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I have a problem with places that use dispatchers with no medical experience, and train them to use EMD exclusively. Someone that drops a bowling ball on their foot. The dispatcher asks them if they're short of breath. They may be in a lot of pain, so they answer yes, and then it becomes ALS. Meanwhile, we get a lot of elderly falls, with a concurrent c/o dizziness or weakness, and it's BLS.
I miss the FDNY EMT and medics working as dispatchers for the NYC 911 system. The call types were pretty accurate much of the time.
That's the PMD system though. I don't agree with all of it either, but it doesn't leave room for dispatcher interpretation to downgrade calls. Thus, you have "not alert" calls with 102 year old demented patients dispatched as Deltas from nursing homes and a 50 year male who faints dispatched as an Alpha sick person. On the other hand, I've heard Omega calls dispatched with ALS because it's dispatch discretion to add them on.
There has to be some form of priority dispatching to allow tiered response, but I do wish it could be implemented more effectively. Honestly, I don't think the average caller understands the definition of "alert" or "normal breathing" as it's presented by the call takers. Heck, we had a call the other day dispatched as a fever that was actually an unresponsive male with agonal respirations. There's no accounting for what people report on the phone.