Dream Dispatcher

[LucidResq]

Since everyone's favorite pastime is b****ing about dispatch... and I'm a dispatch newb... what does dispatch do that drives you nuts? What do you love? How much information do you want?


Think it's funny to watch the dynamics in dispatch... I saw one old-school disptacher get super-irritated with a calltaker who was adding too many notes, in her opinion, but they were putting in what I would think would be somewhat valuable information... ie: the pt overdosed on beta blockers.... of course the medics are not going to start treating a patient based on dispatch notes without an assessment but it seems to me that the more info you have walking in the better.... like what if an RP told me they've been coughing up blood and having night sweats for several days after returning from travel to Asia... wouldn't you like that information prior to coming up on them? Just thinking about some stuff.

 

[Stephanie.]

Everyone works differently in everything. When in dispatch, my partner and I are like psychedelic towards each other. When I work on other shifts, other dispatchers drive me crazy. Simply because they do things differently. I am usually the type of dispatcher that gives that extra information, and I've worked with some dispatchers here that send out a full arrest with CPR in progress- and never tell the crews that CPR is in progress. I am the youngest and newest one here so I hold back from telling anyone 'how or what to do'.
And sometimes I give crews too much information and I get in trouble from the higher ups.. One time we had a full arrest then a few minutes later after EMD it was down graded to a Priority 3. I told the crew that it was downgraded because patient was cold and stiff in a warm environment, apparently I am not allowed to say that over the radio. There is one ex-police dispatcher that doesn't understand the way that fire and EMS works, but anytime anyone wants to help her she gets mad and says "I know what I am doing I have 6 years experience" I give extra information, but everyone is different.

Are you starting to see how things differ by being in dispatch? It was a big eye opener when I came in off the trucks...

 

[abckidsmom]

Everyone works differently in everything. When in dispatch, my partner and I are like psychedelic towards each other. When I work on other shifts, other dispatchers drive me crazy. Simply because they do things differently. I am usually the type of dispatcher that gives that extra information, and I've worked with some dispatchers here that send out a full arrest with CPR in progress- and never tell the crews that CPR is in progress. I am the youngest and newest one here so I hold back from telling anyone 'how or what to do'.
And sometimes I give crews too much information and I get in trouble from the higher ups.. One time we had a full arrest then a few minutes later after EMD it was down graded to a Priority 3. I told the crew that it was downgraded because patient was cold and stiff in a warm environment, apparently I am not allowed to say that over the radio. There is one ex-police dispatcher that doesn't understand the way that fire and EMS works, but anytime anyone wants to help her she gets mad and says "I know what I am doing I have 6 years experience" I give extra information, but everyone is different.

Are you starting to see how things differ by being in dispatch? It was a big eye opener when I came in off the trucks...

Ah, "cold and stiff in a warm environment." We had to come up with a code word for that phrase too. When we switched to the fire radios, they didn't like hearing it. We called it a priority 3 cardiac arrest after that.

And then fire started being auto-dispatched instead of requested by us (we were a secondary PSAP to the city's fire and PD dispatch), and we had a couple of cardiac arrests where fire got on scene before it was downgraded. They do CPR on anything that used to be alive at some point this month, so we got rid of the P3 response when there was a 21 minute response time on an arrest they were *working!*

No more P3 arrests around here, lol.

 

[medicRob]

Well, where I work we use patient codes so we don't get that much info anyways. However, we have one particular dispatcher that calls EVERYTHING code 66 (Sick Patient), whether it is chest pain, abdominal trauma, etc. That is more of a pet peeve than anything. I can deal with it. Also, don't get so damn pissy when I radio in asking for my run #'s and times. Gee, I am so sorry I didn't take the time to write down the time while I was high-fiving John Doe out of V-fib and trying to find a good IV site over all his track marks, I'll make sure to get my priorities straight next time..

Wow, I think the vein in my forehead popped out.

/Reply

 

[Stephanie.]

