# What Are the Dispatchers Thinking?



## MrSalty (Oct 21, 2011)

Has anyone responding as a Good Samaritan off-duty been asked twenty or more questions by dispatch?  

I had a situation at a wedding where I was asked to help with a 74 year old non-responsive choking victim that was cyanotic.

Long story short, I was able to clear the mans airway and was able to restore his breathing.

What really frustrated me were the inane questions that dispatch wanted to ask me as I was providing care.  Normally if I had a qualified partner it would not have been that bad but as I was pretty much running the show and the dispatcher was NEGATIVELY AFFECTING my ability to HELP THIS DYING MAN.

I understand the need to collect pertinant data but if identify yourself an an EMT, Paramendic, Nurse, Doctor and ask for an ambulance shouldn't they send one?  If you mention that you are the only one working on an unconscious choking victim does it really make sense to have you STOP to find out the persons exact age or drug allergies?

I'm just saying.

Has anyone else encountered this and if so what is the best way to handle it?

Thanks


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## EMT11KDL (Oct 21, 2011)

Double Post


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## EMT11KDL (Oct 21, 2011)

what has happened in the past is that the dispatchers have been burned on that exactly thing, by people claiming to be someone that they truly are not. 

 I am lucky in my county if i call dispatch we have direct line to them that ONLY EMS and FIRE have.  Also, with the e911 system, my cell number shows up and it already has my name and information which included my fire dept and my fire id number.  

Also, if you are the responding unit, wouldnt u like to know information, like is the patient breathing, loc, what exactly they are responding too... 

If you cannot talk to the dispatcher hand your phone off to someone else, and have that person relay the information.  If there is no one around call the dispatcher, identify yourself, tell them you have a man down, chocking or code, or trauma or whatever it is, (very quick and precise). and tell them location, and ur the only one on scene.. and if you can put ur phone on speaker phone...


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## Handsome Robb (Oct 21, 2011)

Have you ever sat in dispatch? The system they use spits out the questions at them to give the crew information and to determine the priority of call. They ask the questions for a reason. 

Dispatching sucks, I have a lot of respect for the people that do it, they deal with stupid, rude, angry, upset people all day long.

The only time our dispatch center will disregard the questions is if the EMT/Paramedic calling it in works for our company and IDs themselves with their name and employee number.

I'd personally give someone else the cell phone or put it on speaker and set it down.


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## fast65 (Oct 21, 2011)

It helps to answer their questions instead of double guessing the importance of them, helps the process go a little, I don't know, quicker?

They ask the questions because it helps them determine the priority of the call as others have said. The information you're providing helps EMS have a least a vague idea of what they may be walking into, so the more information available, the better.

I can count the number of times I've been told there was a healthcare provider of some sort on scene and had there actually be one when we got there...once...and he was drunk. I don't work in dispatch, so I can't say that I'm in anyway correct, but I would wager that dispatch doesn't take too much stake into someone telling them that they're an EMT/paramedic/nurse/doctor/superhero/yellow spotted kangaroo. 

Question, if you're at a wedding, why are you the one calling 911? How did you clear his airway?


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## Shishkabob (Oct 21, 2011)

It's called Emergency Medical Dispatch and they have cards they have to read from in order to dispatch the appropriate resources at the appropriate priority.  (Atleast, that's the intent)


If things were that time sensitive, you could have either put someone else on the phone, or just given a brief description, state your certification, then hang up.  Obviously giving someone else the phone is a much more viable and correct way of doing things, but still.


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## Aprz (Oct 21, 2011)

I've made this same mistake at my previous non-EMS job. I agree with everyone else assessment on this; You should've given the phone to somebody else, or if you're the only one then use speaker phone.


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## medicdan (Oct 21, 2011)

As Linuss said, this is EMD... it not only provides you as the responder more information about the scene you are walking into, but also provides pre-arrival instructions to the caller-- both medical, such as to begin chest compressions, but also preparations, such as turning on the porch light, moving pets from the door, etc. 

The dispatchers still need this information for responding crews...


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## abckidsmom (Oct 21, 2011)

Yeah, give the phone to someone else, but I will say that *any* time a dispatcher is asking what meds he's taking, or what he's allergic to, it's idiotic meddling.   

Quality EMD work relies on succinct gathering of as much information as possible, without asking so many questions that it tweaks the caller.  In my experience as a dispatcher in a medium-busy system (taking >150 calls/shift), callers just don't answer questions that they think are stupid.  I was so thankful that we used MPDS EMD, with constant QA and feedback on the system.  In just the 2 years I was dispatching, we went through at least 3 versions of the cardset.  I liked it a lot.

If I was ever presented with a situation like yours, I would just pass the phone to someone or set the phone down and just leave it open to the room.


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## LucidResq (Oct 21, 2011)

MrSalty said:


> Normally if I had a qualified partner it would not have been that bad but as I was pretty much running the show and the dispatcher was NEGATIVELY AFFECTING my ability to HELP THIS DYING MAN.



As a dispatcher, when you don't cooperate with me you are negatively affecting my ability to send this dying man an ambulance, with on-duty paramedics who have the equipment to treat him more effectively and take him to a hospital. If you haven't worked as a dispatcher you don't know everything about what is pertinent and what is not. 



MrSalty said:


> I understand the need to collect pertinant data but if identify yourself an an EMT, Paramendic, Nurse, Doctor and ask for an ambulance shouldn't they send one?  If you mention that you are the only one working on an unconscious choking victim does it really make sense to have you STOP to find out the persons exact age or drug allergies?


1) People lie. 
2) I have talked to some idiot EMTs and nurses. LPNs who want to put salt in lacerations and EMTs who want to stick spoons in seizing patient's mouths. Sorry, the only people who don't get my full shpiel are RNs and Physicians who sound like they are competent.  
3) It sounds like you are falling into the trap a lot of panicked citizens fall into by thinking the questions are delaying response. Policies vary, but I have them en route the second you give me an address and tell me you need EMS. All the answers you give me are given to them while they're on the road. I was hired because I can multitask like no one's business. Don't underestimate me and think I'm not sending help just because I'm talking to you. 
4) We have a medical director just like you, but our protocols are much stricter because we are not medical professionals (even if we are, we are not working in that role). I have a list of questions I am REQUIRED to ask on every call and a list of things I am REQUIRED to tell you verbatim. Please humor me, answer the simple questions, and listen to the directions because arguing with me wastes both of our time and I'm not getting fired because you have a superiority complex. Thanks. 



MrSalty said:


> Has anyone else encountered this and if so what is the best way to handle it?


If you feel you are so important to this patient, give the phone to someone else and let them talk to the dispatcher. Otherwise, cooperate or drive him to the hospital himself if you don't want to help me get you help.


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## JPINFV (Oct 21, 2011)

NVRob said:


> Have you ever sat in dispatch? The system they use spits out the questions at them to give the crew information and to determine the priority of call. They ask the questions for a reason.



As someone that has been in a slightly similar situation, I don't give a damn. In my case, if I call in and say, "Hi, I'm an EMT on a call with ABC ambulance service and need a paramedic response," I don't care what the computers want. I want paramedics dispatched, an ETA (and, no, "They're responding with lights and sirens" is not an ETA, and I almost ended up requesting to speak to a supervisor due to that and other comments made), and the ability to hang up the phone.


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## Handsome Robb (Oct 21, 2011)

Dispatchers have a job, they can lose said job. They deal with :censored::censored::censored::censored::censored::censored::censored:s all day, as a provider who has worked in the field I would think you would be a little more understanding to their situation. 

Now I understand if your calling while working on an IFT truck how the EMD questions would be frustrating.

ETA could be twisted back on the dispatcher and service. I can see it now "Dispatcher said ambulance would arrive in 5 minutes, it turned out to be a 7 minute response and the patient died." Yea 2 minutes probably wont make a difference most of the time but a lawyer could use that to his advantage, thats why 911 dispatchers don't give ETAs.

Edit: also as someone who has worked in the field I would assume that you would appreciate the help the responding crew gets from the answers of these questions.


