Dispatched to disease

[Richard B the EMT]

Our radio system has an "EMS Secure" Channel. Only the ambulance radios have this channel, so fire side can not listen in. .

Hello? Did not I say people use scanners? I'm EMS, but I scan and listen to EMS, FD, PD, aircraft, US Coast Guard, FBI, Secret Service, over several counties outside NYC, as well as inside. I even monitor some frequencies from New Jersey!

Unless the signal is on a fulltime scrambler system, someone with a scanner radio can pick up any radio signal and listen to it. Also, experimenters are building UNscramblers, that have "broken the codes".

Also, due to a "grandfather" clause in the Electronic Privacy Act of 1985, I legally have equipment to listen in to cell phone communications, as all they are is a really fancy 2 way radio system! I simply choose not to use the stuff (sometimes even I can get lazy).

[AnthonyM83]

Once again if the caller gave you that info, why could you not say it over the radio, if it was given to call taker for the responding crew to know? Just like the chief complaint was given for you to know.

[timboyle]

If the disease is highly contagious and predominantly airborne, the best way is to ask the caller if you can tell the responding ambulance crew the condition. If they say yes, then do it the most confidentially-possible way. If you can have the crew call into you on a cell phone, then so be it. But, blabbing the wrong information over a radio can land you in major trouble. Certain diseases cause stigma (HIV or now MRSA for example). If you say that someone at the address you just dispatched has a disease, and a neighbor just happens to be one of those tuning into scannerland, then you could be in serious trouble.

My opinion, the best way is always C-Y-A (cover your ass). If universal precautions (that thing BSI we're all supposed to do) will prevent the spread of said disease, I don't think it's necessary to communicate it. That responsibility is on us (I wouldn't treat bums here in NYC without it, gloves and mask). Tell the patient to let the crew know their condition when they arrive. Also, health care facilities have greater protection when communicating patient information than government or private organizations. There's a lot of federal law about patient confidentiality and who's covered under what circumstances.

[JPINFV]

If the disease is highly contagious and predominantly airborne, the best way is to ask the caller if you can tell the responding ambulance crew the condition. If they say yes, then do it the most confidentially-possible way.

If I was responding and the dispatcher KNEW and REFUSED to inform me of a contagious airborne disease and I got it, I'd make damn well sure to share said disease with that dispatcher. There should ALWAYS be a way to confidentially communicate information with a crew, be it informally [cell phones] or formally [MDT, pages, scrambled radio frequencies]. There is enough risk in health care. Most of this risk, as in numerous jobs, can be greatly mitigated. If such information is not passed on, then the dispatcher is morally and ethically, if [probably] not legally, negligent.

[AnthonyM83]

If the disease is highly contagious and predominantly airborne, the best way is to ask the caller if you can tell the responding ambulance crew the condition.

Do you need to ask permission to tell the responding crew the chief complaint?

[SSG G-man]

Hello? Did not I say people use scanners? I'm EMS, but I scan and listen to EMS, FD, PD, aircraft, US Coast Guard, FBI, Secret Service, over several counties outside NYC, as well as inside. I even monitor some frequencies from New Jersey!

Unless the signal is on a fulltime scrambler system, someone with a scanner radio can pick up any radio signal and listen to it. Also, experimenters are building UNscramblers, that have "broken the codes".

Also, due to a "grandfather" clause in the Electronic Privacy Act of 1985, I legally have equipment to listen in to cell phone communications, as all they are is a really fancy 2 way radio system! I simply choose not to use the stuff (sometimes even I can get lazy).

Well, from what I have been told, this is a "secure" or encrypted channel. For a relatively rural area we have a pretty sophisticated radio system. Partly due to our close proximity to DC and the need for interoperability in case of major event. We are even ahead of some of the closer in, more urbanized and affluent counties.

[timboyle]

Do you need to ask permission to tell the responding crew the chief complaint?

When I worked in a 911 center, we were trained not to transmit unrelated medical information over the radio. If an ambulance is giving a receiving hospital a patient report over radio, they'd give any information relative to the patients condition (vitals, age, LOC, injuries/chief complaint, and ETA). No names ever. That information is part of the transfer of care and is in line with a health professional talking to another health professional about the patient's condition, i.e. protected under federal law. If the disease is not part of the chief complaint, or relative to the nature of the call and responder safety, then it wouldn't be given. However, if serious conditions permitted, the ambulance crew would call the hospital via cell phone to alert them of the patient's medical history. Getting a patient's approval to communicate their medical history will prevent money hungry lawyers from making a case out of a good proactive decision. Make sure it's recorded too.

I've had a patient tell me they had TB AFTER we got to the ER. They were afraid that we wouldn't respond to the call and transport them. Not knowing this, I didn't wear a face shield. Luckily I didn't get anything. I've also found out that bloody trauma patients had HIV days after transporting them, luckily I used gloves. Bottom line, treat every patient cautiously.