Well, where I work we use patient codes so we don't get that much info anyways. However, we have one particular dispatcher that calls EVERYTHING code 66 (Sick Patient), whether it is chest pain, abdominal trauma, etc. That is more of a pet peeve than anything. I can deal with it. Also, don't get so damn pissy when I radio in asking for my run #'s and times. Gee, I am so sorry I didn't take the time to write down the time while I was high-fiving John Doe out of V-fib and trying to find a good IV site over all his track marks, I'll make sure to get my priorities straight next time..

Wow, I think the vein in my forehead popped out.

/Reply

Initially we send all calls out as Priority 2 Medical Emergencies (or MVA). Then about 30-45 seconds we receive additional information from the caller and either bump it up to a priority 1 or down grade it to a priority 3. That is when we give additional ie. fall with hemorrhage or chest pain with SOB. I know guys from every department and all the crews so if there is additional that I think is pertinent that I can't say over the radio- I text them.

 

[medicRob]

Initially we send all calls out as Priority 2 Medical Emergencies (or MVA). Then about 30-45 seconds we receive additional information from the caller and either bump it up to a priority 1 or down grade it to a priority 3. That is when we give additional ie. fall with hemorrhage or chest pain with SOB. I know guys from every department and all the crews so if there is additional that I think is pertinent that I can't say over the radio- I text them.

Texting dispatchers are the best, for real.

 

[medicRob]

[YOUTUBE]http://www.youtube.com/watch?v=T9WiX-Bu5GA[/YOUTUBE]

 

[akflightmedic]

Initially we send all calls out as Priority 2 Medical Emergencies (or MVA). Then about 30-45 seconds we receive additional information from the caller and either bump it up to a priority 1 or down grade it to a priority 3. That is when we give additional ie. fall with hemorrhage or chest pain with SOB. I know guys from every department and all the crews so if there is additional that I think is pertinent that I can't say over the radio- I text them.

Just curious as to what is pertinent or forbidden to say over the radio that leaves you to texting?

This sounds like a smaller department since you have that ability, but again I am extremely curious as to what would qualify for secrecy.

Also, it leads me to wonder if that could ever be a legal problem since you never "officially" advised this pertinent information over the proper channels and you may possibly be violating HIPAA since you are using personal equipment to relay private medical information.

 

[Stephanie.]

Just curious as to what is pertinent or forbidden to say over the radio that leaves you to texting?

This sounds like a smaller department since you have that ability, but again I am extremely curious as to what would qualify for secrecy.

Also, it leads me to wonder if that could ever be a legal problem since you never "officially" advised this pertinent information over the proper channels and you may possibly be violating HIPAA since you are using personal equipment to relay private medical information.

I do not receive any patient information that would violate HIPAA. I don't even receive patient names, therefore I cannot provide any information the crews about this. Mainly it is suicide attempts. We dispatch it out as a psychiatric emergency. We can't say 'Pt is suicidal, thoughts of suicide, or attempted suicide' I can tell them that the scene is not secure and to stage, but when they ask for additional, I can not advise on what they did- such as cutting wrists or banging head into wall. Another thing we cannot say is 'possible'.. we don't have possible heart attacks, or possible back pain. It is what it is. The other day I had an 58 year old female fall from the second story of her home. I dispatch it out as an injured female from a fall greater than 10 feet. I have air on standby. I can't tell them that she has a broken leg. So I sent a text to their chief saying, "Hey, She has a broken leg"

 

[emt seeking first job]

Every organization has it own vibe. The reality is, you can not change it, so if you want to 'fit in', you need to mirror what other people do.

Where I was an LEO, small agency, rural area, they would get a location first, then the dispatcher would send a car to the address, tell them to start moving, and advise more info will be forthcoming.

In NYC 911, the operator (in my mind) tries to get to much information before sending someone, they want address, cross street, number of people, etc etc etc....and the average caller may not be in a state of mind to deal with the litany of questions.

