating on traffic and radio calls.....SAFETY first. You can't possibley tell me you can successfully glean anything more from listening on your own while paying attention to the Radio and the cars/traffic around you; nothing more than your dispatch can provide!

I guess we should take away GPSs and radio/stereos too, then.

One of the best parts about being able to listen instead of actually being on the line is that you don't have to be paying 100% attention. No one is counting on you to respond to everything they say. It's just another tool.

And as I said in my first post in this thread, it could be just the passenger that listens. I'm pretty sure I'm qualified to look to my right at intersections and say "clear" while listening to something else. At least in my area, navigation isn't really an issue.

What else do you do on your trip out? Me, I am usually thinking about the senario ahead, lookin at my protocols if it is something I haven't dealt with in a while. Watching for traffic, navigating, operating the radio....

How would it be more useful, I don't understand. There is nothing relevant a caller tells me I won't tell you. If you want your dispatchers to tell you they are talking to a 78 year old woman on the phone who just didnt know what to do so she called you. Ask your dispatcher that.

Do you want me to relay to you every minute detail in the call? Do you want me to tell you all 50 medications he is on and all 45 times he was in the hospital the last 20 years; using air time that could be needed for you or any other unit to call for help, or do you want me to filter out what is appropriate to this paticular call. If he is bleeding profusely from a cut to the arm, do you want to know all 15 medications he is on, or does it just matter he is on blood thinners? Think about it. It is a waste of resources. If you have a problem with dispatchers, ask to pull tapes and sit down with your supervisor and ask to do a QA with them. Don't ask to do their jobs for them.

Oh, dear lord.

I don't know how I can say this more clearly. I'm not asking to try to do dispatch's job. I don't want dispatch to tell me every minute detail they get. Hell, one of the benefits to being able to listen to the 911 call on the computer en route would be so you DIDN'T have to tie up radio traffic with every single detail from the call. Apparently your system divulges more info to the crews than ours does, because our dispatchers don't tell us if a patient who is bleeding is on blood thinners. It changes the priority in their dispatch protocols, but we don't get that information. That would be one way listening to the calls can be beneficial.

Of course I'm thinking and doing the same things you are on the way to a call. But I don't see how you can argue that listening to the 911 call to the call you are headed to is not helpful in preparing you for the call, just like looking at your protocols is.

It would just be an added resource. More information at our disposal. It's not a bad thing, no one is trying to take anyone else's job, it is just potentially useful info.

If nothing else, it would allow us the hear how much misinformation dispatch gets told on a day to day basis, right?

Dispatchers are not trying to tell you how to do your job via conference call or video camera ( even though I DO sit here with the protocal book to my emediate right and a direct line to ALL our Medical Directors....) So you shouldnt need to "listen" to your calls. TRUST the dispatchers and use the Q&A system that I am MOST certian your county has in place to weed out the bad situations...........

Where did I suggest we start telling dispatchers how to do their job? Again, nothing at dispatch would change one bit. We would just have an extra resource at our disposal which may or may not give as a better idea of what we're walking into. Nobody said anything about "needing" to listen to the 911 calls, again, it would just be a nice tool to have at our disposal. I don't know how to make it any clearer.

Patrick- What you need to do is spend a week in the Comm Center hooked up to your dispatcher, listening to each call, every word and being apart of the setting as the crews get toned out. You truly can not judge these situations until your on the other end and just a couple of hours in dispatch isnt going to give you the full effect either.

I can't tell you how many calls I get- caller is frantic telling me a,b,c is wrong with d,e,f patient only for my med crew to arrive on scene and discover that all along it is 1,2,3 wrong with the 4,5,6 patient. Complete oposites almost. THANK Goodness for recorded lines! You can not argue with a recorded line So I have the ability to listen, relisten and get my facts straight and YOU can not argue with me and tell me I am wrong- YOU also can not try to tell me you where never given this information (which is a common complaint from crews)

I get my stuff in order- YOU as a crew member just have to remember TEAM work is key we are all in this together!

I understand this, and I am not trying to knock dispatchers. I have spent more than a few hours in dispatch listening to calls and watching how they work. To be honest, dispatch intrigues me. When I finish school I would not be opposed to going to train and work as a dispatcher part time.

Again, I understand dispatchers do the best they do with what they are given. I have no problem with dispatchers except for the few times that they withhold pertinent information that they DO have (and I have seen the call log/notes to know that). Yes, I realize this is a dispatch issue but "they are doing their best" and it is rare, anyway.

Well said brent. We tend to forget that we are dispatched on the information provided to dispatch. That information is then relayed nto us by PROFESSIONALS.

Lets not forget that people who work on road are not the only professionals. 95% of calls that come in are different to what is stated. How many patients do you take to hospital & have asked how many times in the past they have cad chest pain with a reply of NIL only to find that this is a hypertensive pt with Angina Pectoris? Does that make you any less professional because you have failed to gain that small, but significant & relevant piece of information? No, it highlights the lack of understandiong that the general public have about what Paramedics (dictionary definition - a person who is trained to assist a physician or to give first aid or other health care in the absence of a physician, often as part of a police, rescue, or firefighting squad.) are able to do, the knowledge they have, or the training they have undertaken.

