The National Academies of Emergency Dispatch May/June 2010 … · 2016-06-24 · The National Academies of Emergency Dispatch May/June 2010 Tone of voice commands protocol’s delivery

THE JOURNAL | May/June 2010 1

Fire protocol spreads to more than 300 centers

The National Academies of Emergency Dispatch May/June 2010

Tone of voice commandsprotocol’s delivery

CDE:Protocol speedsaid to distressed driver

NAVIGATORThe story starts with you

Of EmErgEncy Dispatch

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2 THE JOURNAL | emergencydispatch.org THE JOURNAL | May/June 2010 3

g columns4 | President’s Message5 | Ask Doc6 | Contributors7 | Dear Reader14 | Service Hotline18 | Guest Writer50 | Retro Space

g industry insider9 | In the News

g departmentsBestPractices

15 | ACE Achievers Polk County goes the distance, plus some.

19 | Frequently Asked Questions Protocol 26 revised to curb over- triage in high call volume centers.

20 | International Beat Malaysia and U.S. share a lot in common when it comes to protocol.

OnTrack

38 | Fire CDE Grain bins pose significant danger to rural worker.

43 | Universal CDE New protocol responds to stuck accelerator hazard.

YourSpace

48 | Dispatch In Action

features22 | Navigator

Climb aboard for a look at Navigator 2010. The conference held in Orlando drew record numbers to an event catering to emergency communicators from around the world.

34 | Fire ProtocolFind out why the Fire Priority Dispatch System™ (FPDS™), released nearly a decade ago, continues to gain ground, with now more than 300 centers relying on the 25 scripted protocols.

The following U.S. patents may apply to portions of the MPDS depicted in this book: 5,857,966; 5,989,187; 6,004,266; 6,010,451; 6,053,864; 6,076,065; 6,078,894; 6,106,459; 6,607,481; 7,428,301. FPDS and PPDS patents pending. Protocol-related terminology in this text is additionally copyrighted within each of the NAED’s discipline-specific protocols. Original MPDS, FPDS, and PPDS copyrights established in September 1979, August 2000, and August 2001, respectively. Subsequent editions and supporting material copyrighted as issued.

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Ask the right questions. Get the right answers. Send the right information.

OnCover Francis Jimenez-lucero and lydia Kennedy. Photo by Dave Brinton


Guest Appeal. Disney is master of the magic

g President’sMessage

Scott Freitag, NAED President

Uncertain Behavior. Patient’s level of consciousness can determine state of mind

g asKdoc

Jeff Clawson, M.D.

Mr. Freitag or maybe even the name “Scott” would not be the way any cast member (employee) at Walt Disney World would address me if I happened to work at the vacation kingdom. everyone—ride operators to, I presume, top brass—lacks a surname, at least on their badges. Cast members with the same given name within a department change their moniker. Since the given name Scott is not incredibly unique, I might be reporting to work as a “Duncan,” “Miles,” or “virgil.”

I should have assumed as much considering the names of the more famous cast members: Mickey, Minnie, Pluto, Donald, Goofy, and each of the seven dwarfs, to name only a few. neither “Mouse” nor “Duck” count. Walt Disney wanted it this way. a first name basis is more personal; it is a mark of a closer friendship. “The only Mr. Disney I know is my father,” he would say in explanation of the policy. “My name is Walt.”

Mark “Cory” Matheis said the use of first names, rather than last names, clarifies the relationship cast members try to establish with guests (those visiting the parks and resorts). Matheis, who adopted the name “Cory” when he started 20 years ago in Walt Disney’s reservation center, said the informal approach reduces pretension. Treating everyone equally is mandatory, no matter the position held at the park or in society. He knew that much the first day of orientation along with the requirement of keeping a smile on his face. “you can’t sound happy without one,” he said.

Matheis said a friendly environment is the business behind the magic of Disney. People are hired to the role of cast member based on attitude. Their job is to keep people happy. Jerks need not apply. no matter the job or the time spent with the guest, each of the 60 or 70 cast members a guest encounters each day is responsible for creating an experience that preferably exceeds expectations. Grumpy may be an

exception for a Snow White production, but even the disposition right for the dwarf might be regarded as reasons for termination if displayed outside of character.

even slips made for what might seem o b v i o u s r e a s o n s c o u n t a g a i n s t

a c a s t member. For example, a guest reporting that “Richard” rolled his eyes when asked the time the 3 o’clock parade starts could find Richard collecting his final paycheck the next day. The answer may seem apparent, Matheis said, but that’s not the point. Put aside the sarcasm and in the case of this question—the third most frequently asked at Disney World—cast members are trained to reply in relation to the guest’s plans after the parade. If Splash Mountain is a priority, the parade may start at 3:30 p.m. in relation to the attraction’s proximity to the parade.

Disney also works hard to alleviate negative perceptions. Waiting in long lines holding tight to the hands of restless children on a humid and hot Florida afternoon could be far worse without the coolers Disney installs at each attraction. Did a guest leave a camera or sunglasses back in the hotel room or did the promise of returning with a Disney snow globe for aunt louise and uncle Bob dawn on someone when merely steps away from leaving the Magic Kingdom?

no problem.

Disney is so in tune to its guests that the entrance and exit at Main Street uSa are designed in anticipation of human nature on vacation. Since people generally walk to the right, items in shops at the entrance focus on sunglasses, disposable cameras, and water bottles. last-minute souvenirs are available for purchase on the opposite side, the right side for people leaving the park.

Forget where you parked the car in the Disney World lot that holds

12,000 vehicles? Disney has that figured out, too. Guests are directed to spaces and parking lot cast members write down the time a line

of spaces fills. your car can be found quickly as long as you remember the

time of arrival.Cast members work within guidelines to

keep guests safe—the no. 1 priority—while also remaining courteous and efficient. Say an adult guest lifts his child onto a recycling container to watch the 3 o’clock parade. That’s dangerous. Bins aren’t built to withstand weight on top. The cast member will politely ask the parent to move the child. If the guest hesitates, the cast member persists. Guest safety is nonnegotiable.

The secret is delivering what people want before they know they need it, Matheis said, and it’s a philosophy that extends beyond amusement parks and resorts, of course.

Walt understood his audience; he wanted to give them all they anticipated plus some to create a magical experience for the millions of guests that cast members greet each day. In our world of emergency communications, we do much the same. We look for quality people to guide the experience of callers, mindful that safety is the priority, and we monitor our affect using measurable guidelines. like Disney, we continue to improve our processes through review and modification. We exceed expectations the public never even knew existed. g

Dr. Clawson:a question arose recently regarding the

dispatch of alS on 25-D-1 calls (MPDS® Protocol 25: Psychiatric/abnormal Behav-ior/Suicide attempt).

Generally, we send out psychiatric calls as a lower priority BlS-only response unless there is a specific life-threatening condition indicated, at which time we send it out under “Injury—life Threatening.”

I would ask that you provide the acad-emy rationale for DelTa level responses to psychiatric emergency calls.

In the two cases that were questioned a tape review revealed that the callers clearly described the situation as psychiatric in nature; the criteria used by the calltaker to answer yes to the “Is he completely alert?” question were “confused” and “he’s out of his head right now,” respectively.

It would be a great help if you would

d e f i n e t h e t e r m “completely alert” and clarify whether or

not the two examples would fit that defi-nition or whether you believe the calltaker should have considered the answer yes.

additionally, the term “responding appropriately” needs clarification. For example, a psychiatric patient who is yell-ing and throwing things is clearly not “acting appropriately,” but that person may know who and where she or he is and therefore would be “responding appropriately.” In essence, I need a clear and succinct clarifi-cation of what is and what is not considered “responding appropriately.”

your reply is appreciated as these calls often potentially have an increased likeli-hood of involving personnel and public safety risks.

John R. BrophyCommunications Center Manageremergency Medical Services DepartmentJersey City Medical CenterJersey City, n.J.

John:I’ve asked Ken Hotaling and Brett Patterson

to chime in on a response. My reply follows theirs, and I’ve also included a quiz. Take a shot (note: the answers can be found on page 40).

Doc

John:We are trying to identify patients who

have a decreased level of consciousness when we ask the question “Is he completely alert?” The calltaker is looking for a good answer to the question and it can be very difficult for the calltaker to differentiate between a psychotic break and an altered level of consciousness (confused or out of his head) based on the variety of caller explanations possible. It is also difficult to put in writing a simple way to address the other nonverbal cues that might help the calltaker answer the question.

I f th is i s a cont inuous i ssue and, following several months of high compliance to protocol, the DSC/DRC/Medical Director can evaluate the response decision for 25-D-1.

let me know if there is anything else we can assist you with.

Ken HotalingTraining ConsultantPriority Dispatch

John:Ken has given an excellent explanation. While

it is possible to more clearly define what we are looking for when we ask “Is s/he completely awake?” it is more difficult to precisely define every caller’s answer to the question.

We are looking for level of consciousness changes, which indicate poor cerebral perfusion. While the psych or stroke patient may be completely alert while rambling on in an obvious state of confusion, the normally coherent head injury patient who is confused is likely not alert.

after much debate, and a series of eMD surveys, the academy’s Council of Standards has settled on the term “completely alert”

VIRGILSALT LAKE CITY, UT

MPDS® v12, NAE-std. © 1979–2010 PDC.


The National Journal of Emergency Dispatch is the official bimonthly publication of the National Academies of Emer-gency Dispatch (NAED), a non-profit, standard-setting organization promoting safe and effective emergency dispatch services worldwide. Comprised of three allied academies for medical, fire, and police dispatching, the NAED supports first-responder-related research, unified protocol application, legislation for emergency call-center regulation, and strength-ening the emergency dispatch community through education, certification, and accreditation.

General NAED membership, which includes a Journal subscription, is available for $19 annually, $35 for two years, or $49 for three years. Non-member subscriptions are available for $25 annually. By meeting certain requirements, certi-fied membership is provided for qualified individual applicants. Accredited Center of Excellence status is also available to dispatch agencies that comply with Academy standards. © 2010 NAED. All rights reserved.

g dearreader TheJournal Of EmErgEncy Dispatch

naTional academies of emergency dispaTch139 East South Temple, Suite 200 Salt Lake City, UT 84111 USA USA/Canada toll-free (800) 960-6236 Int’l/Local: (801) 359-6916 Fax: (801) 359-0996 www.emergencydispatch.org [email protected]

inTernaTional academies of emergency dispaTchAUSTRALASIA OFFICE011-61-3-9806-1772

GERMAN OFFICE011-43-5337-66248

ITALIAN OFFICE011-39-011-513-2588

CANADA OFFICE1-514-910-1301

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Boards & councilsACCREDITATION BOARD ChAIRBrian Dale

ALLIANCE BOARD ChAIRKeith Griffiths

CERTIFICATION BOARD ChAIRJeff Clawson, MD

CURRICULUM COUNCIL ChAIRSVicki Maguire (Medical/EMD Board) Mike Thompson (Fire/EFD Board) Bill Kinch (Police/EPD Board) Susi Marsan (ETC)

RESEARCh COUNCIL ChAIRSBrett A. Patterson, Medical/EMD Mike Thompson, Fire/EFD

STANDARDS COUNCIL ChAIRSMarie Leroux, Vicki Maguire (Medical/EMD) Gary Galasso (Fire/EFD) Eric Parry, Jaci Fox (Police/EPD)

college of fellowsChAIRMarc Gay

AUSTRALASIA/SOUTh AMERICAFrank Archer, MD (Australia) Andrew K. Bacon, MD (Australia) Peter Lockie (New Zealand) Silvio Najt, MD (Argentina) Peter Pilon (Australia)

CANADADrew Burgwin (Br. Columbia) Nicole Cimon, MD (Québec) Claude Desrosiers (Québec) Marty Friedberg, MD (Ontario) Marie Leroux, RN (Québec) Paul Morck (Alberta) Wayne Smith, MD (Québec)

EUROPEAndre Baumann (Germany) Jan de Nooij, MD (Netherlands) Gianluca Ghiselli, MD (Italy) Jean-marc Labourey, MD (France) Gwyn Pritchard (Cyprus) (Emeritus) Bernhard Segall, MD (Austria) Gernot Vergeiner (Austria) Christine Wägli (Switzerland)

UNITED KINGDOM/IRELANDTrevor Baldwin (England) Michael Delaney (Ireland) Louise Ganley (England) Conrad Fivaz, MD (England) Chris hartley-Sharpe (England) Andy heward (England) James Gummett (England) Stuart Ide (England) Peter Keating (Ireland) Ray Lunt (England) Andy Newton (England) (Emeritus) John D. Scott, MD (England) Janette K. Turner (England)

UNITED STATESBill Auchterlonie (KS) Robert Bass, MD (MD) Christopher W. Bradford (FL)

naed Journal sTaffCOMMUNICATIONS/CREATIVE DIRECTORKris Christensen Berg

MANAGING EDITORAudrey Fraizer

TEChNICAL EDITORBrett A. Patterson

ASSISTANT EDITORSheather Darata Cynthia harmon Benjamin h. Rose

GRAPhIC DESIGNERSJess Cook Mishael Ulibarri Lee Workman

WEB DESIGNERSErwin Bernales Jason Faga

academy sTaffPRESIDENTScott Freitag

ASSOCIATE DIRECTORS-USACarlynn Page Dave Massengale

ASSOCIATE DIRECTOR-U.K.Beverley Logan

ASSOCIATE DIRECTOR-AUSTRALASIAPeter hamilton

ACADEMICS & STANDARDS ASSOCIATEBrett A. Patterson

DIRECTOR OF CURRICULUM DESIGNERLarry E. Latimer, M. Ed.