In my NYC vollie, when I dispatch, in the rare case we get a call, I get the bus rolling. NYC vollie's selling point is a quicker respense time. Most of the calls, the crews buff of a scanner, but when we do get a telephone call, we first ask address, I then transmit the address to get the bus there, then ask follow up and transmit again when I get the chief complaint.

It is good for the dispatcher to get info, but it should not, IMHO, delay getting a unit moving to the scene.

Regardless of what the dispatcher is told, responding personnel is going to re-assess what is going on.

 

[emt seeking first job]

Just curious as to what is pertinent or forbidden to say over the radio that leaves you to texting?

This sounds like a smaller department since you have that ability, but again I am extremely curious as to what would qualify for secrecy.

Also, it leads me to wonder if that could ever be a legal problem since you never "officially" advised this pertinent information over the proper channels and you may possibly be violating HIPAA since you are using personal equipment to relay private medical information.

As far as I am aware, getting a name or complaint is not violating HIPA, diseminating the information about the care given to a third party does.

I hear on the scanner all the time, "123 Avenue J, speak to John Smith, complains of difficulty breathing"

 

[akflightmedic]

Yes and as I said...what part of that is not for the radio since that is part of the job? I am more curious as to what info needs to be relayed via text which is "pertinent" enough to report but not through official channels.

And again, if it is important enough for them to be aware, then it needs to be over recorded lines or through proper channels to remove any doubt that the message was relayed and no possible complaint could be made about improper use of personal equipment.

 

[LucidResq]

I do not receive any patient information that would violate HIPAA. I don't even receive patient names, therefore I cannot provide any information the crews about this. Mainly it is suicide attempts. We dispatch it out as a psychiatric emergency. We can't say 'Pt is suicidal, thoughts of suicide, or attempted suicide' I can tell them that the scene is not secure and to stage, but when they ask for additional, I can not advise on what they did- such as cutting wrists or banging head into wall. Another thing we cannot say is 'possible'.. we don't have possible heart attacks, or possible back pain. It is what it is. The other day I had an 58 year old female fall from the second story of her home. I dispatch it out as an injured female from a fall greater than 10 feet. I have air on standby. I can't tell them that she has a broken leg. So I sent a text to their chief saying, "Hey, She has a broken leg"

WOW! That all sucks. We can say all of that. We use possible all of the time.

It is good for the dispatcher to get info, but it should not, IMHO, delay getting a unit moving to the scene.

I totally agree. It is policy to ship a call as soon as you have an address and know it's EMS when calltaking. Unfortunately this means we tone our rigs out on a lot of "unknown medicals" but by the time they're en route and they've moved from the primary dispatch channel to the tac channel the calltaker has almost always added enough notes for the dispatcher to tell them what's going on.

 

[Stephanie.]

Yes and as I said...what part of that is not for the radio since that is part of the job? I am more curious as to what info needs to be relayed via text which is "pertinent" enough to report but not through official channels.

Another thing we have a lot of ranches and larger areas of land. Most residents have gate codes that the FD and crews don't have gate codes into. We have the numbers stored in our CAD but can't advise over the radio. So I shoot the guys on the trucks the 4 digit number so they can have access, instead of them having to public service dispatch.

 

[Stephanie.]

I totally agree. It is policy to ship a call as soon as you have an address and know it's EMS when calltaking. Unfortunately this means we tone our rigs out on a lot of "unknown medicals" but by the time they're en route and they've moved from the primary dispatch channel to the tac channel the calltaker has almost always added enough notes for the dispatcher to tell them what's going on.

I don't know how to quote two separate posts, so I apologize for the double post.

