# Dispatch and effective handling of "where are they coming from?"



## deftdrummer1 (Dec 23, 2013)

This goes out to my fellow dispatch peeps. 

I'm not new here but I come here when I run across challenges while on duty, because I can count on solid advice from working professionals. 

I've been dispatching for 6 years and sometimes get this question but have never come up with a good response. I tend to deflect the question for obvious legal issues, but sometimes I do give the town / locale the crew is responding from to a 1st party RP for consolation and call handling. 

I guess I need to not mix and match and come up with a surefire answer to this question, because I was laying in bed the other night thinking about a call (as we all do) thinking - what if I got into a shouting match with the RP because my response to the question was not satisfactory? 

In divulging this information I'm not sure it actually does myself or the RP any good, but only opens the door to lose control of the call.   

I'd love to hear others' thoughts on this.


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## mycrofft (Dec 23, 2013)

Can you state this more clearly? Give an example.


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## ZombieEMT (Dec 27, 2013)

I do not see a problem with asking this questions. My best response would be to tell the truth, if known. Sometimes it makes a difference. One hospital that we regularly go to is in a big residential area. Some people might prefer to drive themselves to the hospital 30 seconds away vs wait 5+ minutes for an ambulance to take them to the same place, this can apply to both BLS and ALS calls. It could also be relevant in systems where EMS is hospital based/staged. Quicker trip to the hospital via POV, most people need the hospital, not the ambulance.


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## EMDispatch (Dec 27, 2013)

If callers ask for it, I tend to give it to them. I view it as their right to know where the crew is coming from, and that they're on their way. It's doubly true in areas where we have a 20+ minute response time, or when units are responding outside of their usual area because we are overloaded. In general I find giving them the information actually helps gain better control of the call, especially after a stressful interrogation for them. 

I have had a handful of callers respond negatively, and it's usually when we've overloaded the system, and are dispatching halfway across the county. Still, I tell them the truth I tell them local units are already on calls, and that we have the closest ambulance we can get en route to help them.

Really the only big legal issue I know of  with this would be giving them exact time frames, or outright lying about their response...Then you're opened up to a good civil suit.


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## deftdrummer1 (Dec 28, 2013)

EMDispatch said:


> If callers ask for it, I tend to give it to them. I view it as their right to know where the crew is coming from, and that they're on their way. It's doubly true in areas where we have a 20+ minute response time, or when units are responding outside of their usual area because we are overloaded. In general I find giving them the information actually helps gain better control of the call, especially after a stressful interrogation for them.
> 
> I have had a handful of callers respond negatively, and it's usually when we've overloaded the system, and are dispatching halfway across the county. Still, I tell them the truth I tell them local units are already on calls, and that we have the closest ambulance we can get en route to help them.
> 
> Really the only big legal issue I know of  with this would be giving them exact time frames, or outright lying about their response...Then you're opened up to a good civil suit.



I agree with both of you guys. Perhaps there isn't a cut and dry guideline when to give the city or locale the crew is coming from. I'm probably just overthinking it, it makes sense that we'd want to avoid giving specifics when the caller is agitated, but divulge the information when there is likely no harm. 

On a side note, any standard verbiage that assists you guys when the RP refuses to pull over and insists you tell them how to get to the closest hospital? 

Sure there's the standard "in order to get help as quickly as possible I need you to stay in one spot" type of responses but I had a call the other night where a stroke patient simply refused to pull over. I found myself giving directions and staying on the line just in case. It's hard to give up sometimes.


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## EMDispatch (Dec 28, 2013)

I remember the first time I had one of those, and I totally lost control of the call.

These days I usually use some phrasing along the line of "I'm getting paramedics to come and help you, but I need you to stop somewhere to meet them". I'll then suggest some common spots along the way, especially fire stations. Ideally I like to get them to spot where EMS crews will beat them, that way they don't drive off after a few seconds. 

I'll try that tactic and 2-3 times and attempt to reason with them. Usually getting them to understand that you're doing what is not hurting but helping is the hard part. Once they understand it, they'll pull over... But sometimes they just don't, and worse case scenario, I tell them You have to stop or I can't help send help. Even then some of them just won't stop, but most will  after suggesting a logical meeting spot.


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## ZombieEMT (Dec 31, 2013)

EMDispatch said:


> I'll try that tactic and 2-3 times and attempt to reason with them. Usually getting them to understand that you're doing what is not hurting but helping is the hard part. Once they understand it, they'll pull over... But sometimes they just don't, and worse case scenario, I tell them You have to stop or I can't help send help. Even then some of them just won't stop, but most will  after suggesting a logical meeting spot.



Sometimes, them not stopping might be a better solution. As long as the patient is not driving, it might benefit the patient more to not stop. I think it depends on where you are on the road and where the units are, hence why they might ask.

Example: At one job (IFT/911) we have a main road that runs to the hospital. If you are on that road heading towards the hospital, the ambulance is coming from behind you. You might be 5 minutes from a hospital with EMS 10 minutes away. It also depends how long it takes for the call to be processed by dispatch and dispatched to crews.


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## DrParasite (Jan 2, 2014)

We have call takers and dispatchers.  when you are a single dispatch center, it's a little tougher.

I have people asking where the ambulance is coming from, or how long will it take to get there.  my usual response is "they have to drive in a safe manner to your location", usually giving them a longer ETA than i expect so they are presently suprised when it shows up before they expect.

Or I say "I don't know, but they will get there as soon as possible."

Or tell them the city they are responding from, or they are coming from their station, or tell them "I am going to get a unit as soon as you have someone to send."  they don't like it?  hold for a supervisor.

As long as I can get their location, I can send an ambulance.  if I don't have a location, or they won't be staying at the location, odds are the ambulance won't find you.  let them make the call, but never give advice over the phone other than you are sending the ambulnace to xyz location, and if you move, call 911 for further instructions.


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