INTERNATIONAL LIAISONTudy Benson

MEMBERShIP SERVICES MANAGERArabella VanBeuge

Thera Bradshaw (CA) (Emeritus) Geoff Cady (CA) Steven M. Carlo (NY) Jeff Clawson, MD (UT) Phil Coco (CT) Brian Dale (UT) Chip Darius, MA (CT) Kate Dernocoeur (MI) Norm Dinerman, MD (ME) Patricia J. Dukes, MICT (hI) James V. Dunford, MD (CA) Marc Eckstein, MD (CA) John Flores (CA) Scott Freitag (UT) Gary Galasso (CA) Keith Griffiths (CA) Jeffrey R. Grunow, MSN (UT) Darren Judd (UT) Alexander Kuehl, MD, MPh (NY) (Emeritus) James Lake (SC) James Lanier (FL) Bill Leonard (AZ) Stephen L’heureux (Nh) Victoria A. Maguire (MI) Sheila Malone (IN) Susi Marsan (GA) Robert L. Martin (DC) Dave Massengale (CA) Jim Meeks, PA-C (UT) Shawna Mistretta (CO) Gene Moffitt (UT) Jerry L. Overton (CA) Eric Parry, ENP (TX) Rick W. Patrick (PA) Brett A. Patterson (FL) Paul E. Pepe, MD, MPh (TX) Ross Rutschman (OR) (Emeritus) Joe Ryan, MD (NV) Doug Smith-Lee (WA) Tom Somers (CA) Paul Stiegler, MD (WI) Michael Thompson (SD) Carl C. Van Cott (NC) Sheila Q. Wheeler, MSN (CA) Craig Whittington (NC) Arthur h. Yancey, II, MD, MPh (GA) Tina Young (CO)

a w e e k h a s f l o w n b y since the closing luncheon of navigator and—to be quite honest—I now look forward to planting my garden this coming weekend. This year’s scheme features just about the same variety compared to previous seasons but with the addition of brussels sprouts. This will be my first attempt at growing them. I generally add something new each year without encroaching on the space necessary for favorites like bell peppers, butternut squash, spaghetti squash, and cherry tomatoes. I like that. Keeps things interesting.

It is with this thought—gardening—that I reminisce over the hectic days spent at navigator digging through the hallways, classrooms, and exhibitor space for stories subsequently published in The Journal of Emergency Dispatch and posted on the national academies of emergency Dispatch® (naeD™) website. Don’t get me wrong. naviga-tor is abundantly above any simple garden-style gathering. But like my garden, assistant editor Heather Darata and I look for something new to include each year in our cov-erage without taking attention away from anticipated confer-ence highlights such as the Dispatcher of the year award and the Dr. Jeff Clawson lead-ership award.

This year’s addition was a handheld video and digital voice recorder (Flip video™) that will allow us to stream

interviews taken at navigator on the website. This wasn’t my first choice for variety since I’m more of a print person and at this stage and age, I’m finding myself forced kicking and screaming into a digital world. I ’ve never relied on tape recorders when inter-viewing and the few times I have, I discovered the best conversations begin when the recorder is turned off. Words are less likely to come back to bite you.

The handheld was great at providing introduction. The interviews were short and sweet. The people graciously accepting my offer to go live answered a few basic questions and will become the faces of navigator when their sound bites are posted on the web-site in the coming weeks. not to be outdone by the video and digital recording device, however, I also seized the opportunity to make the most of people’s generosity. I asked questions beyond the intended focus of discussion once pow-ering down the handheld. We engaged in conversations about their communications centers, dispatch experiences, and per-sonal interests. By turning off the recorder, we could talk beyond the meet and greet.

The stories people te l l me contribute to navigator’s appeal. like my garden, navi-gator provides an opportunity to try the new while savoring the reliable. For me, blend-ing the two definitely keeps things interesting. g

Audrey Fraizer, Managing Editor

Keep Growing. navigator sows the seeds

CON

TrIBUTO

rS

DAVE WOODS

Dave Woods, EMD, is a deployment supervisor for Alberta Health Ser-vices EMS in the South Communi-cation Center, Canada. He teaches EMS, EMD-Q, and mentors instruc-tors new to the EMD course. He is a graduate of the Communication Cen-ter Manager Course. His experience includes dispatch consulting and he is an advocate for strong quality improvement models. In his spare time, he can be found outdoors, with a camera always close by his side.

GUEST WRITER, PAGE 18

Jim AnD ShArOn LAniEr

Jim Lanier, ENP, is the division man-ager for the Manatee County Emer-gency Communications Center in Florida. He has been involved with public safety since 1984. Jim is an EMD, EFD, ED-Q instructor, NAED College of Fellows member, has served on various NAED boards, and is a regular contributor and board member of The Journal.

Sharon Lanier, RN, a.k.a. “The Con-flict Queen” is the ombudsman for a large acute care hospital in Ocala, Fla. Sharon has a graduate degree in counseling in addition to mul-tiple professional certifications and accolades for her work in the area of dispute resolution and conflict management.

SERVICE HOTLINE, PAGE 14

BrETT PATTErSOn

Brett Patterson is an Academics & Standards associate and Research Council chair for the NAED. His role primarily involves training, cur-riculum, protocol standards, quality improvement, and research. He is a senior EMD instructor and a mem-ber of the NAED College of Fellows, Standards Council, and Rules Com-mittee. Brett became a paramedic in 1981 and began a career in EMS communications in 1987. Prior to accepting a position with the NAED, he spent 10 years working in a public utility model EMS system in Pinellas County, Fla.

FAQ, PAGE 19

to best identify a state of altered level of consciousness indicative of poor perfusion. admittedly, this will lead to some over-triage, as lay callers will not always understand exactly what we are looking for. However, with a little eMD education and caution, we hope to err on the side of caution and do the best we can in the non-visual environment.

I’m sorry I’m not to be able to offer anything more definitive. The best solution at present is good education for the eMD regarding the clinical differences between poor perfusion and confusion.

Brett a. Pattersonacademics & Standards associateResearch Council Chair, naeD

John:I completely agree with their answers.May I also add the following: The ability to

judge which patients are truly “alert” or “not alert” is difficult and certainly not a precise science, even in the presence of trained nurses

and physicians physically evaluating these same patients. our rule: the doubt always goes to the patient while in the pre-arrival dispatch environment—until proven otherwise by in person evaluations and testing.

Please consider the following patient examples, then quickly (and non-visually) judge whether they are truly “ just psychotic” normally or are experiencing a current medical emergency rendering their behavior and alertness “inappropriate”—all of which I have personally witnessed and was initially not sure myself:

1. Combative patient, fighting off every-one, wild-eyed, and strong as an ox

2. DuI pullover at 10 a.m., driver some-what incoherent, and slurring speech

3. Shouting patient, throwing things, and stating that the devil was approaching

4. Sleepy patient, saying only yes and

no answers, pushing us away, and rolling over in bed

5. Patient reported as being crazy again, not obeying commands, and wander-ing oddly around a neighbor’s house

6. Strangely obnoxious drunk drifter, not making a lot of sense, but stating he was seeing angels and to let him enjoy them

7. Patient howling, spitting, scratch-ing, and demanding to be released

8. Patient staring forward at no one with vacant eyes, only occasion-ally perceiving and then answering questions “yes” and “no”

Take the test: Which of the above are normally psychotic (“nuts”) and which have an underlying medical problem? If the latter, what is the problem or condition? (See answers to the quiz on page 40.)

Keep up the great work in Jersey City... Doc g


Winter Olympics puts extra zing into BCAS schedule

Seventeen days in February and 10 more in March were extra busy for the British Columbia ambulance Service (BCaS). not only did the BCaS dispatch emergency medical response to more than 4.3 million residents in the province but it also scaled the CaD system for response to hundreds of additional calls for service.

That’s to say nothing about the seven years it took to get ready for the 2010 Win-ter olympics held in vancouver, British Columbia, Canada.

Preparation for the international event

stretches back to July 2, 2003, when van-couver was chosen for the site of the 2010 winter games. The years leading up to the olympics included designing a system and process, participating in multi-agency response scenario exercises, and planning emergency coverage despite an eight-month strike of paramedics and dispatch staff that lasted up until two months before the games were set to begin.

Gordon Kirk, dispatch superintendent for the BCaS lower Mainland Region ambulance Communication Centre, was in charge of dispatch operations from inside the center for the olympics. While he and his staff thoroughly enjoyed the games and

the excitement they brought to the prov-ince, their rooting for the home team took place far from the ski runs and hockey sta-dium. Kirk spent an average of 80-90 hours

IndustryInsider

The national academies of emergency Dispatch® (naeD™) has released version 12.1 of the Medical Priority Dispatch Sys-tem™ (MPDS®).

The release approved by the naeD’s Medical Council of Standards presents a significant revision to the world’s most-trusted and widely used emergency medi-cal dispatch protocol. among the changes, version 12.1 introduces the Stroke Diag-

nostic Tool and Pro-tocol 37: Interfacility evaluation/Transfer.

The Stroke Diag-nostic Tool, triggered during the Key Ques-tions on Protocol 28: Stroke (Cva), enables more accurate evalu-ation and identifica-tion of acute stroke p a t i e n t s . T w e l v e Determinant Suffixes added to Protocol 28 reflect the tool’s rec-ommendation and aid

in pinpointing specific symptoms most pre-dictive of stroke.

Medical Council of Standards Co-Chair Marie leroux said the Stroke Diagnostic Tool represents a significant life-saving prehospital tool for accurately identifying a stroke, and it is an essential tool when distinguishing patients suitable for immediate response.

“The trick to helping these patients is identifying possible signs of a stroke within

a very small window (of time) from onset,” leroux said. “The eMD is a critical first link in the chain of recovery.”

The addition of Protocol 37 corresponds to requests for an interfacility transfer spe-cific to medically trained callers. The new protocol—already proven successful in Beta testing—is an alternative to Protocol 33 and allows dispatchers to minimize Key Questions regarding patient evaluation. Protocol 37 is available in the 12.1 version of ProQa® software only.

naeD academics & Standards associate and Research Council Chair Brett Patterson said Protocol 37 represents the consensus of an expert sub-council that considered feed-back obtained through an academy survey answered by MPDS users internationally.

“The issue boiled down to two primary objectives,” Patterson said. “It was a matter of separating the routine transfer from the evaluation and providing more response options for the trained eMD and health care professional to consider. Protocol 37 does this, and more.”

other revisions in version 12.1 include upgrading the aspirin Diagnostic and Instructions Tool, enhanced responder safety information, and earlier dispatch in certain circumstances.

TimELy ADViCE

Academy releases version 12.1 of MPDS

Medical Priority Dispatch System®

© 1979–2010 Priority Dispatch Corp. 139 E. South Temple, Suite 500, Salt Lake City, Utah 84111United States of America

tgN

RSv EMDPROTOCOL

This protocol system for use under MPDS® license agreement only. U.S. Patents 5,857,966; 5,989,187; 6,004,266; 6,010,451; 6,053,864; 6,076,065; 6,106,459; 6,607,481; 7,428,301. © 2010 Priority Dispatch Corp. All rights reserved.

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— Tom Ling, Johnson County Central Dispatch

Two weeks thatwill change your life

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Online applications for the 2010 course to be held in Kansas City, MO will begin January 5, 2010. Go to www.emergencydispatch.org or call Sharon Conroy at (816) 431-2600 for more course curriculum and registration information.

NENA has approved this course as credit toward recertification for the Emergency Number Professional designation.

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MPDS® v12.1, NAE-std. © 1979–2010 PDC.


per week on the floor of the communica-tions center during both the 17-day olym-pics and the 10-day Paralympics.

“We did have some time to watch the games from our big screen Tv,” he said.

The center depended on automation and a multi-agency and multi-jurisdictional interoperability for incident response at olympic venues in greater vancouver and surrounding communities. Calls relating to athletes ranged in severity from the tragic death of 21-year-old Georgian luge com-petitor nodar Kumaritashvili—who was killed in a training crash at the Whistler Sliding Centre—to broken bones, sprains, and severe bruising from skiing downhill at speeds reaching 85 mph. Calls from spec-tators were little different from the norm, although hazards from the cold did increase the number of calls relating to falls and reports of hypothermia.

The games ended with Kirk looking for-ward to a little downtime before jumping back into the frenzy satisfied with a com-munications plan that had worked.

“The games were fabulous but a lot of work,” he said. “after a few days off, it’s on to a new CaD system.”

BCaS responds to calls for service across six health authorities. The ambulance ser-vice operates 187 stations, 480 ambulances, 47 support vehicles, and nine dedicated ambulance aircraft. The provincial call vol-ume is about 530,000 calls annually.

Centers receive prestigious national industry awards

Several public safety and 9-1-1 groups honored the District of Columbia’s office of unified Communications (ouC) and the director of the Black Hawk County

(Iowa) communications during the annual “9-1-1 Goes to Washington” conference held in March.

The ouC was recognized for its perfor-mance in handling the January 2009 inaugu-ration of President Barack obama. Black Hawk County communications center Director Judy Flores received the Government leader award, primarily for the communications center’s abil-ity to receive 9-1-1 text messaging.

an estimated 1.8 million people visited Washington to witness obama’s inaugura-tion, resulting in a 50% increase in 9-1-1 calls compared to an average day, or totaling about 6,000 calls for assistance. Despite the increase, 96% of 9-1-1 calls were answered within five seconds, while calls to the 311 non-emergency number were answered within 30 seconds. at the peak, more than 300 ouC personnel, including calltakers and IT professionals, were on-duty.

The ouC was formed in 2004 from the merger of separate police, fire, and eMS communications centers, and uses the Medical, Police, and Fire Priority Dispatch Systems™ (MPDS®, PPDS™, FPDS™).

The Black Hawk County communi-cations center is the first text-messaging compatible communications center in the country. It successfully received a text mes-sage sent on June 9, 2009, from Fort Worth, Texas, where the national emergency number association (nena) conference was taking place.