Please respect the fact that dispatch work with the information they recieve & have a unique job. They are not there just for you & to want to talk to the pt prior to arrival is a mere waste of resources & ties up a line that could be better served elsewhere

I'm going to have to assume that this was not in response to my post, unless you didn't read my post at all. I don't see how you could have read my posts and still come to the conclusion that I advocate being able to talk to the patients, I just said it would be helpful to hear the 911 calls. The dispatcher's job would not change one bit.

Then you need new dispatchers. Sorry. Tell your supervisors the problem.

I doubt you would have picked it up, you have less experience then she does, but once again, supervisor?

Sounds like an agency problem. We never send EMS on a 911H.

Yes I am. Unless you have sat at a dispatch console, you don't know the questions to ask, the protcols to follow, and you have alot more that should be on your mind then listening to a 5 or 10 min phone call. Belive it or not alot of times 911 is on the line with the caller until you get into the driveway.

Ok, now I'm really confused. I'll start from the top of your post.

Yes, the supervisors are aware. I think the gist of it is we are told that we should be grateful for whatever info we do get, we should be prepared for anything regardless, and the dispatchers are doing their best.

No, I don't have as much experience listening to 911 calls as a dispatcher does, but two sets of ears are better than one. Can you please explain to me a disadvantage of being able to listen to the 911 call that you're about to go on? I'd love to hear how having more info is a bad thing.

911 hangups are usually a police matter, however apparently that one was an exception. I guess she requested EMS, got transferred to our dispatchers, explained that she ran out of her meds and then hung up. There could be more to it, I don't know. I didn't hear the 911 call.

In response to your last paragraph, that's what really confused me. No, I don't know the questions to ask or "protcols" to follow, that's why I'm not advocating being on the line with the caller. Yes, I fully understand that often times callers are on the line with dispatch until we get there. Sure, a 911 call could be 5 or 10+ minutes, but at least with EMD the majority of the useful information is in the first minute or so. Again, I've sat in dispatch on multiple occasions and listened. I understand how it works. In those cases, the rest of the call is usually emotional support and/or CPR instructions, bleeding control, having the caller re-assess, etc. Again, the bottom line is I don't see how having access to LISTENING to the 911 calls while en route could be a bad thing. Feel free to enlighten me.

Let me just say one more time since there seems to be some confusion:

I am NOT for being on the line with the patient or 911 caller. That's dispatch's job and I am not qualified to do that.

I am NOT for changing dispatch's job at all. They would do everything they're doing now.

I was just suggesting that it would be helpful to be able to listen to the 911 calls before we arrive on scene. It's just more information that could be available to us.

How would that be helpful....

give your damn dispatchers a break for goshs sake!!!

Huh? How was I giving dispatchers a hard time? :?

It would be helpful because dispatchers can't tell us everything. They can't convey to us the tone of the call, if we're stepping into a full arrest situation with five family members all screaming at each other during the call. Sure, we need to be prepared regardless, but we need to be prepared for most things regardless. It's still nice to get a head's up.

At least in my area, we use the EMD system. Our dispatchers often times tell us the age and gender of the patient, the response code and the chief complaint. Sometimes they'll even forget to tell us the age and gender. Sometimes I'll go back and look up a call only to see helpful location info in the call notes that was never relayed to us.

It would be nice to know if the chest pain call we're going on is a "delta response" because the first party caller says he's not breathing normally or because it's a third party caller who says that the pt is altered.

With EMD, they're apparently not supposed to downgrade response levels. The other day a call came out as a delta response for chest pain and then in the middle of the call they figure out that it's an 8yo A&O with abd pain x 2 hours ago. We never got that info, and they sent fire because it came out as chest pain. Yesterday, I went to another delta response for chest pain which turned out to be chronic tingling in the extremities. I went to a shark bite call once involving an 8yo, we were never told it was a ped. That would have been nice to know. Same thing the other day with a seizure. Second floor of an apartment building. Would have been nice to know so we could bring the broselow.

Two shifts ago, we were sent to a pregnancy that turned out to be a domestic. I talked to the calltaker afterwards and she thought the caller started acting kind of odd in the middle of the call, but otherwise didn't think anything of it. Maybe if we heard the call, we could have picked up on it as well and requested PD while we were still en route.

A few shifts ago, we got a 911 hangup. Only info we got was that some lady called, said she ran out of her meds, and hung up. Dispatch acted surprised when I asked if police were en route and if we needed to stage. I don't know if this is a psych patient and neither did dispatch apparently, but maybe if I heard what little they heard I could understand why they didn't think police were necessary.

These are just a few examples I can think of off the top of my head. I realize dispatch can only work with what info they get, which may or may not be accurate. But you're really challenging the idea that being able to listen to these calls might just be helpful every now and then? Of course it would be nice to hear the information first hand instead of just getting a little bit of second-hand info.