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## JPINFV (Oct 21, 2011)

NVRob said:


> Now I understand if your calling while working on an IFT truck how the EMD questions would be frustrating.



Which, in my case I was. Of course this was also after being told that they "don't do [paramedic escorts]" when "paramedic escort" is exactly the term used in the county EMS policy book. That was followed by EMD questions (again, IFT ambulance. I'm calling because I have a patient in rather severe respiratory distress who has used her 2 words a breath to flatly refuse the closest), which was followed by a refusal to give me an ETA. Sorry, I have better things to do than answer a bunch of question that provides zero additional help. 

The dispatcher is sending paramedics because an EMT ambulance requested paramedics for respiratory distress. That is all that matters. This isn't a choice about lights and sirens vs cold. This isn't a choice between EMT ambulance and paramedic ambulance. This isn't a case where phone instructions are needed. 




> ETA could be twisted back on the dispatcher and service. I can see it now "Dispatcher said ambulance would arrive in 5 minutes, it turned out to be a 7 minute response and the patient died." Yea 2 minutes probably wont make a difference most of the time but a lawyer could use that to his advantage, thats why 911 dispatchers don't give ETAs.



...and it could mean the difference between me transporting or waiting for paramedics. On another situation I was given a 2 minute ETA that was more towards the 7 minute mark. Considering I was on the second floor and I call 911 as soon as I realize I needed paramedics or emergency transport, then that 2 minutes is easily the time needed to package, give a once over, and move to the ambulance... in that case to wait for several minutes for fire. Personally, I'd rather have a wrong ETA when calling in as prehospital provider than abject refusal to do, quite frankly, what I consider part of the dispatchers job. 

I wonder if the fire department has this problem with their dispatchers when requesting an ETA for another apparatus. Wouldn't want to give a wrong ETA now, would we?


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## Handsome Robb (Oct 21, 2011)

Not trying to derail the thread but if your working for an ambulance company, as an EMT, with a dispatch center, why do you need to call 911 to request paramedics? Why is there no policy for this? Notify dispatch your request with a quick blurb about what and why then go back to providing patient care and packaging. Rather than having the provider call 911 and get cycled through the dispatch system and have a provider get upset. 

Now as a paramedic responding to a BLS trucks request I'd still like to know more than a general complaint. Do I need to be ready to intubate right off the bat? To push drugs for an allergic reaction? Go straight to CPAP on a CHFer? So on and so forth. 

Just my thoughts.


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## MrSalty (Oct 21, 2011)

*All good Posts!*

I appreciate ther feedback, both positive and negative to my comments.

I did, in fact, hand the phone to someone else.  The problem I was having is that dispatch kept wanting to speak to me directly and as such it was a bit distracting.

Now - I am not going to say that there may not have been someone on the other end that may have been more qualified.  That all the questions asked were not pertinant.

I made a point NOT to be rude to the diapatcher.  I also made a point to answer their questions as time permitted.

What was of concern was after I cleared the patients airway of excess partially chewed organic matter, I was in the middle of attempting resuce breathing when I was told that the dispatcher wanted to talk to me as the bystander could not answer many of the questions that the dispatcher had.

In fairness to an earlier comment, perhaps I was a little stressed.  I had a 74 year old in respiratory arrest who was also cyanotic.  I REALLY was focused on the airway.

What would have helped me feel a little more confident/better would have been the following:

1. Acknowledgement of my assessment that the patient did indeed need an ambulance.

2. Approximate ETA when I could expect help.  (something, anything as I had family members that wanted to throw grandpa in their sub-compact and get him to the hospital.  Some information would have gone a long way to help me help them as I really thought this was not a good course of action.)


Everything turned out fine in the end.  I saved the patient, the ambulance showed up, life went on.

I have nothing against diapatchers and in reference to people jamming spoons into other peoples mouths I guess I could not comment as I have never seen or heard of this behavior.  All I am saying is that there may be a better way to respond to people that identify themselves as EMS professionals on the other end of the line.


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## JPINFV (Oct 21, 2011)

NVRob said:


> Not trying to derail the thread but if your working for an ambulance company, as an EMT, with a dispatch center, why do you need to call 911 to request paramedics? Why is there no policy for this? Notify dispatch your request with a quick blurb about what and why then go back to providing patient care and packaging. Rather than having the provider call 911 and get cycled through the dispatch system and have a provider get upset.



Because Orange County, CA only licensed the fire departments to provide paramedic service, so if paramedics are needed either the dispatcher is going to contact 911 (and we didn't carry portable radios, so this means someone going back to the truck or going and picking up a phone anyways). Calling 911 directly also removes a link in the chain. Ever play the game telephone as a kid?

Additionally, it also removes the potential that the private company dispatcher wants to play medical control and tell the EMTs to just transport. 




> Now as a paramedic responding to a BLS trucks request I'd still like to know more than a general complaint. Do I need to be ready to intubate right off the bat? To push drugs for an allergic reaction? Go straight to CPAP on a CHFer? So on and so forth.
> 
> Just my thoughts.


...but you'd rather have a dispatcher, who has much less information, call 911 to request paramedics?


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## MrSalty (Oct 21, 2011)

*Response*



NVRob said:


> Not trying to derail the thread but if your working for an ambulance company, as an EMT, with a dispatch center, why do you need to call 911 to request paramedics? Why is there no policy for this? Notify dispatch your request with a quick blurb about what and why then go back to providing patient care and packaging. Rather than having the provider call 911 and get cycled through the dispatch system and have a provider get upset.
> 
> Now as a paramedic responding to a BLS trucks request I'd still like to know more than a general complaint. Do I need to be ready to intubate right off the bat? To push drugs for an allergic reaction? Go straight to CPAP on a CHFer? So on and so forth.
> 
> Just my thoughts.



Good question.

I was 200 miles out of my area and not in the county that I am registered as an EMT.  

I was at a wedding.

I was not working.

I was acting as a good samaritan.


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## Shishkabob (Oct 21, 2011)

MrSalty said:


> 2. Approximate ETA when I could expect help.



Urban area?  Probably around 9 minutes.

Rural area?  Depending on coverage, up to 30+. 




You wont ever get a more precise answer from dispatch.


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## Handsome Robb (Oct 21, 2011)

Yea JP, I have played telephone. It's not hard to tell a dispatcher "Unit XX requesting ALS to my location. Pt in respiratory distress secondary to FBAO/Anaphylaxis/Unresponsive pending respiratory arrest. If the dispatcher messes that up they need to find a new job. If they are playing OMD and telling you to transport they need to be removed from their position. 

Thats asinine that crew members of an IFT truck don't carry portable radios.

The dispatcher shouldn't be calling 911 either, they should have a direct line to the 911 dispatch center operator rather than being shuffled through the 911 system.


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## Akulahawk (Oct 21, 2011)

JPINFV said:


> Because Orange County, CA only licensed the fire departments to provide paramedic service, so if paramedics are needed either the dispatcher is going to contact 911 (and we didn't carry portable radios, so this means someone going back to the truck or going and picking up a phone anyways). Calling 911 directly also removes a link in the chain. Ever play the game telephone as a kid?
> 
> Additionally, it also removes the potential that the private company dispatcher wants to play medical control and tell the EMTs to just transport.
> 
> ...


I don't ever have my dispatcher call 911... I do it myself. If I have a non-public, direct number, I'll use that instead. Dispatchers tend to notice things like that. If a person knows the back number, they're probably not the average citizen. The times I've used those numbers, I've gotten what I need faster and easier, with less formality than by calling 911. They've taken what I say generally at face value. Then again that could be a Santa Clara/Sacramento EMS system only kind of thing...


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## looker (Oct 22, 2011)

Being you're off duty and you call 911 and say I am emt off duty have patient here that needs ambulance at and give address. If that is all you can say then you just say I got to go and hang up. Let dispatcher deal with it. If that person needs your full attention to stay alive, then dispatcher will just have to deal with not getting all info. What is dispatcher going to do not send an ambulance because person hang up/got disconnected? That would be one dam fat lawsuit.