The process began about three years ago when it was time to replace the aging phone system with a system adaptable to techno-logical advances. The system selected quali-fied the center for a text-messaging project sponsored by Intrado, a telecommunica-tions vendor. Currently, only iWireless users can access the 9-1-1 texting services, but other carriers may soon join.

Black Hawk County communications

center uses the MPDS.The Government leader award is

among several awards presented in rec-ognition of 9-1-1 services at an annual event sponsored by the e911 Institute, the national emergency number association, the association of Public Safety Commu-nications officials (aPCo), the national association of State 911 administrators, and the 911 Industry alliance.

9-1-1 center takes major step toward full consolidation

The following is from the Charleston Con-solidated 9-1-1 Center

Charleston County Consolidated 9-1-1 Center took another major step toward full consolidation. after extensive cross training of former sheriff’s office and emergency Med-ical Services (eMS) dispatchers and additional technology changes, a pool of calltakers began receiving police, fire, and medical calls.

“This change puts the Consolidated 9-1-1 Center one step closer to being a truly consolidated center,” said Charleston County 9-1-1 Center Director Jim lake. “It also allows for more efficient use of person-nel and allows them to focus on their pri-mary areas of responsibility.”

Prior to the change, calls for the sher-iff’s office would go to one set of dispatch-ers and calls for eMS and fire would go to another. These dispatchers often juggled gathering information from the caller while providing that information over the radio to responders.

now, a pool calltaker receives a call, determines if it is a police, fire, or medical

event (or any combination of the three), and asks questions using ProQa®. While the calltaker gathers information, a com-puter-generated incident report is sent to a dispatcher assigned to talk via radio to police, fire, or medical responders.

This efficiency allows the calltaker to remain on the line with the caller to gather more information and to provide additional scene safety and/or medical instructions while dispatchers send responders.

Previously, a sheriff’s office dispatcher would receive a 9-1-1 call for medical ser-vices and then have to transfer that call to an eMS dispatcher sitting across the room.

The Charleston County Consoli-dated 9-1-1 Center currently dispatches for: Charleston County Sheriff’s office, Charleston County emergency Medical Services, Charleston County volunteer Rescue Squad, awendaw Fire Department, Dewees Island Fire Department, lincoln-ville Police & Fire Departments, and St. Paul’s Fire Department.

The 9-1-1 center is expected to be completely consolidated by 2012, and the following agencies will transition into the center over the next three years: Charleston Police & Fire Departments, Folly Beach Pub-lic Safety, Isle of Palms Police & Fire Depart-ments, James Island PSD Fire Department, Mount Pleasant Police & Fire Departments, north Charleston Police & Fire Depart-ments, Saint andrews Fire Department, St. Johns Fire Department, and Sullivan’s Island Police & Fire Departments.

Calls requiring MPDS Protocol 9 may be male dominated

For all categories of major cardiovascu-lar disease deaths, males have a higher age-adjusted death rate than females, according to a study based on 2007 data by research-ers from the national Center for Health Statistics (nCHS). The death rate for males affected by major cardiovascular diseases is 42% higher than the rate for females (297.7 compared with 209.9 deaths per 100,000 standard population). The death rate from heart diseases is 54% higher for males than for females (237.0 compared with 154.3 deaths per 100,000 standard population). The death rate for coronary heart disease is 69% higher for males than for females (174.5 compared with 103.4 deaths per

100,000 standard population). Differences in the rates of death for males compared with females are smaller for essential hyper-tension and hypertensive renal disease and for cerebrovascular diseases. In the Medical Priority Dispatch System™ (MPDS®), these occurrences are covered under Protocol 9: Cardiac or Respiratory arrest/Death.

Source: Miniño aM, Klein RJ. “Health mortality from major cardiovascular dis-eases: united States, 2007.” Health e-Stats. united States Department of Health and Human Services, Centers for Disease Con-trol and Prevention, and national Center for Health Statistics. 2010; March. http://www.cdc.gov/nchs/data/hestat/car-dio2007/cardio2007.pdf

Bystander CPr benefits outweigh risks of accidental injury

Benefits of dispatcher-assisted CPR outweigh the risks of accidentally injur-ing someone who might not need but did receive the life-saving measure when car-diac arrest was suspected, according to a study published in the January 5 issue of the american Heart association’s journal Circulation.

lindsay White, research assistant in the Medical QI section of Seattle-King County (Wash.), and colleagues analyzed adult patients not in cardiac arrest but for whom dispatchers gave CPR instructions in King County from June 1, 2004, to Jan. 31, 2007. using dispatch reports, eMS reports, hospi-tal records, and a phone survey, their results confirmed a low frequency of serious injury from dispatcher-aided bystander CPR among non-arrest patients.

White and her colleagues focused on the risks associated with performing CPR on subjects who were not in cardiac arrest because the benefits of CPR to patients who are in arrest are well established. The study focused on bystander CPR progressing to chest compressions since it is during the compression phase of resuscitation that most injuries occur.

among 1,700 patients, 938 (55%) were in cardiac arrest, and 313 of the total (18%) were not in arrest but received chest com-pressions. For the 247 of these patients not in arrest who received chest compressions and for whom complete outcomes were ascertained, 29 (12%) experienced discom-fort and six (2%) sustained injuries prob-ably or possibly caused by the CPR. only 5 of the 247 patients suffered a fracture, and no patient suffered a visceral organ injury, according to the authors, who are affiliated with both the Public Health Seattle-King County’s emergency Medical Services Division and the university of Washington Department of Medicine in Seattle.

Results of the study are part of the ongoing randomized Dispatcher-assisted Resuscitation Trial (DaRT), comparing dispatcher-assisted CPR with chest com-pressions alone and dispatcher-assisted CPR with chest compressions plus ventila-tions for out-of-hospital cardiac arrest.

a case is eligible for DaRT if the emer-gency dispatcher determines that a patient is unconscious and not breathing normally and that bystander CPR is not yet ongoing. If the case is eligible, the dispatcher opens an envelope that randomly assigns the case to CPR with chest compressions alone or chest compressions plus ventilations.

E Suspected Workable Arrest (NOT BREATHING/INEFFECTIVE BREATHING):1 Not breathing at all 9-E-12 Breathing uncertain (AGONAL) 9-E-23 Hanging 9-E-34 Strangulation 9-E-45 Suffocation 9-E-56 Underwater 9-E-6

For use under MPDS® license agreement only. © 2008 Priority Dispatch Corp. All rights reserved. AMPDS® v12, NAE-std, 080625

9 CARDIAC OR RESPIRATORY ARREST / DEATH

KEY QUESTIONS g1. (Appropriate j 1) Is there a defibrillator (AED) available?2. (Suspected death) Tell me please, why does it look like

s/he’s dead?a. (OBVIOUS DEATH) Do you think s/he is beyond any

help (resuscitation/CPR)? ?Uncertain –––––––––––––––––––––de 9-D-2

b. (EXPECTED DEATH) Are you certain we should not try to resuscitate her/him? ?

Uncertain –––––––––––––––––––––de 9-D-2

J POST-DISPATCH INSTRUCTIONS B H E F ?j

a. (Suspected Workable Arrest) I’m sending the paramedics(ambulance) to help you now.Stay on the line and I’ll tell you exactly what to do next.

b. (OBVIOUS or EXPECTED DEATH) I’m sending someone to assist you. Is there anything else we can do?

� (OBVIOUS or EXPECTED DEATH) Notify proper authorities.

DLS � Link to R ABC-1 unless: gDanger or Contamination –––––––––––––––––––S X-7Suspected Workable Arrest –––––––––––––––––U ABC-1AED available (age j 1) –––––––––––––––––––––\ Z-1Choked first (Unconscious) –––––––––––––––––––U ABC-1

LEVELS # DETERMINANT DESCRIPTORS 4 SEE ADDITIONAL INFO CODES RESPONSES MODES

D 1 INEFFECTIVE BREATHING (discovered during Key Questioning only) 9-D-1� (select only when linking from other Chief Complaint Protocols)

2 OBVIOUS or EXPECTED DEATH questionable 9-D-2

B 1 OBVIOUS DEATH unquestionable (a through i) 9-B-1

c1 EXPECTED DEATH unquestionable (x through z) 9-c-1

9

� (to be selected from Case Entry only)

MPDS® v12, NAE-std. © 1979–2010 PDC.


Based on December 2009 weather con-ditions and their affect on weather patterns six months down the road, meteorologists from Colorado State university’s Tropical Meteorology Project predict 11-16 named storms will develop, with 6-8 of them becoming hurricanes and 3-5 of those becoming major hurricanes with winds of 111 mph or greater.

In an average year, the atlantic has 10 tropical storms and six hurricanes. The hurricane season runs from June 1 through nov. 30.

There were only two hurricanes and eight tropical storms during the 2009 hur-ricane season, the smallest number since 1997. neither of the hurricanes (wind speeds above 73 mph) and only one tropi-cal storm, Claudette, (wind speeds 39–73 mph) came ashore in the united States.

The Tropical Meteorology Project is a collaborative effort between Colorado State university’s William Gray and Phil Klot-back. They provide forecasts six months prior to when the season actually begins because of the public’s “curiosity in know-ing what the odds are for an active or inac-tive season next year,” according to their statement in the prelude to the forecast issued in late 2009. The seasonal forecasts are based on statistical schemes that will fail in some years, and they do not specifi-cally predict where these storms will strike within the atlantic basin.

Their other early season forecasts for the 2010 season ahead include:

• A64%chanceofatleastonemajorhurricane making landfall on the u.S. coastline during 2010. The long-term average probability is 52%.

• A40%probabilityofamajorhurri-cane making landfall along the u.S. east Coast, including the Florida Peninsula, and along the Gulf Coast from the Florida Panhandle west to Brownsville, Texas. The long-term average for both areas is about 30%.

• A53%chanceofamajorhurricanemaking landfall in the Caribbean. The average probability in that area during the last century is 42%.

Tennessee to go NG-911 digital

The Tennessee emergency Communi-cations Board (TeCB) is spending $25 mil-lion to make sure its 9-1-1 centers meet the next Generation 911 (nG-911) standards.

The future, of course, is the digital age of communication. emergency call centers will be able to exchange and distribute text messages, stream videos of hold-ups at con-venience stores, and transfer those images to police squad cars. When a tanker truck flips over on the highway, a passerby can take a photo using a cell phone and transfer an image of the truck’s hazardous materials symbol to 9-1-1.

Project funds for Tennessee’s move into the future are possible through the cell phone tariffs TeCB collects and distrib-utes to e-911 centers in the form of grants adjusted according to population formu-las. The $25 million, distributed through a reimbursement program, will give each of the state’s 100 emergency communica-tions districts $120,000, plus an additional amount based on the population the center

serves. TeCB plans to have the system in place by early 2011.

The new system will offer many advantages over Tennessee’s exist-ing 9-1-1 infrastruc-ture. For example, 9-1-1 centers will be able to accept text messages and photos from cell phones in addition to standard telephone calls and calls accidentally received from distant counties will be trans-ferred to the appropri-ate 9-1-1 center.

Tennessee’s communications centers operate on a dual-funding mechanism. a center’s operational budget comes through the county general fund, under the control of county government; fund-ing for enhanced 9-1-1 technology is provided by telephone surcharges with oversight by the emergency Communi-cations District board. The state limits application of surcharge funding. For example, the surcharge money can’t pay for dispatchers, who are county employees.

The upgrades are in line with the national next Generation 911 (nG-911) initiative to establish the foundation for public emergency communications services in a wireless mobile society. The system necessary to accommodate the initiative is comprised of hardware, software, data, and policies to:

• providestandardizedinterfacesfrom call and message services

• processalltypesofemergencycallsincluding non-voice (multi-media) messages

• acquireandintegrateadditionaldata useful to call routing and handling

• deliverthecalls/messagesanddatato the appropriate PSaPs and other appropriate emergency entities

• supportdataandcommunicationsneeds for coordinated incident response and management

• provideasecureenvironmentforemergency communications

Incident dispatch presence remains in cyberspace

While the national Incident Dispatcher association (nIDa) is disbanding, don’t think the concept of sending dispatchers to the scene is going away anytime soon.

“an association is an idea that may come back once we have greater acceptance of the concept,” said former nIDa President Chuck Berdan, dispatch manager, alameda County (Calif.) Regional emergency Com-munications Center. “We made progress, but there’s still a long way to go.”

Rather than continue an association powered by a small nucleus of volun-teers, the nIDa board decided to keep the information flowing through a rede-sign of their current website. once up and running, site visitors will be able to down-load information and stories in support of incident dispatch and, perhaps down the road, contact an incident dispatch expert willing to throw his or her name into the mentoring hat.

Berdan admits it was a monumental task taking on the whole country two years ago when he and a small group of incident dis-patchers organized the nIDa. Introductory

free membership encouraged 200 people to sign up, but of those numbers maybe a dozen could find the time to actively par-ticipate in the nIDa goals.

“We struggled,” Berdan said. “People are busy. There wasn’t enough member support to keep us going, so we decided to take a different direction.”

The nIDa was established to address the concept of sending dispatchers into the field and away from the central communications

center during a large-scale emergency. Some agencies, like Berdan’s, have been operat-ing mobile teams of dispatchers for years although, for the most part, it is not a mode of emergency communications the majority of police and fire agencies have embraced.

Berdan said it’s partly the inability of public service agencies to go outside the box that has traditionally defined the work of dispatchers.

“Dispatchers aren’t often seen as agency people able to work in the field,” he said. “yet, the job is done best by someone who, on a daily basis, listens on the radio and relays the information.”

The new Incident Dispatch Research Center (IDRC) website will most likely retain the same domain as the former nIDa site (www.incidentdispatch.net) and will be managed by incident dispatchers Dave lar-ton and Randall larson.