Unknown Medical is a 'no-no'. It's referred to as a 'Medical Emergency'.. We have a whole list of can and can nots when it comes to terminology over the radio.
Guys also like the ones who text so they can say "Hey fax me a copy of our times" or "Great job on that incident, you got us good information fast"

 

[akflightmedic]

I do not receive any patient information that would violate HIPAA. I don't even receive patient names, therefore I cannot provide any information the crews about this. Mainly it is suicide attempts. We dispatch it out as a psychiatric emergency. We can't say 'Pt is suicidal, thoughts of suicide, or attempted suicide' I can tell them that the scene is not secure and to stage, but when they ask for additional, I can not advise on what they did- such as cutting wrists or banging head into wall. Another thing we cannot say is 'possible'.. we don't have possible heart attacks, or possible back pain. It is what it is. The other day I had an 58 year old female fall from the second story of her home. I dispatch it out as an injured female from a fall greater than 10 feet. I have air on standby. I can't tell them that she has a broken leg. So I sent a text to their chief saying, "Hey, She has a broken leg"

Like I said, I am not trying to insult, just trying to understand as everyone has different ways of doing things.

What I do not understand is why you can not say someone has slit their wrists or banged their heads...that is relevant, pertinent information to the call. Why is that info not allowed to be broadcast?

I totally understand not saying possible heart attack as opposed to chest pain. The fall description works as you stated they fell from a height greater than 10 ft and are conscious or unconscious. That is good info...Honestly, I would not need or want more info than that because you telling me a leg is broken is irrelevant. I would worry that some people, this kind of directional info would "tunnel vision" their assessment. And I would question how you know a leg is broken as well. Short of the bone protruding as noted by someone on scene, I have my doubts.

Gate codes make sense...but most systems SHOULD have a tac channel for other information which does not need to be on main broadcast. I just think using personal devices and unofficial channels is poor form and subject to potential legal issues down the road as well.

 

[LucidResq]

Gate codes make sense...but most systems SHOULD have a tac channel for other information which does not need to be on main broadcast. I just think using personal devices and unofficial channels is poor form and subject to potential legal issues down the road as well.

Tac channels are no more private than primary channels. I know when they got a bunch of tac channels here long long ago everyone got giddy and thought that they couldn't be picked up by scanners... which they soon discovered was not the case. Tac channels are good for separating out traffic so you don't have people fighting for air... they are not good for confidential or sensitive transmissions. Sending a message via CAD is usually the best route for this kind of stuff but the firefighters aren't nearly as good at checking those as the cops are.

 

[LucidResq]

Also I can see both ways on the using a personal device.... the thing is, it can sometimes be difficult to relay such information to firefighters via CAD. I'm not surprised that in this day and age field personnel are better at checking their text messages than CAD messages. I also know they often ignore any call notes beyond age, chief complaint and conscious/breathing status.

However, one often overlooked benefit of working in a heavily recorded and archived environment is that it can save your butt. I've been told that when some kind of complaint comes in and they start going through the recordings, more dispatchers have been saved by the records rather than exposed and shown to be in the wrong.

 

[DrParasite]

Since everyone's favorite pastime is b****ing about dispatch... and I'm a dispatch newb... what does dispatch do that drives you nuts? What do you love? How much information do you want?

Speaking as full time dispatcher and part time street person......

Drives me nuts when dispatcher doesn't give me all the information. doesn't give out cross streets, doesn't give apartment or floor numbers in high rises, doesn't have the age/sex of the patient, and doesn't tell me what is going on with the patient. Also, when there is something strange about the call (patient is underground in a constructions site, or the EDP is running around naked swinging from the lamp posts, etc), let me know.

There is a particular dispatch center that dispatches everything as an illness or injury. so a 20 year old who gets shot three times will be dispatched as "a 20 year old injury" and a 20 year old with a stubbed toe will be dispatched as "a 20 year old injury" and that's all they will be told from dispatch.

for any EMS dispatch, I was the following information: "unit assigned, address apt/floor/store name/development name, cross streets age sex brief chief complaint" and any special information that a field person might want to know as a heads up or to make their job easier.

 

[MrBrown]

I like our dispatchers, they're good.

Ambulance calls City 1, City 21, Oscar 5 Auckland; priority one, nine echo