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## Handsome Robb (Oct 22, 2011)

911 hangup messes with the EMD priority dispatching. You can also bet your *** that dispatcher will call you back, at least once if not multiple times. Here 911 hang ups are priority 2, which means the responding unit could be diverted to a priority 1 call. While a unit further away is re-dispatched to the hang-up thus increasing response time and the amount of time your sitting on scene with a dying person, with no gear and no additional *trained* help. 

Now did you help the pt by hanging up on the dispatcher rather than taking 20 seconds to answer their questions? 

Just some food for thought.


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## looker (Oct 22, 2011)

NVRob said:


> 911 hangup messes with the EMD priority dispatching. You can also bet your *** that dispatcher will call you back, at least once if not multiple times. Here 911 hang ups are priority 2, which means the responding unit could be diverted to a priority 1 call. While a unit further away is re-dispatched to the hang-up thus increasing response time and the amount of time your sitting on scene with a dying person, with no gear and no additional *trained* help.
> 
> Now did you help the pt by hanging up on the dispatcher rather than taking 20 seconds to answer their questions?
> 
> Just some food for thought.



That is asking for lawsuit. If you call 911 say you're off duty emt, say i have patient dying, i am alone at address that knows what the hell i am doing.Then say sorry i can't talk send ambulance and hang up. If that call get bumped to code 2 then i hope city got nice insurance as that is asking for lawsuit. Would you rather emt/medic take time to talk to dispatcher or save the dam person live? As op posted further details dispatcher continuously wanted to talk to him. I am sorry if it's decision between keeping someone alive or talking to dispatcher I hope the person picks keeping person alive.


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## Handsome Robb (Oct 22, 2011)

Ever heard of speaker phone? Also, there are very few emergencies that those 20 seconds will count, if your really alone and the person is that bad put the phone down and start relaying what is going on verbally, something is better than nothing. 

Priority 2 is still code 3, but is available for divert to a priority 1 call.

Considering we have an accredited emergency dispatch center here and have had it for 10+ years, our system seems to work just fine.

Also it wouldn't be on the city, I work for a private under a public service model.


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## looker (Oct 22, 2011)

NVRob said:


> Ever heard of speaker phone? Also, there are very few emergencies that those 20 seconds will count, if your really alone and the person is that bad put the phone down and start relaying what is going on verbally, something is better than nothing.
> 
> Priority 2 is still code 3, but is available for divert to a priority 1 call.
> 
> ...



A lot of people can't do two things at once. While you can put phone on speaker etc how much of the brains is that person using to talk to dispatcher while trying to provide care to the patient. Do your dispatch not roll fire with every ems call? Let fire advice arriving ambulance/dispatcher what is going on.


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## Sasha (Oct 22, 2011)

MrSalty said:


> I appreciate ther feedback, both positive and negative to my comments.
> 
> I did, in fact, hand the phone to someone else.  The problem I was having is that dispatch kept wanting to speak to me directly and as such it was a bit distracting.
> 
> ...



Do you not have speaker phone or a blue tooth?

Why would an IFT company need portable radios? Talk about pointless.

Sent from LuLu using Tapatalk


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## Handsome Robb (Oct 22, 2011)

looker said:


> A lot of people can't do two things at once. While you can put phone on speaker etc how much of the brains is that person using to talk to dispatcher while trying to provide care to the patient. Do your dispatch not roll fire with every ems call? Let fire advice arriving ambulance/dispatcher what is going on.



Fire rolls on priority 1 and 2. Police roll on hang-ups as well. Depending on the time of day it isn't rare that we beat fire to the scene. We run SSM so we don't have to run and get suited up then get in the truck before we respond. 

If your an employed EMT you should be able to multi-task, it's kinda a job requirement.

Fire and PD are a separate dispatch center than ours so them relaying info has to go from them to their dispatcher then to our dispatcher then to us. They can come up on our radio channels but it doesn't happen all that often.


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## looker (Oct 22, 2011)

NVRob said:


> Fire rolls on priority 1 and 2. Police roll on hang-ups as well. Depending on the time of day it isn't rare that we beat fire to the scene. We run SSM so we don't have to run and get suited up then get in the truck before we respond.
> 
> If your an employed EMT you should be able to multi-task, it's kinda a job requirement.
> 
> Fire and PD are a separate dispatch center than ours so them relaying info has to go from them to their dispatcher then to our dispatcher then to us. They can come up on our radio channels but it doesn't happen all that often.



People react differently when they are alone with no partner and get thrown in to emergency situation. Yes i agree that being emt requires multitasking but again people sometimes react differently when they are not "on the job"and are alone. Dispatcher should be able to ignore protocol and just send ambulance. Instead of having someone give him back the phone dispatcher should have gotten whatever she/he could and let ambulance get on scene and get the rest of info.  It's good everything working out for the patient and op but what if it didn't. I do not like set rules with no ability to deviate from them as there are situations where they do not work well at all.


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## Shishkabob (Oct 22, 2011)

looker said:


> Dispatcher should be able to ignore protocol and just send ambulance



If a dispatcher follows protocol, they are essentially exempt from liability if it ends up being dispatched incorrectly per EMD.  If they deviate, it opens them up to so much and the agency and NAMED will drop them like a bad habit.




We deviate in the field because that's just how it is.  They don't have that luxury in dispatch.


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## looker (Oct 22, 2011)

Linuss said:


> If a dispatcher follows protocol, they are essentially exempt from liability if it ends up being dispatched incorrectly per EMD.  If they deviate, it opens them up to so much and the agency and NAMED will drop them like a bad habit.
> 
> 
> 
> ...



While that is totally true the same protocol should give dispatch ability to deviate to sending ambulance in such cases as this. At the end of the day it's all about patient care/saving people lives.


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## Handsome Robb (Oct 22, 2011)

I think the biggest difference that's going on here is 911 vs. IFT dispatching. I never have worked IFT so I don't know how exactly it works. We are required to do 12 hours in dispatch annually so I'm pretty familiar, although not proficient by any means, with our 911/EMD dispatching system.




looker said:


> While that is totally true the same protocol should give dispatch ability to deviate to sending ambulance in such cases as this. At the end of the day it's all about patient care/saving people lives.



In a perfect society, yes. In the litigious society we live in it doesn't work like that. I feel like you, as a company owner, should understand that.


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## looker (Oct 22, 2011)

NVRob said:


> I think the biggest difference that's going on here is 911 vs. IFT dispatching. I never have worked IFT so I don't know how exactly it works. We are required to do 12 hours in dispatch annually so I'm pretty familiar, although not proficient by any means, with our 911/EMD dispatching system.
> 
> 
> 
> ...



I understand it and if we feel that call is 911 we transfer it. Dispatcher always take better safe than sorry. However if I did 911 I would hope  protocol could be designed that could give some room to dispatcher in case where common sense should be used.


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## DesertMedic66 (Oct 22, 2011)

If I call 911 then I am going to have to answer all the questions and they are going to dispatch an ambulance and a fire engine. 

If I call my ambulance dispatch directly then they will ask what I need. So depending on a call it could just be an ambulance.  

Fire/police/highway patrol/ sheriff answer the 911 call and talk directly to the person calling 911. Then from there our dispatch recieves a location and type of call and then we get dispatched.


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## BF2BC EMT (Oct 22, 2011)

NVRob said:


> I think the biggest difference that's going on here is 911 vs. IFT dispatching. I never have worked IFT so I don't know how exactly it works. We are required to do 12 hours in dispatch annually so I'm pretty familiar, although not proficient by any means, with our 911/EMD dispatching system.
> 
> 
> 
> ...



IFT all about getting the money, you're patient begins circling the drain as you're loading them to take them back to a SNF from dialysis and you call dispatch you better belive half the time they'll tell you to continue transport. This is due to greedy individuals. I saw it happening at most private 911 BLS calls from SNF's, you know the calls where the nurse tells you pt is stable just complaining of pain and it turns out to be chest pain, so you call dispatch to notify them this is an ALS call and now both dispatch (who doesn't want to lose a contract but will gladly throw you under the bus) and the RN who knows the SNF has had to many 911 calls are yelling at you to take the pt yourself.