Brace yourself for 2010 hurricane season

December 2009 forecasts for the 2010 hurricane season aren’t favoring the rela-tively calm direction characterizing the 2009 storm season.

elk County (Pa.) emergency Services was ready for an event 30 years in the mak-ing the first time it occurred.

after all, a plaque in honor of the Feb. 23 event, with room left for future names, has since been hung on the center’s wall, and

more than one stork pin may be on order.“This is an event that made us incredibly

happy,” said Quality assurance supervisor Sherri lovett. “Most of the time the stories are not so good. This one was.”

The good news was the start-to-finish delivery of Hayden alex-ander Heasley—during the last four minutes of a 20-minute call—routed to eMD Jackie Zuback. lo v e t t s a i d Z u b a c k moved through the Child-birth-Delivery Pre-arrival Instructions (PaIs) flaw-lessly and instructed the father, Jason, to gather towels, a blanket, and a shoelace in case the baby should arrive before para-medics did.

lucky thing Jason was ready. Hayden made

his appearance 16 minutes into the call. The commotion of three little girls in the background drowned out Zuback’s chance to hear Hayden’s first cry, but that’s “oK,” Zuback said.

“Dad told me he was breathing,” she said. “I was glad when the ambulance arrived to make sure everything was all right.”

It was.Hayden and his mother amanda were

transported to elk Regional Health Cen-ter, where Zuback and Center Director Berniece Jarbeck met them the next day to present a gift and celebrate the birth of elk County emergency’s inaugural baby.

“It was so exciting,” she said. “I wanted that call since the day I started.”

lovett, who has worked at the cen-ter since its opening, said the size of the county they serve has pre-empted the event in the past. The Healeys live in a remote part of the county, and most calls come from closer areas.

“The longer time it took for the ambu-lance to arrive gave us the time to finish,” lovett said.

WOrTh WAiTinG FOr

30-year wait ends happily


g SErViCE hOTLinE g ACE AChiEVErS g GuEST WriTEr g FAQ g inTErnATiOnAL BEAT

BestPractices

They say that inspiration comes from strange places. Well I guess I am the poster child for that. as I was getting my teeth worked on the other morning, I started to realize just how vulnerable I was during that time frame. I was deeply reclined in the chair, staring up at a very intense light, with someone wearing a mask and safety glasses about a foot from my face, poking around inside of my mouth with very sharp, evil-looking tools and a diamond-bit drill. Half my mouth was numb, and my hands were essentially useless at that point because they had a claw-like grip on the sides of the den-tal chair, waiting for the sensitive tooth to get hit or the dentist to sneeze and put the drill through my cheek.

Then, I really started to think more about this even though the little voices were saying “Drop it—don’t go there!” For example, I wondered what the dentist would do if all of a sudden I started to freak out from claustrophobia. What if I acciden-tally had a twitch in my mouth and bit her finger? What if that “Mr. Thirsty” suction thing sucked in my uvula? Who works on the teeth of the dentist? What if the novo-cain never wore off? I wonder if anybody ever eats a pack of oreo cookies and a can of sardines as they sit in the waiting room and then go in to get their teeth worked on without rinsing first?

I also started wondering what was going on in the dentist’s mind. I wondered how they handle it when they are having a bad hair day. How do they not take it out on the poor schlep who is laying there in the chair at their mercy? “Take that, you @#$%^%

incisor…and as for you, Mr. Molar…you are the next victim of my pointy pick. oops, did that go into your gum? My bad!” I would imagine (hope) that these folks know how kooky our fears are when they are working on us, but would never exploit that.

So that leads me to the point (the bite) of this article. When we receive calls for service from ordinary folks that are experi-encing what they perceive as an emergency, how similar is the situation to the dental chair? I would contend that there are some common threads.

For instance, in both examples there is a high degree of vulnerability. Just as we are at “the mercy” of the dentist, our callers are at “the mercy” of the situation and the calltaker. We need to ensure that we do not make the situation worse for the caller by unprofessional or judgmental behavior on our part. To some degree, even as calltak-ers, we are vulnerable to the situation when the caller is difficult to manage or is acting in a manner that seems totally improper or unappreciative. But we need to realize what the source of the caller’s behavior is and not take it personally. We need to have empathy for the caller.

High Anxiety. Dental visit compares to calling 9-1-1

g servicehotlineempathy is necessary in both situations

to better ensure a successful outcome. The caller is often exposed to a wide range of emotions and fleeting thoughts from the discomfort of experiencing an emergency, and for the most part the caller isn’t familiar with the questions and instructions we will subject them to in the calltaking environ-ment. The caller is out of a comfort zone and prone to react in a variety of ways. We need to try to keep this in mind at all times so we can understand what the caller is going through and empathize. This is simi-lar to how a good dentist will explain to you the work he or she anticipates because of the realization that you might be worried or scared—before the work begins—and give you a heads up if it could be uncom-fortable. Remember, we are the profes-sionals and they are requesting our service, even though to do so, it means that there is potential discomfort that has to be endured and sometimes on both sides of the phone.

another comparison is trust. To me, this might be the most important parallel of all. Spontaneous trust is often given in situations such as these because we really don’t have much choice but to trust. If we don’t trust the dentist, then we might avoid the dentist’s office and get a case of yuck-mouth, Billy-Bob teeth, or periodontal disease. That kind of stuff may not kill you, but it will put a damper on your social life. However, if the caller does not place the 9-1-1 call due to mistrust of the system, the caller will not get any professional assistance in the pre-arrival environment, and a chance to make a signifi-cant positive difference in the outcome of a bad event is lost. We are fortunate, and in many ways very privileged, to be trusted to help people in an empathic manner when they are the most vulnerable.

and Mr. lanier: “We expect to see you again in another article in a couple of months. Please stop by the front desk as pay-ment is due in full, and here is a free tooth-brush and some floss-flavored floss. By the way, you have some drool on your chin.” g

By Jim and Sharon Lanier

By Heather Darata

If you’re looking for a dispatch attitude where the sky’s the limit you may have found your match in the Polk County (Fla.) Sheriff’s office emergency Communications Center.

The comm. center in central Florida received its medical accreditation in april 2010 and even before the plaque was on the wall, new goals to benefit an area population of 587,000 in a 2,010 square mile area were already in the works. X marks the center’s location in Imperial Polk County—the area where the majority of Florida’s major roads run through.

The county, about the size of Delaware, has stayed the course of diversity. a vari-ety of languages are spoken—63 languages to be exact—representing 151 countries. Polk County's economy has been histori-

cally based on three primary industries: citrus, cattle, and phosphate mining. The county has the second largest amount of farmland in the state, with an estimated 626,634 acres, and consistently ranks among the top three in the state for total citrus production.

Polk County also offers a mixture of recreational opportunities.

The county’s largest city is lakeland, only fitting since Polk County is known as the Water Ski Capital of the World, home to 135 square miles of natural freshwa-ter lakes, including lake Kissimmee; 88 lakes in the area are boat-ramp accessible. Cypress Gardens, Florida’s first theme attraction, became the birthplace of per-formance waterskiing in the early 1940s.

Polk County is also home to Fantasy of Flight, Sun ’n Fun Fly-In, and Bok Tower Gardens—a national Historic landmark. an hour away in the car and tourists can

enjoy Walt Disney World, SeaWorld, Busch Gardens, or universal Studios.

Getting down to businessBut it’s not all fun and games for those

working in the dispatch center, a primary and secondary Public Safety answering Point (PSaP). The 57 employees currently at the center—32 are eMS/fire calltakers—dispatch for emergency medical services (eMS), 10 fire services, and support services including parks and recreation and emer-gency management.

a merger is taking place this year between the Polk County Communica-tions Center and the Polk County Sheriff’s office Communications Center. as a result, the 90 sheriff’s office employees who dis-patch for four law enforcement agencies including animal control, will merge with the primary PSaP and eMS/fire dispatch to form the emergency Communications

Sky’s The Limit. new medical aCe has attitude to match expectations

g aceachievers


Center (eCC). The eCC’s new building will replace a 20-year-old facility with a center constructed to withstand 165 mph hurricane force winds.

The Polk County eMS Divis ion responds to approximately 75,000 events yearly and operates a total of 32 paramedic ambulances around the clock, as well as three Peak load paramedic ambulances, from 22 stations throughout the county. It is also the lead agency in coordinating the countywide Paramedic Response vehicle Program for the County Fire Services Divi-sion and city fire departments.

In 2009, fire and eMS calls alone totaled 125,000. each month the center receives about 6,000 calls for emergency medical events and 3,200 calls for fire events. law enforcement calls for the Polk County Sher-iff’s office totaled 383,724 from october 2008 to September 2009, with 54,257 of those being 9-1-1 calls.

The tough job of handling the calls wasn’t enough for center Manager Ivan Whitaker when he arrived in September 2008. The center was using the Medical Priority Dispatch System™ (MPDS®), but lacked guidelines designating whether to send a hot or cold response.

“Before MPDS, eMS and fire services used base response matrixes with the atti-tude of ‘sending out the cavalry,’” Whitaker said. “The Dispatch Review and Steering Committees became the nucleus of field response in Polk County.”

The center went live with a total field response on Feb. 22, 2009, and from there Whitaker and Polk County Medical Direc-tor Greg White, M.D., turned to the task of becoming a national academies of emer-gency Dispatch® (naeD™) accredited Center of excellence, or aCe, in medical protocol dispatch.

“our initial goals for the accreditation were dispatch based,” said Whitaker, who came to Polk County from Marion County (Fla.) Public Safety Communications, now a dual aCe. “We saw the accreditation as an opportunity to boost the morale of the associates within the center. We also looked at the customer service aspect. By becom-ing a center of excellence, our customers can be confident that we are using a proven protocol effectively.”

But there was also a second reason behind the goal. Dr. White wanted to take advantage of the oMeGa determinant and access the Priority Solutions™ patented clin-

ical triage and emergency dispatch software called PSiam™. Both are exclusive benefits of the aCe designation.

an oMeGa situation does not need emergency response and transport, but requires careful evaluation and a referral to a more appropriate healthcare pathway: urgent Care Centers, Poison Control Centers, Sui-cide Help lines, scheduled doctor’s appoint-ments, and other health/social agencies.

The PSiam software is an algorithm-based questioning sequence for the oMeGa response that gathers further information from the patient/caller and then matches him or her with appropri-ate care avenues or provides the self-care instructions necessary to avoid a trip to the hospital or doctor’s office. use of the soft-ware reduces the number of cases in which ambulances are inappropriately dispatched for non-emergent cases and according to Whitaker’s figures, Polk County averages 12% to 15% non-emergent calls.

“our estimates showed that if implemented, the PSiam program could provide a huge savings to the county,” Whitaker said. “This makes the accreditation even more valuable.”

ACE not easy accomplishmentTime management was a crucial issue,

particularly with the upcoming merger.

But Whitaker wouldn’t put aCe on hold. He took on aCe project management and the center’s lone communications train-ing officer (CTo), later joined by another CTo, comprised the rest of the accredita-tion team. They brought the plan to staff.

“If telecommunicators do not under-stand the importance of the accreditation or there is no buy-in, meeting the demands of the process may be futile,” he said.

Their first task was bringing dispatchers up to accreditation levels. Quality assurance (Qa) staff was limited to one CTo, and the job of monitoring and training was too much in a job that also required time spent on the floor. There wasn’t the budget to hire addi-tional people to assist with Qa, so Whita-ker turned to outsourcing. The company selected, Protocol Support, identified prob-lem spots from the data collected and used that data to help improve dispatch.

“In evaluating the hour utilization of the training officers, the outsource com-pany proved to be a much cheaper and reliable resource; reliable in a sense of Qa turnaround,” Whitaker said. “We can now count on prompt feedback and a quick turnaround regarding Qa results.”

The outsourcing paid off. Polk County reached Qa levels necessary for accreditation in august 2009 and continues to do in-house

Qa of particularly complex incidents such as ST segment elevation myocardial infarc-tion (STeMI) alerts, stroke alerts, trauma alerts, and internal investigations.

With performance levels on target, Whitaker tackled the 20 Points of accredi-tation. He divided them into manageable assignments, set clear goals, and established deadlines. as project manager, Whitaker monitored Qa scores, maintained con-tacts, and gathered the data necessary for packet completion. The accreditation team attended every Dispatch Steering Commit-tee meeting to keep everyone in the loop.

“Having the buy-in from the decision makers in the Dispatch Steering Commit-tee makes the process easier from a field perspective,” Whitaker said.

once the paperwork was in, it was time to hold their breath.

Good newsThe day word arrived Whitaker went

to the floor holding an issue of The Journal of Emergency Dispatch open to a picture of Harford County (Md.) personnel celebrat-ing their tri-aCe (an aCe in medical, fire, and police dispatch protocol). Before Whi-taker said a word, the secret was out.

“They were elated,” he said. “We had been waiting on the answer. They started cheering ‘oh, we got accredited.’”

The Polk County emergency Com-munications Center, soon to be the Polk County Sheriff’s office eCC, was recog-nized april 29 at the navigator conference in orlando. The center is now among the more than 100 centers worldwide that cur-rently bear the aCe distinction, including 101 medical aCes, 16 fire aCes, two police

aCes, and two tri-aCes.Whitaker has no intention of stopping at

a single aCe designation. His plans include implementing the Fire Priority Dispatch System™ (FPDS™) and at some point, the Police Priority Dispatch System™ (PPDS™) and, when that happens, Polk County will shoot for accreditation times three.

and he isn’t alone in his desire for accred-itation. Sheriff Grady Judd strongly believes accreditation is crucial, as shown by the fact that the Polk County Sheriff’s office was already a seven-star accredited agency.

Judd finds state, national, and interna-tional accreditation vital to maintaining standards of the highest calibre in every department, including the Polk County Sheriff’s office eCC.

