The IAED™ EMD-Q® Performance Standards state that “the calltaker may not use freelance questions or instructions at any time.” Giving a freelance instruction is considered a moderate deviation. But what happens when a dispatcher gives a freelance instruction that actually enhances the patient’s chance of survival?
“It’s still considered a deviation,” said Adam Johnson, Division Chief, Austin-Travis County EMS, and Regional EMD and EMD-Q Instructor. “You’re talking a very slippery slope here. You can’t have people freelancing instructions.”
South Australia’s arid and semi-arid rangelands and low mountain ranges create a haven for outdoor adventure. Situated in the south-central part of the country, it is the fourth largest of Australia’s six states and two territories.
The Mediterranean climate in the southern part of the state makes for long, hot summers and mild winters that are ideal for year-round fishing, boating, and surfing along South Australia’s 2,361-mile (3,800-kilometer) coastline. The Flinders Ranges, Cleland Wildlife Park where much of the wildlife is free roaming, self-drive Aboriginal Dreaming Trail with stops at sites of ancient cave wall paintings, and the Arkaroola Wilderness Sanctuary are among the sites in the arid interior.
An early but important article in the history of emergency dispatch was hidden in plain sight as a sidebar in the initial concept article “Priority Medical Dispatch—Strengthening the Weak Link” that turned out to be, even today, the most responded to article in the history of JEMS magazine. As far as we know, this was the first public call at addressing the issue of lights-and-siren use and EMVCs via the protocolized prioritization within the dispatch center. The use of lights-and-siren was epidemic at this time and often, if not routinely, the end result was “sending everything, to everyone, always”! This short but powerful paper addressed some specific clinical and time-based parameters that public safety systems should use to evaluate the myriad calls entrusted to them. The game is not over, as emergency vs. non-emergency response mode issues still plague us to this day.
It’s 3 a.m. and eerie silence fills the fire hall. The six-member crew of responders is sleeping in the back, and the occasional snore or grunt comes from the captain’s office across the hall. You are the only dispatcher on the platoon. You are the only one awake at this unearthly hour and possibly for the next five hours to come. Anticipating the next life-or-death situation, you sit there with your imagination running wild or practicing protocols for insane scenarios that you may encounter tonight.
It is too calm tonight … too calm. That is one thing you never want to say out loud because when you do, all havoc will break loose.
In a recent survey investigating repeated stress and its potential impact on a 9-1-1 dispatcher's quality of life, what percentage of the study's participants revealed a rate of acute stress disorder (ASD) significantly greater than the general population