I'm sorry all the needs to be said is I'm off duty, pt chief complaint, priority of call and nothing else. The crew can receive a more detailed report on arrival. Sorry speaker phones aren't the best, handing the phone to someone who is stumbling over their words in a charged up situation is just as bad. 

Leaving 911 hang ups for units farther away is not good practice in my opinion, a hang up or a connected line that once had someone speaking but now they aren't is just bad news.

Edit-this wasn't directed towards you Rob just the first bit about the mentality of IFT dispatchers


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## fast65 (Oct 22, 2011)

If they're that charged up over someone choking, to where they can't perform:

A) abdominal thrusts 
B) chest compressions 
C) airway maneuvers 

While talking to dispatch on speaker, I'm questioning how calm they are on other emergencies, just sayin'.

Honestly, wouldn't it have been easier to just answer the questions that dispatch had for you, than to assume they're just BS questions and that you're time is more important? Those questions are there for a reason, either answer them yourself or have someone else call 911.


Sent from my iPhone using Tapatalk


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## BF2BC EMT (Oct 22, 2011)

fast65 said:


> If they're that charged up over someone choking, to where they can't perform:
> 
> A) abdominal thrusts
> B) chest compressions
> ...



No, I personally don't think dispatch questions are more important then focusing care on the pt. Espically questions about PMH/allergies. Stuff you prob won't know unless the pt is a family member or friend. Pt status can easily change between the time you gave info to the dispatch and the time the medic gets there. The medic should do their own assessment when they arrive, instead of relying on info that might be reliable from someone who might be in the medical field


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## PotatoMedic (Oct 22, 2011)

IF I am counting correctly, my county has 6 different dispatch centers.  Since I drive all over the county (which is not that big) on a regular basis I have gotten to the point where I first confirm which dispatch center I am talking to since cell phones can get routed anywhere and I know the boundaries (and or agency I need to speak too) of each com center.  IE. 

Dispatch: What's your emergency?
Me: Is this "XXXCom?" I need EMS.
Dispatch: One second sir I will transfer you now.


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## CAOX3 (Oct 22, 2011)

I dispatch at times, we don't EMD calls if a medical provider is on scene.  EMD is designed to instruct bystanders.  If you tell me your a nurse or an EMT that should remove you from any liability, they have identified themselves as a medical provider on scene, it isn't a dispatchers job to determine if the caller is  or isn't what they say they are.

We get a general summary and send an ambulance.


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## mycrofft (Oct 22, 2011)

*So let me get this straight...*

I can call 911, tell them I'm a paramedic and they'll leave me alone and do whatever I tell them to as far as dispatch?:rofl:

When you receive a phone call to any official number like that, unless you can absolutely positively identify the caller and stake your job on it ( and sometimes that is not enough, there are codes or such), then the subtext to the conversation is "Thanks you for your call, as you surely understand I can take this on advisement but until my people get back to me on it, this is  anonymous hearsay. Have a nice day".
Yes, it can be really frustrating, especially when the adrenaline is pumping and every second feels like a minute, but the fastest way to get through is to be quiet and do what they say. The fastest way to get blown off is to yell, threaten, get sarcastic or demand to speak to a supervisor. Those are the tactics used by the very people you don't want to be trusting at the other end of the line.


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## imadriver (Oct 22, 2011)

Personally I've been on both ends of this. I've called in a few of MVA's, a couple of them I stopped by, I had almost the same thing with two different dispatchers.

I just told them I'm First Responding, came up on this wreck. 

Both had one Unconscious, one single car, the other two car. Both I pretty much said:

"I have one unconscious, unresponsive, breathing adequately, (whatever type) injury, and 2/3 minor patients that have a couple of light scraps and bruises."

First Dispatcher: "Alright, thanks, we'll get a couple units going, Fire, and HP. Is there anything else you might need?"

Second Dispatcher: I'm not going to quote, but it's pretty much as the OP said. They started asking the questions on the flip cards, and yes I know they have a reason, but some of them were just a waste of time because I had already told her most of the information she was asking for. She just couple type fast enough or put it all together I suppose.


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## fast65 (Oct 22, 2011)

BF2BC EMT said:


> No, I personally don't think dispatch questions are more important then focusing care on the pt. Espically questions about PMH/allergies. Stuff you prob won't know unless the pt is a family member or friend. Pt status can easily change between the time you gave info to the dispatch and the time the medic gets there. The medic should do their own assessment when they arrive, instead of relying on info that might be reliable from someone who might be in the medical field



Yes, because I rely solely on the information I get from dispatch. No need to do my own assessment, I'll just ask dispatch what they think I should do for treatment as well...


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## DesertMedic66 (Oct 22, 2011)

fast65 said:


> Yes, because I rely solely on the information I get from dispatch. No need to do my own assessment, I'll just ask dispatch what they think I should do for treatment as well...



Ooh ok good. I thought I was the only one who did that


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## fast65 (Oct 22, 2011)

firefite said:


> Ooh ok good. I thought I was the only one who did that



Nope, I figure that I'm just there to drive to the hospital


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## BF2BC EMT (Oct 22, 2011)

fast65 said:


> Yes, because I rely solely on the information I get from dispatch. No need to do my own assessment, I'll just ask dispatch what they think I should do for treatment as well...



Then there's no reason for someone to be on the phone giving more then a 30 second report. No need for questions that can or can't be answered, send the ambulance and let the people with the tools get to work


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## Handsome Robb (Oct 22, 2011)

BF2BC EMT said:


> Then there's no reason for someone to be on the phone giving more then a 30 second report. No need for questions that can or can't be answered, send the ambulance and let the people with the tools get to work



If there's no reason why does EMD exist? Just a question, and before you say it's for laypersons read below.

I understand being frustrated with the questions being an off-duty provider but like someone else said, *people lie*. There are a lot of EMTs out there with 0 field experience other than the 12-24 hours of ride time they got in class as well.

Now if your talking to one of your own dispatchers and ID yourself along with your employee number it's a different story and I'm right there with you and your frustration.


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## fast65 (Oct 22, 2011)

Personally I like to have some sort of idea about what I might be walking into, if that takes another few seconds from someone on the phone, then so be it. I'm no dispatcher, but I imagine that they send an ambulance shortly after the call and then attempt to gather more info after the fact.



Sent from my iPhone using Tapatalk


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## fast65 (Oct 22, 2011)

NVRob said:


> If there's no reason why does EMD exist? Just a question, and before you say it's for laypersons read below.
> 
> *I understand being frustrated with the questions being an off-duty provider but like someone else said, people lie. There are a lot of EMTs out there with 0 field experience other than the 12-24 hours of ride time they got in class as well.*
> 
> Now if your talking to one of your own dispatchers and ID yourself along with your employee number it's a different story and I'm right there with you and your frustration.



Exactly. I was dispatched for an MVA a few weeks ago, dispatch said there was a "trained medical provider" on scene that reported there were 3 patients, one of which was ejected...we got there to find *0 patients*. The trained medical provider? He said he wasn't sure where they all went. The person identifying themselves as a healthcare provider may be an EMT that got their cert in the 80's and never used it or it may be an ER doc, either way there's no way for dispatch to know that they are actually competent enough to provide care without their pre-arrival instructions. 

EMD was formed to help provide pre-arrival care instructions to people who call 911. The questions they ask aren't just a bunch of BS questions, they're there for a reason, and should be answered. It's nice to know that you're responding to a "52 yo M, respiratory distress after ingesting peanuts, history of peanut allergies" rather than just getting "50's yo male, respiratory distress". That little extra info is great to have and it paints a picture of what I MAY be walking into.


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## Handsome Robb (Oct 22, 2011)

fast65 said:


> Personally I like to have some sort of idea about what I might be walking into, if that takes another few seconds from someone on the phone, then so be it. I'm no dispatcher, but I imagine that they send an ambulance shortly after the call and then attempt to gather more info after the fact.
> 
> 
> 
> Sent from my iPhone using Tapatalk



Seconded. I take dispatch information with a grain of salt, unless its "Stage out of the area"  but it does get you thinking about treatment paths you may need to be heading down.