“Dispatchers are often the first pub-lic safety professionals with whom our customers interact, and are the backbone supporting fire, eMS, and law enforcement agencies,” he said. “ensuring that our dis-patch center is accredited reaffirms our commitment to excellence, professional-ism, and customer service for the people of Polk County.”

ACE adviceWhitaker provides the following sug-

gestions for agencies seriously considering the aCe designation:

• Assignaprojectmanagerandestablishan accreditation team before launch-ing into the academy’s 20 Points of accreditation. look for someone who is detail-oriented to function as project manager and have that person respon-sible for the team, initiating goals, and establishing deadlines, he said.

• Breakthe20Pointsdownintomanage-able assignments among the appointed groups and put the project manager in charge of overseeing deadlines. For example, one group could compile the center description while another gath-ers comparative local/state policy.

• Achievebuy-in.Dispatchersmustbeinterested and excited about what accreditation says for the team, Whi-taker said. and down the road, let the team know how much you appreciate their strides toward excellence.

• Seekoutadvicefromaccreditedcenters.visit an aCe if possible. “There’s another thing to visit a center and see it (accredi-tation) in action,” Whitaker said. g

nEW EmD ACE132 Union County Emergency Communi-

cations; Monroe, N.C.133 EMA/MetroSafe; Louisville, Ky.134 Guilford Metro 911; Greensboro, N.C.135 Orlando Fire Department; Orlando,

Fla.136 Polk County Emergency Communica-

tions Center; Bartow, Fla.137 City of Oakland Fire Department;

Oakland, Calif.138 City of Hialeah Public Safety Commu-

nications Division; Hialeah, Fla.

nEW EFD ACE13 Union County Emergency Communi-

cations; Monroe, N.C.14 Hanover Emergency Communica-

tions; Hanover, Va.15 Marion County Public Safety Commu-

nications; Ocala, Fla.16 Metro/Nashville Emergency Commu-

nications Center; Nashville, Tenn.

re-ACE EmD4 Clark County Regional Emergency

Services Agency; Vancouver, Wash.41 Muskogee County E.M.S.; Musko-

gee, Okla.49 Kent County Emergency Communica-

tions; Dover, Del.75 MedStar EMS; Fort Worth, Texas82 Jefferson County Emergency Com-

munications; Charles Town, W. Va.86 Broward Sheriff’s Office; Fort Lauder-

dale, Fla.88 Sedgwick County Emergency Com-

munications; Wichita, Kan.89 Sarasota County Public Safety Com-

munications; Sarasota, Fla.90 Mecklenburg EMS Agency; Charlotte,

N.C.92 American Medical Response; Oregon

Communications; Portland, Ore.107 American Medical Response West-

ern Washington Communications; Seattle, Wash.

110 Central EMS; Fayetteville, Ark.139 Northwest Central Dispatch System;

Arlington Heights, Ill.

re-ACE EPD1 Medicine Hat Regional 911 Commu-

nications; Medicine Hat, AB, Canada

“They were elated. We had been waiting on the answer. They started cheering ‘Oh, we got accredited.’”

-Ivan Whitaker

Accredited Centers of Excellence.

Full Plate Those staffing the Polk County Emergency Communications Center worked toward medical accreditation while they were preparing for an upcoming merger to become the Polk County Sheriff’s Office ECC.

moving in. The new Polk County Sheriff’s Office ECC building is ready.


as I travel from city to city, dispatch centre to dispatch centre, I hear the same words over and over: “The protocol makes me sound like a robot.”

I was recently at an Instructor update, and those same words found their way into one of the presentations. “We don’t want our dispatchers to be sounding like robots,” the facilitator dutifully stressed in his remarks. Does the protocol really “make” you sound like a robot? Could it be some-thing else that makes you sound robotic? Is there actually a choice in how you sound? What should you sound like? If robotic is bad, what, then, is good?

First of all, we know that protocol-centered dispatch is the standard of care, be it police, fire, or medical. We also know that protocol compliance ensures that lives are touched in a consistent and predict-able manner while help is delivered in the best possible way. We know that the words in the protocol are engineered to elicit a response on the part of the caller. addi-tionally, the words must be offered in a way that is completely verbatim to the protocol script. How can we take the words from the cardset or computer monitor, as the case may be, and give them life?

are there any other professions outside of the communications environment that use protocol-like phraseology? Several come to mind. law enforcement uses a protocol daily as they read the Miranda Rights if they are in the united States or their Constitu-tional Caution if they are in Canada. at that point, the suspect is being addressed with his or her right to legal council. I don’t really think the suspect cares too much about the emotion in the police officer’s voice. Is there something else, then? How about the pre-flight safety briefing you encounter each time you fly? Then place the flat metal portion into the buckle . . . Robotic? a cus-tomer of Westjet airlines knows that even the pre-flight safety briefing can be delivered with passion and feeling far removed from robotic as they review the important safety

features of the Boeing 737 aircraft. Westjet adds humour and life to what is otherwise drab, at best.

Maybe we sound bored because we get tired of saying the same thing over and over again? That must be it. There are a

lot of people earning their living by saying the same thing day in and day out when they work. Do they sound robotic? not if they plan to enjoy a long and distinguished career in his or her chosen field. Broadway actors go to work each night prepared to say the same words in the same order every time it is their turn to speak. They have a scripted protocol. The medical, police, and fire protocol used in our communications centres is also a script. Does a Broadway actor simply “say” the words devoid of emo-tion and enthusiasm? not if the actor wants to keep on stage. What about Disney World, where navigator 2010 was held? Hundreds of costumed characters use the protocol of the character they’re portraying. It wouldn’t be Disney without that.

our list of protocol performers would not be complete without the examples of a visit

to a live concert, or listening to our music and words on the radio, a CD, or an iPod. oK, it’s lyric compliance rather than protocol compliance, but you get the idea. let’s think back to navigator ’05 in las vegas. Imagine that we have tickets to elton John’s “The Red

Piano” at Caesars Palace. you settle into that expensive front row seat expecting the show of a lifetime. The musicians begin to play, and you immediately recognize the introduction of “Bennie and the Jets.” you get into the song and when Sir elton gets to the chorus, you’re singing right along, toe tapping, and body swaying to the beat. There’s a problem. elton is singing “Bennie and the airplanes.” at first break, Sir elton tells his audience that he simply felt like changing things up a bit. “I’m tired of those old words, I sing them every night,” he says.

you suddenly realize all the work that your eD-Q has been doing and the frustra-tions that he or she has been up against back at the office. like the words to Sir elton’s music, you too have words that are impor-tant to the success of your performance. There are times, however, that the chang-

g guestWriter

By Dave Woods, Vancouver Fire and Rescue

ing of a word may add to the meaning of the song. at a recent nitty Gritty Dirt Band concert, you remember such an example. you were two stepping up a storm to Cadil-lac Ranch. Jeff Hanna and Jimmie Fadden decide to enhance Cadillac Ranch by sub-stituting “Colorado night” with “California night.” The California crowd goes wild with hoots and hollers of appreciation. unlike the Sir elton John concert, the enhance-ment by the Dirt Band made that part of the song more accurate and applied directly to the end user, the audience. This is just like an enhancement to the protocol when you substitute a more accurate noun in the place of a pronoun.

Let’s ask the questionDo you perform the protocol? or, do

you choose to become robotic and address the caller without emotion and passion? Do you struggle to get from the Case entry to Case exit? Do you rehearse your script? We can all tell when we are faced with a lousy performance be it a movie, a concert, or the table service and meal from a favorite restaurant. even though most of our cus-tomers call us only once or twice in their lifetime, they too can pick up on lousy cus-tomer service, usually, in an instant.

How much customer service can you provide after the caller has hung up the phone frustrated because of poor-to-no customer service? your snappy comeback might be, “I’ll simply call the person back when that happens.” Is there a rule some-where that says the caller must answer the phone when we try and call them back? I don’t think so.

Remember, you have a choice to make. you can choose to “perform” the protocol with passion and care, or choose to sound robotic. you need to ask yourself this ques-tion early on and decide to provide out-standing customer service from the start.

Does protocol make you sound like a robot? Protocol doesn’t make you do any-thing. The eMD chooses to sound robotic or the eMD chooses to sound professional while performing the protocol to a new audience each and every shift. your job now is to practice your lines. g

Delivering Your Lines. It’s your voice, not protocol, making delivery robotic

Do you perform the protocol? Or, do you choose to become robotic and address the caller without emotion and passion?

Brett:our center has recently started using

the Medical Priority Dispatch System™ (MPDS®) version 12.0, and we have come across a question regarding Proto-col 26, Sick Person (Specific Diagnosis). When it asks if the patient has pain and the caller says “yes” and then states, for example, abdominal pain or back pain, should we switch to another protocol or continue along the sick person protocol? If the answer is “yes” to not breathing normally [Key Question: is s/he breath-ing normally], the program does not shunt to Protocol 6, Breathing Problems; if the answer is “yes” to chest pain, there is a shunt. So, should we shunt when given a specific complaint? My first instinct would be to say, “of course you would shunt,” but then I came across a couple of circumstances that confused the issue.

Situation 1: Patient not feeling well today . . . Protocol 26. Patient is alert. Patient is not breathing normally. Patient has abdominal pain, shunt to Protocol 1 and find out the pain is below the navel. Protocol 1 provides an alPHa response; Protocol 26 provides a CHaRlIe response due to the breathing difficulty.

Situation 2: Patient not feeling well today . . . Protocol 26. Patient is alert and is breathing normally. Patient has abdom-inal pain, shunt to Protocol 1 and find out the pain is above the navel. Protocol 1 provides a CHaRlIe response; Proto-col 26 provides an alPHa response.

Thank you in advance for your help in this matter.

Sandi Morgan—eMD-Q, eFDCommunications SupervisorMD ambulance Care ltd.

Sandi:let me provide you with some ratio-

nale before I address your question specifically.

The Standards Council discontin-ued the shunt from Protocol 26: Sick Person (Specific Diagnosis) to Protocol 6: Breathing Problems in version 12.0 because these “shunted” patients had a much lower acuity than patients with an initial Chief Complaint of difficulty breathing. This was causing significant over-triage, especially in high-volume centers. By handling patients with “dis-covered” abnormal breathing on Protocol 26, rather than shunting to Protocol 6, agencies can set a separate and specific response for these 26-C-2 patients.

The chest pain question was altered to be non-leading. While the Council wanted even “discovered” chest pain patients to be handled on Protocol 10: Chest Pain (non-Traumatic) because of the genuine risk of heart attack associated with this symptom, the new question eliminates at least some of the over-triage associated with leading questions.

as noted, the new pain question was changed to be non-leading, but was retained to uncover the priority symp-

Sick Person. Shunt specific to initial Chief Complaint

g frequentlyasKedquestions

MPDS® v12, NAE-std. © 1979–2010 PDC.


Malaysia and the united States have quite a bit in common when it comes to emergency dispatching.

In March, seven hospital call centers in the western coastal state of Selangor, which includes parliamentary capital Kuala lumpur, went live with the Medi-cal Priority Dispatch System™ (MPDS®). Within the first 30 days of using pro-tocol, emergency phone instructions proved successful for childbirth, CPR, and thousands of other more routine calls for emergency medical assistance transferred from a centralized response center to certified emergency medical dispatchers at the hospitals.

Plans during the next two years call for bringing MPDS to the rest of the country, similar to the advance of pro-tocol across the united States. Training and certification are all part of the pack-age. accredited Centers of excellence loom in the future.

Then, there’s that other aspect the Malaysian dispatchers have come up against, similar to communications cen-ters located in the united States.

“We have resistance from the public about all the questions,” said Rozinah anas, project director for the Malaysian

emergency call service network (MeRS 999). “Some become impatient, saying we ask too many.”

But that’s a hurdle anas is convinced the public will overcome and in short order too, particularly considering the distance emergency services has trav-eled in the past year throughout Malay-sia’s most densely populated and fastest growing region.

moving right alongnational academies of emergency

Dispatch® (naeD™) President Scott Freitag calls the progress remarkable.

“There’s been a tremendous amount of effort put into the project,” said Fre-itag during a meeting between represen-tatives from the naeD and Malaysia held at naeD offices in april. “our visit to Malaysia for the roll-out was a refresh-ing experience.”

To anas, a standardized set of ques-tions was a must for the developing MeRS 999 Project.

“The protocol improves the service level to the public,” she said. “I’ve seen it work. Protocol helps save lives because of the advice given over the phone.”

anas had heard about the dispatch system many years ago and in 2008 started visiting centers using MPDS in Canada and the united States in antici-pation of national incentives promoting

g internationalbeat

Welcome Aboard. Malaysia goes full speed ahead in implementing MPDS

By Audrey Fraizer

tom of chest pain. If the caller does not tell the eMD where the pain is when asked this question, which they normally do, the eMD may clarify. However, no shunt is necessary unless the caller offers “Chest Pain” as an answer to this purposefully open-ended question. If non-priority com-plaints such as back or abdominal pain are not offered during Case entry Questions, but are incidentally “discovered” on Proto-col 26, no shunt is made from Protocol 26 unless the priority symptoms of chest pain or hemorrhage are discovered. When the patient complains of pain other than chest pain, the alPHa Determinant Descriptor for “other Pain” should be used, provided no higher descriptors are appropriate.

The bottom line is that patients with “discovered” pain or abnormal breathing (not part of the initial Chief Complaint) are not as likely to have a problem related to that symptom as patients with that same primary complaint. With that said, there is certainly the possibility of iden-tifying a specific condition that is clearly “hunted” by the protocol, i.e., heart attack or stroke symptoms, where a move to another protocol is appropriate. For instance, if during Key Questions for Sick Person (Specific Diagnosis), the eMD learns that this “other pain” is actually a dull ache in the left arm and jaw, a move to Protocol 10: Chest Pain (non-Trau-matic) is appropriate. If the eMD learns that the patient had sudden, unilateral weakness, a move to Protocol 28: Stroke (Cva) is appropriate. These “discovered” signs or symptoms are clearly defined and listed in the protocol to ensure that they are not missed.

