Pre-arrival pt. contact

[medic_texas]

Don't we have enough to do just DRIVING to the call than to call someone and do an assessment over the phone? That's stupid.

I've worked both sides of the fence as a dispatcher and a field medic. Dispatching is a very important and complex job. Lots of multi-tasking (reading maps, talking on the radio, and giving pre-arrival instructions over a 911 line at the same time) and lots of training to do these many jobs.

So, while driving to a call "spiking bags", reading maps, talking on the radio, looking at intersections so your partner doesn't get you killed, reading street signs, operating sirens, and talking to this patient over the phone sounds like a good idea huh?

Ridiculous.. Sorry if I sound harsh, but this is really a stupid topic. Maybe your dispatchers need better training so you won't have to second guess them. I think your questions need to be geared elsewhere like "how do we get EMD certified?"

[madwis911@yahoo.com]

The thing is in both systems 90%+ what we find does not match what we were told. So neither system is that great and as much as I pick on dispatchers it sucks trying to get people to calm down and answer questions. Thank you dispatchers but never forget I will continue to bash you.

[unknown]

I can see where both sides are coming from on this thread. I work fulltime with incognitogirl, and feel safe hearing her voice on the other end of the radio. If there is not much info, it's not because she isn't trying. The CIA calls her for help on interrogation techniques. She can get blood from a rock.

I used to think the same as the original poster when I first started in EMS. I work part time on a rural ground service in a very impoverished area of the country. 60,000+ city, majority of it is hood with few street signs or house numbers, very bad streets, over worked and under staffed PD, you get the picture. EMS also runs >1000 calls/mo in this county. That's when I started to really learn things.

Dispatchers are very trained in what they do. They are a very integral part of the EMS system. They get more information than you will ever realize. Let's just say they didn't. Let's just say, for the sake of arguement, that all they gave you was the location. There isn't a call out there that you shouldn't be able to handle. I've been called for "sweating". They were dead. I've been called to a dead person. Got a refusal on them. It happens. We've all had calls like these. Dispatched for a vaginal itching. Met us on the side of the road doing the PEE PEE dance. Late 3rd trimester OB constipated >1mo. A naked Schyzophrenic 8 yo - WTF?!?!?! But you handle it. Just like every other call, with or without information, you just handle it.

A true patient advocate can.

Skids up

Scrappy I LOVE YOU!!!! AND you better not ever forget who your angel on the airway is!! MUUWWAHHH! Here is to the long trips to memphis just to kiss your forhead and will you to be better! You don't even remember I know but I left lipstick marks on your check and forhead......You looked so pitiful but I new you would prevail!! See you soon and DON'T over do it with the PT!!!!!

[mrmeaner]

I actually liked at my old job that if at all possible we talked to the caller. This allowed us to gather additional information and get patient or family to have things ready. We did get a better feel for what we were going into.

My new job all we get is a tone followed by address and basic complaint. Sometimes on the way dispatch will radio additional info that they have gathered.

The thing is in both systems 90%+ what we find does not match what we were told. So neither system is that great and as much as I pick on dispatchers it sucks trying to get people to calm down and answer questions. Thank you dispatchers but never forget I will continue to bash you.

Thanks, spenac. I kind of figured that since this would be more applicable in a rural setting , you would most likely have experience with this given your location.

To the dispatchers that responded, how in depth to your caller's/patient's history do you go? For example, with a seizure pt., would you ask if there is a history of seizures, how long this one was, if they recovered and went back into it or was it one long seizure, etc? If you do and once you have this information, how do you update the responding crew? Do you give the information once they request it or do you give them updates regardless of whether or not they asked?

On the other side of the coin, do the other dispatchers you work with do the same thing as you do or do you go above and beyond what is necessary?

I assure you, none of the questions are loaded. :wink:

[mrmeaner]

Ridiculous.. Sorry if I sound harsh, but this is really a stupid topic. Maybe your dispatchers need better training so you won't have to second guess them. I think your questions need to be geared elsewhere like "how do we get EMD certified?"

Yes, that would probably be the best answer. However, considering the past history of our local government and training history, I won't be holding my breath.