Only ever been in our dispatch center but we have a primary call taker and a primary dispatcher. Once the call taker gets the address it's kicked over to the dispatcher who then dispatches the appropriate unit while the call taker gathers information from the caller. 

Too add to that we have an Air Communications Specialist at their own console controlling our HEMS guys and all other area HEMS traffic, but if there's no chopper in the air they will answer calls or dispatch units if we get busy. There's also a supervisor at his own console who will do all of the above if we get busy as well. If it is insane we have the ability to bring in another person to aid in the workload at a separate station. Our dispatch center only does EMS, no Fire or Police, that's at a separate center.


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## fast65 (Oct 22, 2011)

NVRob said:


> *Seconded. I take dispatch information with a grain of salt, unless its "Stage out of the area"  but it does get you thinking about treatment paths you may need to be heading down.*
> 
> Only ever been in our dispatch center but we have a primary call taker and a primary dispatcher. Once the call taker gets the address it's kicked over to the dispatcher who then dispatches the appropriate unit while the call taker gathers information from the caller.
> 
> Too add to that we have an Air Communications Specialist at their own console controlling our HEMS guys and all other area HEMS traffic, but if there's no chopper in the air they will answer calls or dispatch units if we get busy. There's also a supervisor at his own console who will do all of the above if we get busy as well. If it is insane we have the ability to bring in another person to aid in the workload at a separate station. Our dispatch center only does EMS, no Fire or Police, that's at a separate center.



Oh, don't get me wrong, I don't take dispatch information as gospel, but at least it gets you thinking.


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## adamjh3 (Oct 22, 2011)

Wait, dispatchers give you guys info about the call? We have to fight tooth and nail to get a bed number out of our dispatchers

Sent from my DROIDX using Tapatalk


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## Handsome Robb (Oct 22, 2011)

adamjh3 said:


> Wait, dispatchers give you guys info about the call? We have to fight tooth and nail to get a bed number out of our dispatchers
> 
> Sent from my DROIDX using Tapatalk



It will come out as "Medic XX respond priority 1 to address for chest pain and SOB, map page xx, coordinants #X Apartment Guide page X (if appropriate), to address, map page xx, coordinants #X Apartment Guide page X (if appropriate) at 1545.

Then we get a page on our pagers or phone depending on your favorite flavor with info gathered from the call taker. Usually will contain age/sex of patient chief complaint then onset, hx if present, a gate code if we need it and usually who called it in (pt or 3rd party or PD) usually if PD requests us it will be made clear in the initial radio dispatch that your meeting XX PD on scene.


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## Shishkabob (Oct 22, 2011)

At my old agency, we could ask all the questions we wanted of our dispatchers while going to the call.  Granted we were rural, so not only did we have time, but also the need to know further if we should start sending more resources to help out.  


At my new agency, they just dispatch, but all the call information is available on the laptops in the truck, including every question asked by EMD and the callers answers.


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## dstevens58 (Oct 22, 2011)

It's been too many years since I've done EMS Dispatching, but I have more recent information/experience in law enforcement dispatching.

After initial introductions (hi, I'm EMT so-and-so, here's what and where), I could get unit(s) going, then tend to the additional questions I need to ask and update the crews while they are en route to the scene if need be.


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## DesertMedic66 (Oct 22, 2011)

NVRob said:


> It will come out as "Medic XX respond priority 1 to address for chest pain and SOB, map page xx, coordinants #X Apartment Guide page X (if appropriate), to address, map page xx, coordinants #X Apartment Guide page X (if appropriate) at 1545.
> 
> Then we get a page on our pagers or phone depending on your favorite flavor with info gathered from the call taker. Usually will contain age/sex of patient chief complaint then onset, hx if present, a gate code if we need it and usually who called it in (pt or 3rd party or PD) usually if PD requests us it will be made clear in the initial radio dispatch that your meeting XX PD on scene.



I would love to get that information. If our pagers work we receive map page grid, C/C (which is hardly ever right, Address, and the fire engine we are responding with. So it is a normal thing to hear "Medic 104, we are at a locked gate".


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## Tigger (Oct 22, 2011)

Here once the call taker gets an address and the nature of the call they pass it on to the dispatchers and an engine starts rolling. Most of the time the initial dispatch has the EMD code included in it as well, but if the call taker is struggling to get it the engine will still leave and AMR will assign a medic unit to the call as well. You do not waste response time answering the dispatchers questions. Answering the questions ensures that that the responding units don't get diverted and that ambulance is sent priority as well. The crews appreciate having some information too.


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## LucidResq (Oct 22, 2011)

I took a call from a nurse at an urgent care center for a 20 year old male, c/c: difficulty breathing. 
Me: "do you have any idea what's going on? " (trying to get a general idea - asthma? anxiety attack?)
RN: "no but the PA is starting to intubate him." 
Me: "Ok they're on the way bye." (I now know she needs to get off the phone and tend to the patient) 

I then told the dispatcher (no medical background) to be sure to tell the responding units that they're intubating the patient. He had no idea what it meant or why it was important but thankfully trusted me, aired it and asked questions later. Although it's not a big deal, I bet this is info you want to know as a responder. This nurse answered all my questions politely and things went smoothly.  

This is how it should go!!! Please don't be rude to us or act like half the jerks we talk to and say something like "why does it matter, just get them here!!" and hang up. I know there's a lot of terrible dispatchers out there and I'm sorry for that, but there are a lot of terrible EMTs in the field also. 

Just don't forget there's another person on the other end of the line. I'm glad to see so many of you realize that because it's surprisingly uncommon. For some reason there's a lot of us vs. them mentality and an assumption that dispatchers are stupid or failures. We have experienced paramedics, PhDs, and yes some idiots among our ranks.... just like out in the field.


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## adamjh3 (Oct 22, 2011)

LucidResq said:


> For some reason there's a lot of us vs. them mentality



And I think that's where a lot of the issues arise. When you're on the ambo (at least in my limited experience) a lot of the things your dispatch does doesn't make sense from your perspective. Yeah, I've sat there and thought "how hard can it be to get a little bit of info from the nurse on the phone?" But when we get on scene and I'm having a hard time getting anything from the nurse and she's standing right next to me I realize how difficult the job must be. 

And this isn't even a 911 system.

EDIT: All forms of "you" are general and not pointed at any one person.


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## Handsome Robb (Oct 22, 2011)

firefite said:


> So it is a normal thing to hear "Medic 104, we are at a locked gate".



Oh trust me, we make the locked gate call more often than not. Thankfully most of the gated areas here are starting to implement a universal code for EMS/Fire/PD to use to gain access. We have a few tricks to getting gates to open that don't involve any sort of physical contact with said gate or it's components too but thats about all I can say about that.

Edit: Lucid that surprises me that your partner dispatcher had no medical training. Is this pretty common throughout the nation? Here all the dispatchers are required to have EMT-B prior to hire then complete the first EMT-I course offered by our service ( offered 2 times a year. the dispatcher's tuition is waived and they are payed their hourly wage during class) about half of our dispatchers hold a current EMT-P card. They are also required to work 1-2 12 hr shifts annually as a 3rd in the unit with us to keep 'fairness' with the street crews being required to work in dispatch.

Also, I can't say I have never gotten frustrated with dispatch while working. I mean if we have a huge unit hour utilization number don't post us central!!!!


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## Shishkabob (Oct 23, 2011)

LucidResq said:


> For some reason there's a lot of us vs. them mentality and an assumption that dispatchers are stupid or failures.



Usually due to cartain dispatchers acting (intentionally or not) like field crews de facto supervisor, when in fact, they are support staff.

It got to the point at my last agency where field supervisors and operations management actually had a meeting with dispatch supervisors essentially telling them to "back off" the field crews.



Sat in with my new agency's dispatch 2 days this week and the interaction between dispatch and field crews is rather minimal compared to my last agency, and also looked less strained.  Though I did warn the dispatchers as I was leaving that I would probably cuss them out a time or two under my breath.  They said they'd do the same


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## LucidResq (Oct 23, 2011)

NVRob said:


> Edit: Lucid that surprises me that your partner dispatcher had no medical training. Is this pretty common throughout the nation?