The “discovery” of pain that was not part of the initial Chief Complaint should still be handled on Protocol 26—with the excep-tion of chest pain, which should be shunted to Protocol 10. exceptions to this rule should only include specific protocol direc-tives, in which “discovered” symptoms may relate to a specific diagnosis such as heart attack or stroke, as defined by protocol.

I hope this explanation helps your eMDs select the most appropriate Chief Complaint. as Dr. Clawson is famous for saying: “If you want to be on the right train, buy the right ticket.”

Brett a. Pattersonacademics & Standards associateResearch Council ChairnaeD g

the 999 system. Her latest visit to the states as part of a team of 10 emergency service officials from Malaysia included stops to view protocol in action at centers in Wash-ington, D.C., Prince George’s County (Md.), and Cambridge (Mass.).

a layover in Salt lake City prior to leaving for los angeles brought them to the capital city of protocol where a further introduction took place of a dispatch system found in 3,129 centers worldwide and used by almost 60,000 certified dispatchers.

new kids on the blockThe seven hospitals and associated

dispatchers may be the new kids on the block, but they’re quickly catching up to other international members. Dispatch-ers are trained and certified and using the english version of ProQa® while awaiting a language-specific version now in trans-lation at Priority Dispatch Corp. offices in Salt lake City. Malaysia will be recog-nized as part of the International acad-emies of emergency Dispatch® (IaeD™) Standards Committee reviewing protocol for cultural context.

MeRS 999 Technology Project Director Puteri Mariana abdul Majid admitted the country has a long way to go before the plan is fully operational.

“But we’re moving in the right direc-tion,” she said. “It’s very good that we’re working on establishing international best practices throughout the country.”

Time to advanceWhile protocol might be new to Malay-

sia, dialing 9-9-9 for emergency assistance isn’t. The country adopted the three-num-ber system nearly 30 years ago but it stalled due to habit and economic pressures.

a large segment of the country’s popu-lation, now nearing 28 million, never fell into the habit of calling 9-9-9 for emergency assistance. Prior to the MeRS 999 Project, Malaysians called the ambulance service or medical center in an emergency or simply placed the sick or injured patient into a personal vehicle for a trip to the hospital. Tourists used to an emergency call system were at a loss. There was also talk several years ago of scrapping the universal 9-9-9 in favor of instituting three separate three-

digit emergency numbers for summoning police, fire, and ambulance.

But a country bursting at the seams of industrialization needed to do something.

Malaysia’s burgeoning population and recognition of Kuala lumpur as a global city demanded changes to existing laws and regulations, including those governing emergency medical services. In 2009, the Government of Malaysia signed an agree-ment with Telekom Malaysia to develop a unified MeRS 999 System. according to the letter of agreement, the transaction reflected government’s commitment to protecting human life using a single three-digit number.

Phase 1 of the first stage of MeRS 999—now completed—covered the estab-lishment of a 999 call center in Melaka and upgrading existing call centers at the seven hospitals. Phases two though four bring the rest of the country into the fold. The second stage, also in process, includes Computer aided Dispatch (CaD) tech-nology, connecting calls from MeRS 999 response centers to the dispatch centers, and public education. g

Different But The Same Malaysia’s shift from an agricultural-based economy to one favoring industry and technology ushered in a world of advanced capability on all fronts, including emergency communications. In March 2010, seven hospitals in the country met the challenge by implementing the Medical Priority Dispatch System (MPDS), with NAED and PDC representatives there to assist.


the conference navigator the conference navigator

Page 26ACE is the Place. navigator brings touch of aCe class to stage

Page 28 Caught Off Guard.leadership award surprises recipient Jerry overton

Page 28 Career Born of Tragedy. Dispatcher puts positive spin on negative experiences

Page 30 Fire Station for a Kingdom. Reedy Creek Fire Station boasts high-tech protection

Page 31 Once Upon a Time.Some stories began and others celebrated happily ever after

B y A u D R E y F R A I z E R

P h O T O G R A P h s B yL A R R y L A T I m E R

D A V E B R I N T O N

Boots Are Made For Walking. navigator covers a lot

of ground in three days

Some might think that Jill (Stevens) Shepherd has seen and done just about everything anyone could want.

after all, the Miss utah 2007 winner and former u.S. army combat medic who served in afghanistan has celebrated more achievements during her first 30 years than most of us do in a lifetime.

That is, with one possible exception.The “america’s Choice” semi-finalist in

the Miss america 2008 pageant has never been a dispatcher. She’s never sat behind a CaD console, taking calls from distraught parents, frantic children, or lonely souls needing someone to talk to.


shop highlighting the role dispatch plays in response to finding a missing child.

The day after the traditional gala reception in the exhibit hall Tuesday evening, sessions went full steam ahead on the heels of Shepherd’s keynote pre-sentation. a trip to Disney’s Typhoon lagoon Water Park, created—according to legend—in the wake of a monster storm, rounded out the day; although, most conference goers opted for an eve-ning outside the waterways, rivers, rapids, and slides the park features.

Thursday introduced dispatchers to graduates of the Communication Center Manager (CCM) Course, recipients of the accredited Center of excellence (aCe) awards, the recipient of the Dr. Jeff Claw-son leadership award, and a new twist to watching Protocol in action.

Student CCM representative Sherri Sti-gler spoke for the 29 graduates when she

lauded the connections they made, and the wonderful experience of reconnecting with many classmates at navigator.

“They are quite a ‘cracked’ group, and I mean that in the most positive of ways!” Stigler said. “CCM gave us the ability to lean on each other for support, encour-agement, and good old-fashioned advice. This class provided us with an outside network that we can reach out to for help at any time, and that is an invaluable, tan-gible gift that we know will be there for our entire career.”

While Stigler said it was “a little nerve-wracking” to address such a large audience made up of so many industry professionals, she was comforted in knowing that the mes-sage of CCM was an important one to share, particularly among the line dispatchers.

“These are the most important mem-bers of our teams,” she said. “These are the people whose careers and work life will be

affected by the quality in their leadership.”aCe recipients took the stage next, each

escorted by naeD and Priority Dispatch Corp. staff members dressed in tuxedos. accreditation Board Chair Brian Dale, Salt lake City Fire Department deputy chief logistics/support, gave the introductions and, among other notable center achieve-ments cited, commended 144 notruf no in austria, the first accredited Center of excellence (aCe) in continental europe.

Ing. Christof Chwojka, 144 notruf no communications manager, said achieving an aCe proved the impossible.

“Many said we could not do this because of differences in language,” he said. “not only did we have the desire but we also had Tudy [Benson, PDC Director of european operations] and she speaks perfect German. It’s our hope we can stand here again later announced as the first two-accredited center in con-tinental europe.”

This year’s Dr. Jeff Clawson leadership award went to Jerry overton, president and chief executive officer of Road Safety International and former executive direc-tor of the Richmond ambulance authority (Raa) in virginia.

overton said he was honored and sur-prised by the award.

“I’m actually speechless,” overton said. “Totally surprised. This is one of the most treasured honors I’ll ever receive from a visionary such as Jeff Clawson. It’s a very high honor.”

Scenarios in the 15 minutes of filmed Protocol in action depicted urgent fire, police, and medical situations combined with callers and certified dispatchers to demonstrate how they interact in an emer-gency. naeD President Scott Freitag said the scenes emphasized the importance of adhering to the protocols.

“There are only certain times we can’t get things wrong,” Freitag said. “Protocol gets rid of the variability we face every day and gathers the information we need to know for the appropriate response.”

Friday’s closing luncheon culminated three days of full schedules, leaving Bob Bloodsworth feeling better for the wear.

“I started in the business 11 years ago and it’s been best job I’ve ever had,” said Bloodsworth, an eMD, eFT, and nR-enT for Kent County (Del.) Department of Pub-lic Safety. “Coming here and meeting people who feel the same has been fantastic.”

and it’s an experience Shepherd might enjoy if only she could find the right shoes to wear.

“I have a shoe fetish,” Shepherd admit-ted. “Shoes carry memories for me. I grow attached to them. each pair represents a milestone in my life.”

Shepherd brought out several pairs of shoes and boots during her 45-minute key-note presentation on the opening day of navigator 2010 at the Coronado Springs Resort in orlando, Fla. The full-time nurse at a children’s hospital in Salt lake City and in-demand speaker said the progression—combat boots to high-heeled shoes—sym-bolizes the risks she accepted in the writing of her own life story.

“I love pushing myself, challenging myself, and seeing what I can do,” Shepherd said. “I never would have discovered much of what I have learned without a willingness to wear a new pair of shoes.”

Shepherd’s metaphor for a fulfilling life characterizes the world of emergency medi-cal, fire, and police dispatchers; the people who not only write their own stories but—in many ways—add pages to the stories of those they help during their times of crisis.

national academies of emergency Dis-patch® (naeD™) Dispatcher of the year Meridith Jensen called it a profession intrin-sically rewarding for that very reason.

“For that one moment, I am the only person able to help the other person on the line,” said Jensen, an eMD, eFD, and ePD for the Colorado Springs Police Depart-ment. “I’m there for that person at the moment of crisis.”

Jensen received the award not based on a single phone call or even the 97.3% compli-ance score in all three protocols, according to naeD associate Director Carlynn Page. While certainly commendable, the choice was made based on a chain of events, from her direct efforts in CPR to save the life of a girl stricken by a fatal heart condition on a school playground to the calls she now answers as an eMD, eFD, and ePD.

“Meridith had started on this path long before she took the job,” Page said. “I’m

excited to see where the future takes her.”Jensen was among the more than 1,200

people from emergency communications centers from around the world attending pre-conference and conference events. This year’s show turned the resort right outside the gates of Walt Disney World into dis-patch central mixing field trips, education, entertainment, and networking.

Pre-conference sessions featured naeD focused classes describing accreditation and strategic planning and certifying dispatchers in the use of the Medical, Fire, and Police Priority Dispatch Systems™.

The national emergency number asso-ciation (nena) offered four workshops highlighting operations and leadership, while Public Safety Training Consultants (PSTC) provided insights into manag-ing people—dispatchers and callers. The national Center for Missing and exploited Children (nCMeC) sponsored a work-

the conference navigator the conference navigator

“Coming here and meeting people who feel the same has been fantastic.”

-Bob Bloodsworth

2. your Attention Please Instructor Kim Rigden presents one of the many educational sessions available to attendees.

3. Footprints Jill Shepherd displayed her shoes representing the twists and turns of a life dedicated to challenge.

4. Til We meet Again Navigator pulls together those eager to hear the latest news from others in the profession.

5. Beach Party A lagoon fable says Typhoon Lagoon was cre-ated after a storm of all storms. The park provided after hours fun.

1. Story Telling Keynote speaker Jill Shepherd shares a tale about making dreams come true.

6. Table Talk Conversations spilled out of classrooms and into the main hall during the busy days of Navigator.

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acenavigator acenavigator

ACE is the Place. navigator brings touch of aCe class to stage

Proper etiquette at a dinner party, gala, luncheon, ball, or any other event requiring an invitation simply demands a certain level of formality.

and navigator 2010 was no exception, particularly for an invitation issued only to those achieving the academy’s highest level of achievement.

“These are among the best centers in the world,” said Salt lake City Fire Depart-ment Deputy Chief logistics/Support Brian Dale, who introduced representa-tives from accredited Centers of excel-lence (aCe) during a black tie and tux presentation held Thursday, the second

day of the conference. “We hope to see more of you up here next year.”

This year’s new twist in celebrating the annual occasion epitomizing excellence in 9-1-1 were the black ties and tuxes worn by Priority Dispatch Corp. staff. Representa-tives present from each aCe were whisked to stage from where they sat in the audi-ence, arm-in-arm by elegantly dressed client services representatives and consultants. Their efforts to achieve aCe status were heralded for singular focus on what may have seemed the impossible when deciding to tackle the project.

“There was no question the second and

third aCe was going to happen for us once we achieved the first,” said Tami Wiggins, training and quality assurance supervisor for the Harf-ord County 911 Center in Maryland. “our only questions were when and how long it would take to accom-plish all three.”

The Harford communications center took two years to achieve the seemingly super impossible feat—tri-accreditation—to become the first tri-aCe in the united States, second only in the world to the Med-icine Hat Regional Communications Centre in alberta, Canada. Harford earned its medical aCe in March 2008 and its fire aCe in april 2009. The police aCe was added to the list in october 2009.

Wiggins was quick to credit dis-patchers for the tri-award based on Twenty (challenging) Points of accreditation. “our dispatchers do a

great job every day and they do it for the citi-zens,” she said. “The award goes to them.”

That being the case, the 9-1-1 communi-cation specialists at Harford were among an elite group of dispatchers from 49 centers recognized for achieving a first-time aCe or reaccreditation during the past year. on the medical side, 12 centers were new to the aCe scene while 26 centers were reaccred-ited for another three years. Seven centers were announced as new fire aCes and three centers were reaccredited. Harford was the only new police aCe.

Ing. Christof Constantin Chwojka, 144 notruf no (austria) communica-

tions manager, said achieving an aCe proved the process fits the international member. as the representative on stage for the first aCe in continental europe, Chwojka said he hoped his center ’s example would provide the impetus for others to follow.

“If you have the desire, you can do it,” he said. “We wanted the accredita-tion and hope we stand here again to be the first dual accredited center in conti-nental europe.”