[spenac]

If 90% of the information you get enroute to a call is wrong.... then you have SERIOUS problems that go WAY beyond just poor dispatching!

In my agency (we dispatch 85 agencies) our EMD/EFD calls are accurate more than 95% of the time!

I call BS. If caller states they are having a heart attack. More than 90% of the time it ends up they just need to fart, ate spicy food when they have an ulcer, etc. You are claiming that where you you are at all your callers are educated enough to know what is actually wrong with them. BS. BS. BS. Now maybe you are accurate in that you tell the responding unit what the caller stated, but that is almost never what they are actually suffering from. The caller states I broke my leg, we get there stubbed toe, not accurate. The caller that says she has gone into labor, we find she is not in labor she just has pain caused by an UTI. So in conclusion BS .

[bethea]

[/font:94ba2b8998] It should be the dispatchers responsibiity to make sure all required information is made available to the EMT'S, even a call back number, but as a dispatcher it does not hurt my feelings if te EMT places a call to the pt or family.

[Richard B the EMT]

I mentioned the FDNY EMS EMD is staffed by EMTs and Paramedics. The dispatchers can and do call back to verify information, sometimes independently of requests by the field crews.

Someone quoted Dr House, that "People lie". True. I have heard a tape from the EMD, where a CRO gave information on assisting an in home birth, complete to the newborn crying. Crew arrives, the location is a vacant lot, and the cellphone callback number is no good. That CRO is now a lieutenant, but he was a good CRO and then a dispatcher, but even the best might not catch a caller in a lie.

Then, there are those who know how to work the system. For getting the LEOs sooner, say "Shots Fired". For getting an ambulance, say "I think he's having a heart attack." We used to call these callers "professional callers", as they know our key phrases that get a quick response. How much can a call taker, a dispatcher, or the field crew do, when the caller says, and unfortunately, correctly so, "You have the address, and the nature of the problem. It's your job and responsibility to get here and treat, so give me no 'until the ambulance gets here' instructions, and get here!" Of course, they didn't give a callback number, and hang up at that point.

There will always be the situation where the caller does that, but gave the address incorrectly, like saying "21st Street", as they would say it locally, when meaning "121st Street". Hey, I refer to my local numbered streets like that, too, so it's human nature. However, if and when they call back, they get upset with us, because we're supposed to be mind readers and have gotten it correctly the first time.

These are also the same people who have ambulances sitting across the street from where the ambulance is needed, the crew gets the call, and instead of saying "on the way," say "we're here" to the dispatcher, and still gets yelled at by the bystanders/friends/family/patient for taking so long to arrive.

There have been many improvements, like the E-9-1-1, which is a caller ID at the Public Safety Answering Point. However, nobody's system is perfect, and there will always be room for improvement. The calling public will still be those professional callers, and figure ways around the newer, perfect, system, too.

[brentoli]

To the dispatchers that responded, how in depth to your caller's/patient's history do you go? For example, with a seizure pt., would you ask if there is a history of seizures, Yes how long this one was yes, if they recovered and went back into it or was it one long seizure, etc? yes If you do and once you have this information, how do you update the responding crew? Tell the crew on the radio Do you give the information once they request it or do you give them updates regardless of whether or not they asked?

On the other side of the coin, do the other dispatchers you work with do the same thing as you do or do you go above and beyond what is necessary? The ones that do the job the way they are supposed to, so yes, 13 out of 15 or so.

I assure you, none of the questions are loaded. :wink:

[brentoli]

I call BS. If caller states they are having a heart attack. More than 90% of the time it ends up they just need to fart, ate spicy food when they have an ulcer, etc. You are claiming that where you you are at all your callers are educated enough to know what is actually wrong with them. BS. BS. BS. Now maybe you are accurate in that you tell the responding unit what the caller stated, but that is almost never what they are actually suffering from. The caller states I broke my leg, we get there stubbed toe, not accurate. The caller that says she has gone into labor, we find she is not in labor she just has pain caused by an UTI. So in conclusion BS .

You also have to remember, anything "odd" to an older person, seems to be a stroke. Wifey tripped and fell? She had a stroke. Hubby can't get out of bed, he had a stroke. ALOT of older callers will call in saying someone had a stroke, and it was only a syncopal

episode.