It is sooo varied. I work at a totally integrated 911 center - we handle medical, fire and police for the entire city. Everyone starts as a calltaker and soon cross-trains to dispatch police and fire/EMS. People here will often spend a few hours dispatching PD, then a few on Fire, then some taking 911 calls. A place like this, having your EMT isn't required and wouldn't be any more beneficial than being a firefighter or having law enforcement experience. 

The places that tend to require or strongly prefer EMT certification are those that are segregated from PD call-taking and dispatch and only do EMS.


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## Yarbo (Oct 23, 2011)

BF2BC EMT said:


> No, I personally don't think dispatch questions are more important then focusing care on the pt. Espically questions about PMH/allergies. Stuff you prob won't know unless the pt is a family member or friend. Pt status can easily change between the time you gave info to the dispatch and the time the medic gets there. The medic should do their own assessment when they arrive, instead of relying on info that might be reliable from someone who might be in the medical field




So, you're not going to do radio patches anymore or give a patient report to the nurse? They should do they own assessment. Lol

Constant communication is important in the chain of survival.


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## BF2BC EMT (Oct 23, 2011)

Yarbo said:


> So, you're not going to do radio patches anymore or give a patient report to the nurse? They should do they own assessment. Lol
> 
> Constant communication is important in the chain of survival.



Dont know where you got that from.

Most of the time when an off duty emergency happens and you happen to be on scene questions about PMH/allergies will be useless as you probably don't even know the pts name. Your time(in a true emergency) would be better helping the pt with the tools you have. All I'm saying, nothing about handing off report, get real.


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## EMT11KDL (Oct 23, 2011)

BF2BC EMT said:


> Dont know where you got that from.
> 
> Most of the time when an off duty emergency happens and you happen to be on scene questions about PMH/allergies will be useless as you probably don't even know the pts name. Your time(in a true emergency) would be better helping the pt with the tools you have. All I'm saying, nothing about handing off report, get real.



also, once the medics/emt get there, i usually give a hand off report with 99 percent of the information that they are going to need.


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## DrParasite (Jan 7, 2012)

oh, i can't believe I missed this thread:





MrSalty said:


> Has anyone responding as a Good Samaritan off-duty been asked twenty or more questions by dispatch?


yep, almost every time I have called 911.  answered every question, often before they even asked it.  and when I forgot to say if the person was conscious and breathing, they called me back to ask it.





MrSalty said:


> What really frustrated me were the inane questions that dispatch wanted to ask me as I was providing care.  Normally if I had a qualified partner it would not have been that bad but as I was pretty much running the show and the dispatcher was NEGATIVELY AFFECTING my ability to HELP THIS DYING MAN.
> 
> I understand the need to collect pertinant data but if identify yourself an an EMT, Paramendic, Nurse, Doctor and ask for an ambulance shouldn't they send one?  If you mention that you are the only one working on an unconscious choking victim does it really make sense to have you STOP to find out the persons exact age or drug allergies?


do you know what to do?  does an OB/GYN know what to do?  what about a podiatrist?  both are doctors.  what about an ortho RN.  does she know what to do in an emergency?  lets say you are on the ambulance, and get the report that a doctor is on scene.  will you take orders from him on a critical patient?  what if the doctor is a proctologist, than what?

Do your thing, give the dispatcher the information he or she needs, he will get the resources you need.  it should take less than 2 minutes.  when in doubt, have someone else call 911 and give all the information (some of which will be relayed to the ambulance crew) to the dispatcher, while you save a life.  not really rocket science here.





JPINFV said:


> As someone that has been in a slightly similar situation, I don't give a damn. In my case, if I call in and say, "Hi, I'm an EMT on a call with ABC ambulance service and need a paramedic response," I don't care what the computers want. I want paramedics dispatched, an ETA (and, no, "They're responding with lights and sirens" is not an ETA, and I almost ended up requesting to speak to a supervisor due to that and other comments made), and the ability to hang up the phone.


As someone who dispatches now after several years on the ambulance, I can honestly say unless you are on a BLS ambulance, treating the patient, and requesting a paramedic intercept, I will treat your call just like I would treat any other civilian.  If you are on the ambulance, I will need nature, location, age, and sex of the patient, and then you will get your paramedic unit.

You won't get an ETA, since I don't know what their ETA is (liability reasons too), as they can get diverted or stuck in traffic, etc.  You can speak to my supervisor too, and he will tell you the exact same thing.  

Unless I know you personally, you are a random civilian and are screened as such.  Even if you are calling from a facility, you still get screened.  All too often I get clinics calling for paramedics, and it's the secretary or the tech calling for the Doc, who just want an ambulance transport to the hospital.  And yes, I have agency policy backing me on that too.


JPINFV said:


> ...and it could mean the difference between me transporting or waiting for paramedics.


never ever ever wait for paramedics.  if they are not there when you are ready to go, start going to the hospital, meet the paramedics enroute.  that's why ETA's don't matter.  They will get there when they get there, and a dispatcher giving you an ETA won't help you.  If you are ready to go, meet the paramedics enroute to the ER, or call the ER and let them know what you are bringing in.


Sasha said:


> Why would an IFT company need portable radios?


how else are you expected to contact dispatch for routine operations? 

I'll do you one better, if you are picking up a patient on room 321 of a SNF, called in as a BLS fever who needs to go to the hospital/Doctor's office, and you get there to find them 80 years old, grossly diaphoretic, AMS, with the nurse saying he was fine 10 minutes ago, wouldn't you want to contact your dispatch center and request ALS?  or to ask for a 2nd truck for the 400lb patient?  you expected to run back to the truck to call for help?

Radio/nextel/agency provided cell phone, doesn't matter, as long as you have a company issued device to contact your dispatch center





NVRob said:


> I think the biggest difference that's going on here is 911 vs. IFT dispatching. I never have worked IFT so I don't know how exactly it works. We are required to do 12 hours in dispatch annually so I'm pretty familiar, although not proficient by any means, with our 911/EMD dispatching system.


with all due respect, unless you have actually sat in the chair, and dealt with some of the callers over the phone, trying to pry accurate information out of them, you don't know squat.  You might see it done, might even think you know how to do it all, but sitting in the dispatch center for 12 hours watching is a lot different than spending 12 hours answering phones.


CAOX3 said:


> I dispatch at times, we don't EMD calls if a medical provider is on scene.  EMD is designed to instruct bystanders.  If you tell me your a nurse or an EMT that should remove you from any liability, they have identified themselves as a medical provider on scene, it isn't a dispatchers job to determine if the caller is  or isn't what they say they are.


should, but doesn't, because you don't know if the person is really a medical provider.  Ever had a "nurse" call, but when the crew got there, it was a nurse assistant?  or a medical professional call, but they turned out to be a lifeguard with CPR training?  That's why everyone gets treated the same, just like they are a civilian (until some reputable person gets on scene and confirms what is going on).





Linuss said:


> Usually due to cartain dispatchers acting (intentionally or not) like field crews de facto supervisor, when in fact, they are support staff.


umm, that's because they sorta are (kinda but not really).  

who tells the unit where to go?  dispatch.  who is responsible for making sure the unit makes it to the scene, and on time?  dispatch.  if a unit is on scene for an extended period of time, who is responsible for making sure they are ok, and keeping abreast on what the situation is?  dispatch.  for IFT who handles scheduling of runs?  dispatch.  

are dispatchers support staff?  absolutely.  they are an essential part of the EMS operation.  they are also responsible for resource management, keeping track of all the units, making sure everyone is safe, and coordinating additional resources with other agencies on major scenes.  Sound like another job description you know?


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## JPINFV (Jan 7, 2012)

DrParasite said:


> As someone who dispatches now after several years on the ambulance, I can honestly say unless you are on a BLS ambulance, treating the patient, and requesting a paramedic intercept, I will treat your call just like I would treat any other civilian.  If you are on the ambulance, I will need nature, location, age, and sex of the patient, and then you will get your paramedic unit.


