Could Emergency Medical Dispatch be in our future? By KAREN KENNEDY In communities that have Emergency Medical Dispatch (EMD), people who call 911 for an ambulance are greeted by certified emergency medical dispatchers (EMDs) on the other end of the line. These dispatchers not only dispatch an ambulance to the scene of the medical emergency but are also trained to provide treatment over the phone until help arrives. After EMDS have asked the caller standardized questions, the dispatcher may then provide what are often live-saving instructions on CPR, delivering a baby, removing an object from the throat of someone choking, and caring for injuries. Using medically based protocols – scripted medical instruction cards – dispatchers determine the appropriate level of response (emergency or nonemergency), and provide pre-arrival and post-dispatch medical instructions to callers seeking emergency medical assistance from 911. As the pre-arrival instructions are being provided by the trained emergency medical dispatcher, ambulances and first responders are simultaneously being dispatched to the scene of the medical emergency. EMD is utilized in some areas of Kentucky – Louisville, Lexington, Fayette County, and other cities and counties. However, EMD services are not currently part of Meade County’s emergency medical services program. When someone calls Meade County 911with a medical emergency, the first thing the 911 operator on duty does is notify the closest EMS Department. If the operator feels extra help is needed – that it is a life-threatening medical emergency and/or it would be beneficial for additional help to possibly arrive at the scene prior to EMS or be there to provide extra assistance to EMS – the dispatcher notifies the correct fire department by pager. Pagers are hard wired into a radio system with an encoded tone that opens up the pager. This opens up the receive channel and the operator makes an announcement, such as: “Male subject located at 123 Broad Street with possible heart attack.” The additional help called for by the dispatcher is a group of people in Meade County known as first responders. First responders are volunteer firefighters who have received intensive medical training which enables them to respond to emergency medical situations. First responders typically carry pagers so that they can be immediately notified when a emergency arises, be it day or night. When they are paged, the first responder will either proceed to the firehouse or directly to the scene of the emergency, depending upon which protocol has been mandated by the applicable fire department. Often, if traveling directly to the scene in a private vehicle, the first responder may arrive at the scene before EMS and will begin providing medical assistance until the paramedics and EMTs arrive. At present, there are six full-time and three part-time dispatchers (911 operators) employed by Meade County 911 Dispatch. “When our employees come on board, within six months of their hire date, they must all receive and pass the EMD training certification course provided at the academy,” said Meade County’s 911 director Mark Bennett. The academy Bennett refers to is located at the Department of Criminal Justice Training Center in Richmond, Kentucky. For a number of years, EMD training has been included within the four-week long course which covers all areas of dispatch-related skills. Interestingly enough, Kentucky Revised Statutes mandates EMD training even if the county employing the dispatcher has not adopted EMD as part of their emergency medical services program. Given the state requirement for EMD training, Bennett thinks it is highly possible that EMD may at some point in time become mandatory in Kentucky. Most likely the main obstacle to offering EMD is the additional money that would have to be made available to support the program. “There’s got to be two people working dispatch because you can’t put someone on hold in the middle of giving them emergency medical instructions,” stated Bennett. “Therefore, in order to provide EMD in Meade County, the number of dispatch employees would most likely need to double.” Of course, before Meade County ever considers EMD, there would need to be a serious look at liability. “A doctor won’t give you medical advice over the phone. Try to get him to do it and see how far you get. There’s a reason for this,” said Bennett. He opined that policies and procedures to protect everyone’s interests would need to be firmly in place in order for EMD to work in Meade County. Yet Bennett isn’t saying that EMD in Meade County is not a possibility some time in the future. “We always need to look ahead and try to promote better service for everyone,” said Bennett.
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