Dispatch protocols

[C.T.E.M.R.]

In my area We have BLS trucks and when ALS is needed we have medic intercepts. It seems to work well, Well over 75% of the time but i think the way my dispatch protocol is written, it leaves a bit of an issue, The protocol basically just has the broad term for the call such as respiratory distress, or MVC with a list of possible details below, it is written that all calls have R1&R2 response by default R1 being F.D. and R2 being Ambulance, Then going down the list on each call it dictates Whether there will be an R5(medic) response, There seems to be an issue that the Medic could be dispatched to a call because of what the caller is telling the dispatcher even if Its a frequent flyer B.S. call, especially when a cardiac or respiratory call comes in right after that medic makes PT contact and is now stuck on that call until PT care has been handed off to the receiving facility, Do any of you that use medic intercepts have any problems like that?, are they severe? i don't believe it is a big problem for us but i think the protocols should be slightly more detailed

 

[nakenyon]

Out here, we don't have fire response on the majority of our medical calls. We have Class 1 (ALS L&S), Class 2 (BLS L&S), Class 3 ( BLS Non-Emerg.). At the moment, the EMD system that my county uses escapes me. But basically the callers info is taken and plugged into the computer and then a response level is spit out. The problem with discriminating against frequent fliers is that (happened to us) eventually that frequent flier might have a real medical issue that needs ALS. Thankfully the dispatch sent ALS, but the point was moot because she waited too long to call when she was having an actual emergency.

 

[wyoskibum]

There seems to be an issue that the Medic could be dispatched to a call because of what the caller is telling the dispatcher even if Its a frequent flyer B.S. call, especially when a cardiac or respiratory call comes in right after that medic makes PT contact and is now stuck on that call until PT care has been handed off to the receiving facility, Do any of you that use medic intercepts have any problems like that?, are they severe? i don't believe it is a big problem for us but i think the protocols should be slightly more detailed

Unfortunately, I don't see how you can do any better short of having more Medics. You always have to err on the side of caution. So you send the Medic if you 'think' that your going to need one. Most cases, you won't know what you need until someone actually assesses the patient.

 

[C.T.E.M.R.]

I can see how The frequent flyer may sooner or later have a real problem, or how having more medics might be better, But my thought was to maybe go through and change the protocols, especially seeing how some calls that have a medic default may or may not actually need one, I also just realized another problem today, our medics can choose to downgrade if they dont see the need for an ALS transport, wyoskibum i see that your also from ct, how does your area do things?

 

[JPINFV]

how some calls that have a medic default may or may not actually need one,

Why is that a problem?

Let's say you walk into the emergency room with a complaint that may or may not need a physician. Would you rather have a physician on site and able to treat you immediately or would you rather be in the ED tech's care for 30 minutes while the physician responds from home? Would the fact that it may not need a physician sooth your mind if you had an adverse outcome due to a delay in care?

 

[C.T.E.M.R.]

I hear what your saying JPINFV, At this point i feel like our medics just need to make better decisions on what calls to stay on and what to downgrade. And to answer your question, It doesn't really matter because i know at all 3 of our hospitals you never know who your gonna get. Thanks for the responses!

 

[wyoskibum]

I can see how The frequent flyer may sooner or later have a real problem, or how having more medics might be better, But my thought was to maybe go through and change the protocols, especially seeing how some calls that have a medic default may or may not actually need one, I also just realized another problem today, our medics can choose to downgrade if they dont see the need for an ALS transport,

It boils down to a crap shoot. No matter what you do, you are eventually will get caught with your pants down. A pt that needs a Medic, but you didn't initially send one. That is why some people advocated having a Medic on every call whether you need one or not.

wyoskibum i see that your also from ct, how does your area do things?

I work both Southwest region and Northwest region. On my 911 job we run Medic/AEMT trucks. If the pt doesn't need a Medic, I will drive and let my partner ride the patient in. On my other IFT job, I'm usually in a fly car and will respond with the BLS ambulance. IF the pt needs a Medic, I ride it in and one of the EMT will drive the fly car to the hospital.

 

[wyoskibum]

I hear what your saying JPINFV, At this point i feel like our medics just need to make better decisions on what calls to stay on and what to downgrade. And to answer your question, It doesn't really matter because i know at all 3 of our hospitals you never know who your gonna get. Thanks for the responses!

Unfortunately, you will get some Medics who turf an ALS call to the BLS crew. I don't know if they are being lazy or stupid. I always ask my EMT partner or the BLS crew if they are comfortable taking the patient before I downgrade the call. If they have any doubts, then I'm happy to ride the patient in to the hospital.

 

[Lady_EMT]

In my area We have BLS trucks and when ALS is needed we have medic intercepts. It seems to work well, Well over 75% of the time but i think the way my dispatch protocol is written, it leaves a bit of an issue, The protocol basically just has the broad term for the call such as respiratory distress, or MVC with a list of possible details below, it is written that all calls have R1&R2 response by default R1 being F.D. and R2 being Ambulance, Then going down the list on each call it dictates Whether there will be an R5(medic) response,

We have ILS trucks and BLS trucks (I'm talking volunteer right now.) The medics are sent to any Charlie, Delta, and Echo calls, unless we call for them to come to an Alpha or Bravo (if the pt deteriorates.) It works pretty well.

There seems to be an issue that the Medic could be dispatched to a call because of what the caller is telling the dispatcher even if Its a frequent flyer B.S. call,

Ok, example time: Stew is the town drunk. He calls every friday night around 2300, complaining of something different every time. Well this friday, you've had a long day. You've been out all day, and have just crawled into bed, when you get toned out to Stew's local hangout for a cardiac issue. The medic is dispatched with you. You know that it's going to be another run of the mill BS call, so when you get on scene to find Stew slurring about how his chest hurts, you cancel the medic because you know that Stew just wants a warm place to sleep off his drunken stupor. You bring him into the hospital, ignoring his complaints the whole way there. A few days later, you receive a summons to court, telling you that the had a full blown heart attack, and is now dying in the ICU because of maltreatment. Pretty sure that telling them you "cancelled the medic because Stew is a BS frequent flyer" isn't going to get you out of this one. (I know, total worst-case-scenerio,)

especially when a cardiac or respiratory call comes in right after that medic makes PT contact and is now stuck on that call until PT care has been handed off to the receiving facility, Do any of you that use medic intercepts have any problems like that?, are they severe? i don't believe it is a big problem for us but i think the protocols should be slightly more detailed

I run into issues where the actual people on the crew are calling for a medic when they don't need one. In this area, the medic can downgrade when they get onscene if they don't think they're needed. And if they're on my call, and another squad needs them, its unfortunate but they're going to have to wait, because I needed a medic.

 

[truetiger]

More medics is your answer....even out here in the "sticks" we run at least medic/basic on every rig.