Strange, because I was on a BLS ambulance at a facility, treating a patient, and requesting a paramedic intercept. I have no problem giving nature, location, age, and sex of the patient. What I don't want is to run through various EMD questions like, "Is the patient breathing?" The patient may have been breathing when I left the room (and in this case it was, stand in the door way and go, "Ok... we need to go now. Approach patient with shortnes of breath, tripoding, and accessory muscle use to initiate care, patient adamantly refusing nearest hospital in the hope that she wouldn't be sent back to current facility), but if something changed then me getting back and helping my partner is infinitely more important than answering questions that should have no bearing on whether paramedics are dispatched or not. 


> You won't get an ETA, since I don't know what their ETA is (liability reasons too), as they can get diverted or stuck in traffic, etc.  You can speak to my supervisor too, and he will tell you the exact same thing.


Then it seems to reason that no one should ever get an ETA. Transporting to a facility? Nope, can't give an ETA because I might hit traffic while transporting. That sounds like a complete cop out from someone who should know where the closest unit is. Now, if that was my only problem, then I wouldn't have cared. However I was initially refused paramedics ("Hi, this is ABC Ambulance requesting a paramedic escort [the term "paramedic escort" is specifically used in the protocol and policy book to describe a patient being transported with paramedics]." [in a somewhat snotty voice] "We don't do those"). Now add on EMDing a BLS ambulance AND refusing an ETA...



> Unless I know you personally, you are a random civilian and are screened as such.  Even if you are calling from a facility, you still get screened.  All too often I get clinics calling for paramedics, and it's the secretary or the tech calling for the Doc, who just want an ambulance transport to the hospital.  And yes, I have agency policy backing me on that too.


Wow, so a dispatcher is allowed to overrule a medical crew on a treatment decision despite never seeing the patient (including an ambulance crew), but you don't want the liability of giving out an ETA? Want to take a guess at which one I think has more liability, refusing to dispatch or refusing an ETA?


> never ever ever wait for paramedics.  if they are not there when you are ready to go, start going to the hospital, meet the paramedics enroute.  that's why ETA's don't matter.  They will get there when they get there, and a dispatcher giving you an ETA won't help you.  If you are ready to go, meet the paramedics enroute to the ER, or call the ER and let them know what you are bringing in.


How, pray tell, do you plan on arranging a mid transport meet up in an area not set up at all to arrange a mid transport meet up? Should I call the fire ambulance on my fire dispatch radio that I don't have? Call 911 on my cell phone after getting off the phone at the facility? The area that I worked in for most of my time did not operate in that fashion, for good, bad, or indifferent. 



> how else are you expected to contact dispatch for routine operations?


If out of the ambulance, cell phone and 1-800 number or land line at the facility.


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## JPINFV (Jan 7, 2012)

DrParasite said:


> who tells the unit where to go?  dispatch.  who is responsible for making sure the unit makes it to the scene, and on time?  dispatch.  if a unit is on scene for an extended period of time, who is responsible for making sure they are ok, and keeping abreast on what the situation is?  dispatch.  for IFT who handles scheduling of runs?  dispatch.
> 
> are dispatchers support staff?  absolutely.  they are an essential part of the EMS operation.  they are also responsible for resource management, keeping track of all the units, making sure everyone is safe, and coordinating additional resources with other agencies on major scenes.  Sound like another job description you know?


Oh, can't believe I missed this one.

If I'm calling 911 for a paramedic response, than the 911 dispatch is certainly not my supervisor. It's not even support staff. It's someone who's going to push a few buttons, speak into a different microphone, and start paramedics to my location because a member of the EMS system is saying, "We need paramedics at this location for our patient."


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## Nervegas (Jan 7, 2012)

Older thread, but ill toss in my views. I have only needed to call in off-duty a handful of times, every time I have just told someone else to call 911 and gone off to do my own thing. Usually there are enough gawkers to just get someone else to handle the phone call thing. 

And with EMD dispatching that the OP was referring to, the box is already on its way before they start asking all of the EMD questions. On our dispatch youll hear "Medic XXX need you en-route to XX for a priority 1/2 whatever the caller stated or unknown medical." While we are on the way, they will update us with further information, and alter the priority accordingly.


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## DrParasite (Jan 7, 2012)

JPINFV said:


> Strange, because I was on a BLS ambulance at a facility, treating a patient, and requesting a paramedic intercept.


Ahh, I see, you were on the the IFT ambulance, and instead of contacting your dispatch center to call for ALS, you called 911.  IDK if that's your company's policy or standard practice, but it might have led to some confusion.  

Typically, if we receive requests for ALS, they come from the IFT's dispatch center, not from a private 911 cell phone.  In fact, I think I have received only one such call and we sent a paramedic unit to meet up with them (once I figured out what they wanted)





JPINFV said:


> Then it seems to reason that no one should ever get an ETA. Transporting to a facility? Nope, can't give an ETA because I might hit traffic while transporting.


pretty much while when I'm on the truck, I either give a longer than I need ETA (when 2 minutes away, gave dispatch a 5-7 min ETA), or didn't give an ETA, just my present location.  They can guess my ETA, but that's on the other person, not me.  but when you are on an IFT, you are on a schedule, so ETAs are important because other runs need to be scheduled around them.





JPINFV said:


> That sounds like a complete cop out from someone who should know where the closest unit is.


Not a cop out at all, just reality.  I know what unit should be closest.  but if i'm working as a calltaker, I might not know what else is going on in the city/county, as the dispatchers handle it.  not only that, but if you need an ALS unit, and next door to you a person has just been shot 3 times, the medic unit might end up getting diverted to them.

plus I can give you a 4 minute ETA, but when they get delayed by a train, or get flagged down for an MVA, or can't start the truck when they try to respond and a next due station needs to be sent, who are you going to yell at?  that's right, the dispatcher who gave you the 4 minute ETA.





JPINFV said:


> Now, if that was my only problem, then I wouldn't have cared. However I was initially refused paramedics ("Hi, this is ABC Ambulance requesting a paramedic escort [the term "paramedic escort" is specifically used in the protocol and policy book to describe a patient being transported with paramedics]." [in a somewhat snotty voice] "We don't do those"). Now add on EMDing a BLS ambulance AND refusing an ETA...


sounds like you had a bad day, maybe you should get a job in dispatch and show them how it's done?





JPINFV said:


> Wow, so a dispatcher is allowed to overrule a medical crew on a treatment decision despite never seeing the patient (including an ambulance crew), but you don't want the liability of giving out an ETA? Want to take a guess at which one I think has more liability, refusing to dispatch or refusing an ETA?


you can't be sued for refusing to give an ETA.  and yes, a dispatcher can overrule a civilian on the phone.  an EMT on an ambulance is a little shady (and no, I have never EMDed an ambulance on scene, usually get the info asked for above + call back number, agency name and ambulance number), but then again, most ambulances go through dispatch to request paramedics, they don't call 911.





JPINFV said:


> How, pray tell, do you plan on arranging a mid transport meet up in an area not set up at all to arrange a mid transport meet up? Should I call the fire ambulance on my fire dispatch radio that I don't have? Call 911 on my cell phone after getting off the phone at the facility? The area that I worked in for most of my time did not operate in that fashion, for good, bad, or indifferent.


sounds like you worked for a :censored::censored::censored::censored:ty service who didn't believe in giving you the tools needed to do your job properly.  sucks for you, I wouldn't work there.





JPINFV said:


> If out of the ambulance, cell phone and 1-800 number or land line at the facility.


see previous statement.





JPINFV said:


> If I'm calling 911 for a paramedic response, than the 911 dispatch is certainly not my supervisor. It's not even support staff. It's someone who's going to push a few buttons, speak into a different microphone, and start paramedics to my location because a member of the EMS system is saying, "We need paramedics at this location for our patient."


if you are an IFT service, than the 911 dispatcher isn't your semi-supervisor, your IFT dispatcher is.  the 911 dispatcher is responsible for all the 911 vehicles, not the private vehicles that aren't in his or her system.

and if you are an IFT truck, you aren't IN the EMS system, you are in the Interfaciliy transport system.  You have your own policies, your own dispatcher, your own supervisor, and your own priorities, completely separate from the 911 system.  