The list of aCes has grown to more than 140 centers worldwide since the first aCe was awarded to the albuquerque (n.M.) Fire Department communications center in 1993. according to the current numbers, there are 101 medical aCes, 16 fire aCes, and two police aCes. Two cen-ters have achieved tri-aCe status and 16 centers have earned accreditation in two of the three protocols.

Centers received more than the hon-orary certificate framed for display. Their enthusiasm also went out for the banners displaying the names of the centers in bold letters hanging from the ceiling beams. They were in popular demand.

To say this is an exciting event is an understatement at best, said naeD asso-ciate Director Carlynn Page.

“They each worked very hard to get here,” she said. “It’s a seminal event in the life of their centers.”

a separate round of applause during the same presentation ceremony went to Craig Whittington, special projects coordinator at Guilford Metro 9-1-1 in north Carolina and outgoing president of the national emergency number association (nena). Whittington is the academy’s first “four star” instructor, certified to teach eTC, eMD, eFD, and ePD courses. Guilford Metro 9-1-1 is accredited in both fire and medical protocols.

EPD ACE

2 Harford Co Division of Emergency Oper-ations; Forest Hill, Md.; Oct. 6, 2009

EPD reACE

1 Medicine Hat Regional 911 Communica-tions; Medicine Hat, AB; April 8, 2010

navigator 2010 ACE honoreesEmD ACE

128 144 Notruf-NO; Niederösterreichring 2, Austria; Sept. 16, 2009

129 Stockton Fire Department; Stockton, Calif.; Sept. 18, 2009

130 Caref l i te ; Grand Pra i r ie , Texas; Oct. 6, 2009

131 Poudre Emergency Communications Center; Ft. Collins, Colo.; Oct. 29, 2009

132 Union County Emergency Communica-tions; Monroe, N.C.; Jan. 4, 2010

133 EMA/MetroSafe; Louisville, Ky.; Feb. 1, 2010

134 Guilford Metro 911; Greensboro, NC; March 26, 2010

135 Orlando Fire Department; Orlando, Fla.; April 2, 2010

136 Polk County Emergency Communications Center; Bartow, Fla.; April 8, 2010

137 City of Oakland Fire Department; Oakland, Calif.; April 12, 2010

138 City of Hialeah Public Safety Communica-tions; Hialeah, Fla.; April 14, 2010

139 Northwest Central Dispatch System; Arllington Heights, Ill.; April 19, 2010

EmD reACE

04 Clark County Emergency Services Agency; Vancouver, Wash.; Feb. 5, 2010

07 Memphis Fire Department; Memphis, Tenn.; Sept. 25, 2009

13 American Medical Response of Den-ver; Denver, Colo.; June 24, 2009

15 Salt Lake City Fire Department; Salt Lake City, Utah; April 15, 2010

23 American Medical Response–CT State-wide; New Haven, Conn.; Dec. 16, 2009

31 Marion Co Public Safety; Ocala, Fla.; Sept. 9, 2009

37 EMS Authority-Eastern Division; Tulsa, Okla.; Nov. 24, 2009

38 EMS Authority-Western Division; Okla-homa City, Okla.; Nov. 12, 2009

39 Austin Travis County; Austin, Texas; Oct. 6, 2009

41 Muskogee County EMS; Muskogee, Okla.; March 12, 2010

45 Metro Communications; Sioux Falls, S.D.; Nov. 24, 2009

49 Kent County Dept. of Public Safety; Dover, Del.; Jan. 26, 2010

75 MedStar EMS; Fort Worth, Texas; March 5, 2010

80 Three Rivers Ambulance Authority; Fort Wayne, Ind.; Nov. 11, 2009

82 Jefferson County Emergency Com-munications; Charles Town, W.Va.; Feb. 26, 2010

86 Broward Sheriff’s Office; Fort Lauder-dale, Fla.; Jan. 4, 2010

88 Sedgwick County Emergency Commu-nications; Wichita, Kan.; Jan. 5, 2010

89 Sarasota County Public Safety Commu-nications; Sarasota, Fla.; March 5, 2010

90 Mecklenburg EMS Agency; Charlotte, N.C.; April 2, 2010

102 AMR Sacramento; Sacramento, Calif.; July 1, 2009

104 Reedy Creek Emergency Services; Lake Buena Vista, Fla.; July 16, 2009

105 East Midlands Ambulance Service; Not-tingham, U.K.; May 22, 2009

106 Dublin Fire Brigade; Dublin, Ireland; Dec. 10, 2009

107 AMR Western Washington Communi-cations; Seattle, Wash.; Feb. 1, 2010

110 Central EMS; Fayettevi l le, Ark.; April 8, 2010

112 Gold Cross; Salt Lake City, Utah; April 15, 2010

EFD ACE

10 Bernalillo County Emergency Communica-tions; Albuquerque, N.M.; May 22, 2009

11 Manatee County ECC; Bradenton, Fla.; Sept. 2, 2009

12 Guilford Metro 911; Greensboro, N.C.; Dec. 16, 2009

13 Union County Emergency Communica-tions; Monroe, N.C.; Feb. 2, 2010

14 Hanover Emergency Communications; Hanover, Va.; Feb. 26, 2010

15 Marion County Public Safety Commu-nications; Ocala, Fla.; March 1, 2010

16 Metro/Nashville Emergency Communica-tions; Nashville, Tenn.; April 19, 2010

EFD reACE

3 Albuquerque Fire Department; Albu-querque, N.M.; May 5, 2009

4 Mecklenburg EMS Agency; Charlotte, N.C.; Oct. 27, 2009

5 Salt Lake City Fire Department; Salt Lake City, Utah; April 15, 2010

more At

www.emergen-cydispatch.org/video/triace.php

www.emergen-cydispatch.org/acc_home.php

ACE Times Three Members from the Harford County 911 Center in Maryland went on stage to celebrate the ACE giving them tri-status.

Two in One Salt Lake City Fire Department goes on stage to accept recertifications for the medical and fire ACE.

A First Ing. Christof Chwokja of 144 Notruf NO (Austria) acknowledges the first ACE achieved in continental Europe.

Celebration The Northwest Central Dispatch System (Illinois) is recognized for achieving its medical ACE.

reaccredited Melissa Allen from MedStar in Fort Worth, Texas, is escorted by Chip Hlavacek from Priority Dispatch.


negatives into something positive because I believe that’s all a person can really do.”

on Feb. 22, 2006, Meridith’s brother-in-law Jared Jensen, a Colorado Springs police detective, was killed in the line of duty while arresting a suspect for attempted mur-der. Police believe Jensen was shot and killed at a close range while he was down from the first shot fired. The suspect was apprehended nearly two hours after the shooting took place and he was later con-victed of second-degree murder.

almost exactly a year later almost to the exact date, Jensen, then a health assis-tant for an elementary school in Colorado Springs, was called to the playground to revive a nine-year-old girl who had col-lapsed during recess. The girl was uncon-scious and not breathing and Jensen gave 11 cycles of CPR until paramedics arrived nine minutes later. Despite heroic efforts, the girl died because of complications from an undiagnosed heart condition.

The two incidents, though tragic, were pivotal to the next two steps Jensen made. Since the school had no automated exter-nal defibrillator (aeD) on site—which may have helped to save the girl’s life—Jensen started a fundraising campaign to buy one for the school. She not only succeeded but her actions convinced other district schools to follow suit. She donated the money for an aeD at a school unable to raise the funds.

“I always felt an aeD could have possi-bly made a difference that day on the play-ground,” Jensen said. “For such a tragedy, I needed to do something positive.”

eight months later, Jensen noticed a

job opening for a dispatcher. as part of the interview process, she was asked about her response to a stressful situation. She played the tape of the 9-1-1 call made from the playground and was subsequently one of four hired out of 300 applicants.

“I think the experiences were impor-tant in their decision,” said Jensen, who was hired in January 2008. “I have devel-oped a feeling of what people might go through in an emergency.”

The Dispatcher of the year award presented at navigator marks a first for Jensen. yes, it was her first national award but also the onstage appearance with John lofgren, who nominated her, might have

been the only t ime Jensen felt a slight case of the nerves.

“ I h a d n o i d e a , ” Je nse n sa id . “ I wa s honored and very ner-

vous. I never anticipated an award for something I truly love doing. The job is very intrinsically rewarding.”

lofgren, an emergency medical, fire, and police quality assurance specialist for the el Paso-Teller e-911 authority Board, said Jensen was his immediate choice when he read the nominating form.

“I saw the qualities the academy was look-ing for and it was Meridith all over,” he said. “The hard part was keeping it a secret.”

Career Born of TragedyDispatcher puts positive spin on negative experiences

Dispatcher of the year Meridith Jensen sits on a bench inside Disney’s Coronado Springs Resort convention center in Florida looking every bit as composed as she prob-ably did giving CPR Pre-arrival Instructions (PaIs) to an adult son of a 83-year-old man following a sudden cardiac arrest.

“I don’t get nervous when answering calls,” said Jensen, an eMD for the Colorado Springs Police Department. “For that one moment, I am the only person able to help the other person on the line. I’m there for that person at the moment of crisis.”

Jensen speaks not only with an air of con-fidence, but also from life experiences few might—or would want to—embrace, espe-cially at an age far from suggesting prime time viewing of the Tv show Emergency! had any influence on her career path.

“It was a decision that came from tragic circumstances,” said Jensen, who, in addi-tion to being a certified eMD, is also cer-tified as both an eFD and ePD. “I turned

Editor’s Note: Meridith sent the following letter to NAED offices in Salt Lake City less than a week after receiving the Dispatcher of the Year award. She gave us permission to print it alongside her story in The Journal.

To Everyone at nAEDI wanted to extend my most sincere and heartfelt gratitude and respectful appreciation to all

of you for recognizing me as this year's recipient of NAED National Dispatcher of the Year."Thank You" just doesn't seem sufficient to express how deeply touched and honored I am to

have been recognized with such a prestigious award, and the incredible tribute at the ceremony last week.

My experience at the Navigator conference was nothing less than amazing and will be near and dear to my heart always. From the star treatment I received from your staff, the resort staff, and everyone in attendance, to the amazing people I met, the accomplished mentors I heard speak in sessions, and the VIP events attended, I am absolutely moved beyond words to describe how much this honor truly means to me. This is especially true when I think of the thousands of dispatchers nationwide and worldwide just like me, who show up every single day, to do the job and go above and beyond in helping others. We are the adrenaline junkies, humble heroes, and silent guardians quietly typing in the back-ground, touching the lives of countless strangers, one call at a time.

We do it not for the praise or recognition, but because we accept a calling to do it. This is a HUGE responsibility, one that I am humbled by, and privileged to accept. To be able to turn the tragic events I have survived into something that allows me to have a positive impact in the lives of others, bringing even a small amount of hope to a caller's most desperate time of need offers an indescribable intrinsic reward that makes my heart swell with pride every time I am asked what I do for a living. It makes us ALL worthy of acknowledgement, so I thank you for recognizing these heroes in the ways that you have done and continue to do so.

It was my sincere pleasure to meet you all, and I most certainly look forward to seeing you all again someday in the future. Please feel free to contact me at any time if there is anything that I can do to help in the work that you do to further the mission of the Academy.

Thank You, Thank You, THANK YOU!Respectfully,Meridith Jensen, ERT - Colorado Springs Police Dept.

aWardsnavigator aWardsnavigator

Caught Off Guard. leadership award surprises recipient Jerry overton

The Jeff Clawson leadership award took Jerry overton completely by surprise.

or, so he says.“I’m actually speechless,” said overton,

president and chief executive officer of Road Safety International, Inc., developer of the SafeForce™ Driving System for emer-gency vehicles. “Totally surprised. This is one of the most treasured honors I’ll ever receive from a visionary such as Jeff Claw-son. It’s a very high honor.”

overton accepted the award on Thurs-day, april 29, during the morning keynote presentation at navigator 2010 from Jeff Clawson, M.D., inventor of the Priority Dis-patch Systems now used in more than 3,000 communications center around the world.

Dr. Clawson acknowledged overton for his unflappable support of emergency medical services, spanning a 36-year career in public service beginning with overton’s departure from Sears, Roebuck and Co. to become leg-islative assistant to the first Jackson County (Mo.) legislative chairman. one year later, he moved into the offices of the Mid-america Regional Council where he became heavily involved in eMS operations.

overton’s foray into emergency services led to positions with the Metropolitan ambulance Service Trust (MaST) in Kan-sas City, Mo., where he served as executive director, and to similar positions with the Kansas City eMS system and the Richmond ambulance authority (Raa) in virginia.

a resolution the Kansas City Council passed in 1999 acknowledges overton for the type of service he continues to provide on behalf of emergency services although now through the private sector since step-ping down from Raa in 2009.

“He is the backbone of everything the academy (naeD™), eMS, and public

safety stand for,” Dr. Clawson said during the award presentation. “He is instrumental in changing the face of eMS in america.”

overton’s celebrated expertise in eMS business plan management has its roots at MaST where he pushed legislation and raised funding to implement a 9-1-1 emergency telephone system. He guided the develop-ment and expansion of the MaST-provided emergency services program, and later in his career, he was among the first directors of a large eMS to embrace the Medical Priority Dispatch System™ (MPDS®).

overton and Dr. Clawson began their long-time association in 1989 when over-ton was looking to improve dispatch ser-vices in Kansas City.

“If you ever hear me talk about eMS system design, you know my beliefs regarding where it all begins,” he said. “That’s dispatch. When it goes right we’re going to save a life. When it doesn’t, there’s going to be a problem.”

Dr. Clawson also acknowledged overton for his expertise in System Status Manage-ment (SSM),which is the management of eMS resources between calls to prepare for the best possible response to the next call.

“Jerry is probably the most knowledge-able man on the planet (since Jack Stout’s retirement) regarding SSM—also at times referred to as a fluid or dynamic ambulance deployment,” stated Dr. Clawson. “SSM and Priority Dispatch go hand-in-hand together in refining eMS system design and management.”