But I stand by my original statement, if med school doesn't work out for you (and I honestly hope you become an MD and don't have to deal with IFT ever again, especially private IFT companies because they generally suck), you should get a job in dispatch, to show them how it's done.  it's a little more complicated than pushing buttons and speaking into microphones, but without ever having to do the job, you wouldn't know that.


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## JPINFV (Jan 7, 2012)

DrParasite said:


> Ahh, I see, you were on the the IFT ambulance, and instead of contacting your dispatch center to call for ALS, you called 911.  IDK if that's your company's policy or standard practice, but it might have led to some confusion.


Standard practice for that area. Never had an issue with it outside of that one time. 




> plus I can give you a 4 minute ETA, but when they get delayed by a train, or get flagged down for an MVA, or can't start the truck when they try to respond and a next due station needs to be sent, who are you going to yell at?  that's right, the dispatcher who gave you the 4 minute ETA.



That's a "stuff happens." On the other hand, I guess the take away message is to say, "BLS ambulance needs paramedics at _____ for a __ y/o male/female for ____," and hang up after confirming that that information has been received. After all, why stay on the phone if dispatch isn't going to tell me anything useful. It will also prevent me from "having a bad day" when the dispatcher can't figure out how to do her job. 




> sounds like you had a bad day, maybe you should get a job in dispatch and show them how it's done?


Yes, I'm having a bad day because a dispatcher didn't know how to do her job. That's my fault that apparently the dispatcher has a stick up her butt. 



> you can't be sued for refusing to give an ETA.  and yes, a dispatcher can overrule a civilian on the phone.  an EMT on an ambulance is a little shady (and no, I have never EMDed an ambulance on scene, usually get the info asked for above + call back number, agency name and ambulance number), but then again, most ambulances go through dispatch to request paramedics, they don't call 911.



Yes, because playing telephone with dispatch instead of calling 911 directly makes a whole ton of sense. If I've gotta talk to someone in order to get paramedics, I might as well talk to someone who can actually get me the resources I need instead of calling someone else to get me the resources I need. 




> sounds like you worked for a :censored::censored::censored::censored:ty service who didn't believe in giving you the tools needed to do your job properly.  sucks for you, I wouldn't work there.



It's the county rules, not the service. Of course aren't you from the state that still lets ambulances respond without even an EMT on board? Pot, meet kettle. After all, who would work in a state with such asinine and archaic rules like that? 



> see previous statement.if you are an IFT service, than the 911 dispatcher isn't your semi-supervisor, your IFT dispatcher is.  the 911 dispatcher is responsible for all the 911 vehicles, not the private vehicles that aren't in his or her system.
> 
> and if you are an IFT truck, you aren't IN the EMS system, you are in the Interfaciliy transport system.  You have your own policies, your own dispatcher, your own supervisor, and your own priorities, completely separate from the 911 system.
> 
> But I stand by my original statement, if med school doesn't work out for you (and I honestly hope you become an MD and don't have to deal with IFT ever again, especially private IFT companies because they generally suck), you should get a job in dispatch, to show them how it's done.  it's a little more complicated than pushing buttons and speaking into microphones, but without ever having to do the job, you wouldn't know that.




I never said dispatch was easy, but I don't have to be in dispatch to know that telling a crew, "Sorry, we don't do that" when using a term verbatim out of the protocol/policy manual (that is county wide, not company specific) is... well... stupid. Especially when the meaning is clear. You don't need to be in dispatch to realize that asking an ambulance crew, "Is the patient turning blue" is stupid. 

...and yes, the dispatcher is responsible for the 911 units. When the *county* (not the company) decides to limit paramedics only to the fire departments, then a patient requiring paramedics becomes a 911 system problem.


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## DrParasite (Jan 8, 2012)

JPINFV said:


> Standard practice for that area. Never had an issue with it outside of that one time.


weird practice.  but I guess Cali has some weird practices.





JPINFV said:


> That's a "stuff happens." On the other hand, I guess the take away message is to say, "BLS ambulance needs paramedics at _____ for a __ y/o male/female for ____," and hang up after confirming that that information has been received. After all, why stay on the phone if dispatch isn't going to tell me anything useful. It will also prevent me from "having a bad day" when the dispatcher can't figure out how to do her job.


sure.  and you might get a paramedic unit.  or you might have the dispatcher calling you back at the call back number you gave and until he or she is able to properly follow dispatch protocol and ask all those questions, not send a paramedic.  I don't know, I would have just answered all the questions that were asked, it seems like wasting a minute is much better answering questions than being argumentative.  





JPINFV said:


> Yes, I'm having a bad day because a dispatcher didn't know how to do her job. That's my fault that apparently the dispatcher has a stick up her butt.


again, without ever being a dispatcher, how do you know what their job is?  in fact, unless you have done their job, I am pretty sure you aren't qualified to say they don't know how to do their job.  Just like I can't tell a doctor they don't know how to do their job without MD after my name.  





JPINFV said:


> Yes, because playing telephone with dispatch instead of calling 911 directly makes a whole ton of sense. If I've gotta talk to someone in order to get paramedics, I might as well talk to someone who can actually get me the resources I need instead of calling someone else to get me the resources I need.


it might be playing telephone, but that's standard practice on the east coast.  but again, your protocols might vary.





JPINFV said:


> It's the county rules, not the service. Of course aren't you from the state that still lets ambulances respond without even an EMT on board? Pot, meet kettle. After all, who would work in a state with such asinine and archaic rules like that?


because they pay me 18 an hour?  and that whole "ambulance responding without an EMT on board" happens much less frequently than you think, and it's usually only in the rural volunteer covered areas, or areas that are covered by a volunteer FF ambulance.  Scary, yes, correct, absolutely not, and when I was told this was happening I couldn't believe it, because NO agency near me would permit something like that to happen.  

but we are talking about your issue dealing with dispatch, not the actions of unlicensed and unaligned ambulances that are permitted to do what they want without any oversight.





JPINFV said:


> I never said dispatch was easy, but I don't have to be in dispatch to know that telling a crew, "Sorry, we don't do that" when using a term verbatim out of the protocol/policy manual (that is county wide, not company specific) is... well... stupid. Especially when the meaning is clear. You don't need to be in dispatch to realize that asking an ambulance crew, "Is the patient turning blue" is stupid.
> 
> ...and yes, the dispatcher is responsible for the 911 units. When the *county* (not the company) decides to limit paramedics only to the fire departments, then a patient requiring paramedics becomes a 911 system problem.


maybe they can't do that, especially if it's a protocol/policy violation?  You can quote terms from the policy manual all you want, but if what you want them to do something that dispatch policy doesn't allow, than quote all the terms you want, it's not going to happen.  I don't know what the rules are, or what their policies are, and neither do you, so I can't say for sure.

I'll end with this: follow your company and county rules.  if your county says to get ALS, you need to play telephone and go through your IFT dispatch center, do it.  if your county lets private ambulances call 911 to request ambulances, do it.  If you decide to deviate from the standard practice and policy, because you think it will work better, and find out it doesn't work as smoothly as you expect, don't blame the dispatcher; follow the rules that are applied to everyone else.  And then if you are doing everything correct, following the policies, than you have your boss call their boss, file a complaint, and get someone fired.  But that will only happen if your right and they were wrong, which may not be the case.


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## WuLabsWuTecH (Jan 8, 2012)

Around here, when I ask for an engine or a medic over a land line, i'll generally get it.  But we also don't have a tiered response system.  If i'm on scene and someone is sick/hurt, a medic will come.  The only determination is if the engine also comes with it for manpower.  Generally if I say it's ALS and give indicators for such, they'll send me an engine.  It's only happened a handful of times though.

And yes, sometimes dispatchers ask for some really unnecessary info.  The dispatcher at a college campus once ased me for both my student ID number and that of the student I was trying to help.  I later learned that she had already dispatched the police and first response unit, and was just trying to gather information for the CAD so the officer wouldn't have to do it all later, but it was certainly a good thing I wasn't trying to do CPR while answering these questions!


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