In addition, overton has provided tech-nical assistance to numerous eMS systems throughout the united States and to gov-ernments and agencies in europe, Russia, asia, australia, and Canada.

overton is an emeritus member of the emergency Medical Department of the Medical College of virginia and the national association of eMS Physicians (naeMSP). He serves on the Board of Directors of the north american associa-tion of Public utility Models and is also a member of the naeD College of Fellows. He was the first director of a public ambu-lance system to serve as president of the american ambulance association.

“I’m there for that person at the moment of crisis.”

Peer Praise Meridith Jensen, second from left of the podium, was hailed as Dispatcher of the Year.

Thank you


There are no mouse ears extending from the chief’s cap, the firefighters don’t detail their trucks using water from magic buck-ets, and nobody on duty goes around wear-ing a sailor shirt and red bow tie without putting on a pair of pants, unless going for a swim.

In fact, the sole quality distinguishing the newest Reedy Creek Fire Station isn’t so much about the Walt Disney World theme park it’s there to protect, but rather the high-tech equipment the magical kingdom helps afford.

“Disney is a resource to us like few oth-ers have,” said Deputy Chief Richard D. lePere, Jr., fire marshal of emergency ser-vices. “But most of the stuff here is because of Disney and their unique needs.”

The department’s newest fire station—making a total of four fire stations in the Reedy Creek Improvement District—built near Downtown Disney welcomed four busloads of navigator attendees during two days of tours, treating them to a close look at a facility that only Disney trivia geniuses might recognize as any different from the other three.

Two are somewhat “whimsical” in design—one with spots painted on the exte-rior and an engine bay shaped like a dog-house and the other has a large yellow and red steel helmet built over the entrance—and the third will soon be replaced by a facility similar to station 4. only one other station, aside from no. 4, has flagpoles out-side because of Disney’s obsession with maintaining an international flair. The only Mickey at station 4 is a picture mounted on the wall—Mickey shaking hands with a life-size firefighter.

The station is grateful for Disney’s pres-ence, especially since as the district’s largest land owner the amusement park also pays the largest portion in property taxes.

The fire department began operations in 1968 and occupied the first structure on Walt Disney World Property (a mobile home) and provided protection from the earliest days of the development of the first theme park (Magic Kingdom).

The district’s major taxpayer is Disney, which also pays taxes to orange and osceola

counties. The tax revenue covers fire and emergency services for an area that’s roughly the size of San Francisco and features every-thing the City by the Bay offers except the

Golden Gate Bridge (which, coincidentally was completed in 1937, the same year Dis-ney released its animated Snow White and the Seven Dwarfs movie). additional specialized services Disney requires, like Medical assis-tance Response Cart (MaRC) services, are paid for through ad-valorem taxes.

Going all out for the guests, however, is one positive trait Reedy Creek firefighters and Disney definitely share.

The 160 firefighters/eMT/paramedics, dispatchers, supervisors, and administrative assistants make sure their delivery is part of the same upbeat guest experience visitors expect from the 65,000 Disney “cast mem-bers” (employees) creating magic within approximately 10,000 acres devoted to family amusement, lePere said.

“People here are passionate about what they do,” he said. “I love the place. We do whatever it takes for safety and security.”

Firefighting equipment includes alS ambulances, an alS squad for extrication

and HaZMaT mitigation, a tanker, and brush units. also included in the depart-ment’s equipment roster are two specially designed escape towers called “platypus” that

can extend extrication and rescue response over swamp areas for an emergency evacua-tion of the monorail. Grassland is dampened prior to the nightly fireworks display, but just in case, each station has trucks to fight brush and wildfires.

There is no hospital on Disney property, but each one of the theme parks and water parks has a first aid station. Paramedics can be at the scene of an injured “guest” within minutes when driving a MaRC, which are stationed at each of the theme parks and Downtown Disney.

If parents of younger guests are injured, Disney makes arrangements for the family. There is no cost for the services, whether you need an ice pack or full advance life support procedures.

“What other place in the world would deliver popsicles?” lePere asked. “When we need to give a child an ice pack for a swollen lip, Disney will offer a popsicle instead.”

The communications center located

in station 3 serves as the primary Pub-lic Safety answering Point, or PSaP, on hard-line calls for the Walt Disney World Resort and immediate area, while orange County Sheriff’s Department is the primary PSaP for wireless calls. The Reedy Creek dispatchers, all eMD trained and certi-fied using the Medical Priority Dispatch System™ (MPDS®), answer about 450,000 calls per year and ultimately send 33,000

responses. The center is an accredited Cen-ter of excellence.

In addition to emergency calls, dis-patchers monitor the alarm-activated sprinkler systems protecting all hotel guest rooms. The majority of fire calls are responses to fire alarms, which typically turn out to be false alarms caused by the system reacting to construction dust or cleaning solvents.

“We have very few fire calls,” said Com-munications assistant Supervisor Claude Rogers. “We like to say Disney is one of the safest places you can come to.”

Rogers started as a Reedy Creek dis-patcher in 1991, after a brief period work-ing as a security guard at Pleasure Island. The former patrol officer from louisiana threw his hat in when a dispatch position opened up and—much to his surprise and delight—got the job.

“our center is one of the nicest you’ll ever find,” he said.

field triP navigator storiesnavigator

Fire Station for a KingdomReedy Creek Fire Station boasts high-tech protection

Once Upon a TimeSome stories began and others celebrated happily ever after

Making a difference starts at the grassroots

an empty lawn chair and a grill without the burgers sent just the kind of message Carlynn Page intended for the legislative kickoff campaign held at navigator 2010.

The associate director of the national academies of emergency Dispatch®

(naeD™) has nothing against a leisurely backyard picnic but there’s also a time when abandoning the fun—even for just a few minutes—can pay off big in rewards for the naeD membership and the public.

“People keep telling me something the academy has known for a long time,” she said. “and that’s the need for highest stan-dards in the communications center.”

Built For Tight Spots The Medical Assistance Response Cart (MARC) is a miniature although fully-equipped ambulance able to pick up injured or ill guests at any location in the amusement park.

my hero The only Mickey at station 4 is shaking hands with a fabricated firefighter from Reedy Creek.

Poster Appeal Jeff Clawson, M.D., wants members of the dispatch community to rally for regulations that take every communica-tions center to the highest standard of response.


he said, and he’s a stickler for details supporting the many presentations he has delivered to audi-ences interested in the strategy Disney uses to keep guests happy and their stay enjoyable.

Matheis was eventually allowed to drop the name “Cory” for “Mark,” and he no longer turns his head when someone says the name “Cory” in reference to someone named that or not.

“I was ‘Cory’ here and ‘Mark’ when I left work,” he said. “never a problem.”

Award praises missing children initiative

a degree in social work says a lot about the decision Westerville Communications (ohio) Manager Holly Wayt made about adopting standards for calltakers answering calls about missing and sexually exploited children.

“The safety of children is a huge passion of mine,” Wayt said. “The program is a com-mitment to helping protect them.”

Westerville Communications Center is one of two emergency dispatch centers in the country to complete the criteria it takes to become a recognized national Center for Missing and exploited Children (nCMeC) call center, an achievement the honored Wayt went on stage to accept dur-ing a presentation at navigator 2010.

Wayt, former president of the ohio chapter of the association of Public-S a f e t y C o m m u n i c a t i o n s o f f i c i a l s (aPCo), was approached three years

ago about the chances of the ohio 9-1-1 Council adopting the Model Call-Taker guide for missing and exploited chil-dren as a state standard. It was one of four states the nCMeC Joint Steering Committee subsequently designated as an accelerated calltaker outreach pro-gram, giving these states priority in-state training.

The program promotes awareness of the critical role of the 9-1-1 call cen-ter in handling calls related to missing, abducted, and sexually exploited chil-dren and develops training materials for all levels of public safety communica-tions. Participating centers must complete nCMeC training for call center man-agers or directors and adopt the anSI-approved Standards for Calltakers when Handling Calls Pertaining to Missing and Sexually exploited Children.

The Missing Kids and 9-1-1 Readiness Project is a collaborative effort among the u.S. Dept. of Justice, nCMeC, naeD, aPCo, and the national emergency num-ber association (nena).

“The whole nCMeC Partner Program is a very exciting one,” Wayt said. “The more agencies to complete the require-ments, the better.”

So, what does all of this have to do with a barbecue?

Page put together a booth that little resembled any of the other 58 exhibitors at navigator 2010. artificial turf laid over the cement floor served as the metaphor for a grassroots campaign while the grill, chair, and one-hole putting course certainly drew the attention of the hundreds of people entering the backyard-styled booth through an opening in the white picket fence.

“of course I’m interested,” said Dave o’neill of Metroatlanta ambulance in Mareitta, Ga. “Whatever Carlynn wants, I’m there.”

The “there” in this case is a national push that Page and naeD Director of Spe-cial operations Mark Rector are leading to make training, certification, and accredita-tion a requirement of dispatch. although a majority of states have some form of legis-lation governing a Public Safety answering Point (PSaP), most of the legislation barely scratches the surface of public good.

“That’s why the grassroots campaign is so important,” Page said. “People are inter-ested and excited. They want legislation that makes a difference in their profession.”

Phase I of the campaign includes com-piling legislation state-by-state and putting that into a database naeD members will soon be able to access. at navigator, Page collected the business cards of those willing to join a naeD Grassroots Council. once back to offices in Salt lake City, she com-piled them according to state.

now comes the next step, she said. The naeD will contact Grassroots Council members by state when there’s news of legislation that will affect them and they, in turn, will be encouraged to contact their local and state legislators.

But there’s also more to the campaign than reacting to proposals formulated at state and national levels. Page and Rector will advance the cause at every opportunity even without legislation.

“The Grassroots Council is a great way for dispatch professionals to get involved in legislation that affects us,” she said. “We can make a difference through a collective voice passionate about this profession.”

Cookbook serves up funds for advocacy

Mention the name “Denise amber lee” and memory connects to the January 2008

murder of the young mother, forced to aban-don her two children by a then unknown assailant and later found buried with a fatal bullet wound to her head in a shallow grave not far from her family’s home in Florida. not only did the senseless act jar the public, but also, the issues arising from the 9-1-1 calls received during the ordeal.

The issues centering on inadequate funding and subsequent 9-1-1 inefficiency have since become the focus of lee’s immediate family and in-laws. Together, they operate the nonprofit Denise amber lee Foundation, dedicated to improving the emergency communications system.

But running an operation takes money, and that’s why the grandmothers of Denise and nathan lee’s two children compiled a cookbook featuring 200 recipes and rainy-day specialties just for kids, like rainbow play dough. Photos of the lee children— noah and adam—dressed in cooking attire grace the pages opening each culinary section. Denise’s recipes for chicken gumbo and mari-nated skirt steak fajitas are among the most ambitious. eric Parry’s recipe for five-day ice-cream-bucket pickles is among the oddest.

nathan’s father Mark lee said the money raised goes toward travel expenses. During the past two years, the foundation has maintained a high profile during dispatch debate before the Florida legislature and other states. The family attends several industry conferences.

“our goal is to bring our story and message around the country,” Mark lee said. “every victory gives us the con-fidence that we’re on the right path, but we still have a long way to go.”

o n a p r i l 2 8 , 2 010 , t h e Florida House of Representa-tives unanimously approved a S e n a t e b i l l r e q u i r i n g newly hired calltakers and dispatchers to compile 232 hours of training before going solo on t h e d i s p a t c h f l o o r. existing personnel must pass a com-p e t e n c y e x a m , a n d t h o s e w h o don’t pass must attending train-i n g c l a s s e s . T h e b i l l a u t h o r i z e s f u n d s generated by the state’s 9-1-1 tax for training and it would take effect in october 2012.

First-name basis gives chance to trade places

Fellow cast members called him Cory, a name Mark Matheis selected by closing his eyes and letting his finger do the choosing.

“The name was available so I said oK,” said Matheis, featured speaker at the navi-gator closing luncheon. “Walt Disney liked first names. He said his father was the only person he knew as Mr. Disney.”

The first-come, first-served policy meant selecting an acceptable substitute from a list handed out on his first day as a telephone operator for the amusement park; since the name “Mark” had long been taken in that department, Matheis let his finger do the talking, so to speak, when no name popped out as better than the rest.

Matheis was nonplussed by the policy, find-ing the personal touch one of many reasons he has made Disney his choice for careers.

“all 60,000 cast members have a com-mon goal,” he said. “We align ourselves with our guests’ expectations. We create happi-ness for them.”

During the past 20 years, Matheis has climbed out from the reservation center to the floor as a

business program facilitator and content specialist for the Disney Insti-

tute. He has a passion for the “Disney

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Save The Child Westerville Communications received an award recognizing compliance with NCMEC dispatch criteria.

All About The magic Mark Matheis gives Disney’s secrets for keeping guests coming back time and time again.


First there was the Medical Priority Dispatch System™ (MPDS®), covering the emergency medical side of public safety. Then fire burst through the door, followed closely by police.

Does the progression of protocols sound like a scene taken from your communica-tions center?

That very well could be the case with MPDS surpassing the 3,100 mark in centers

using the medical protocol in 37 countries. More than 350 centers use a combination of the fire and police protocols, in addition to the medical protocols.

The Fire Priority Dispatch System™ (FPDS™) is one of the hottest protocol sys-tems going, with 308 centers relying on the 25 scripted protocols literally at the finger-tips of trained and certified emergency fire dispatchers (eFDs).

Salt lake City (utah) Fire Department Deputy Chief logistics/Support Brian Dale said FPDS puts dispatchers in the driver’s seat of managing fire response, much the same way MPDS does for medical response and the Police Priority Dispatch System™

(PPDS™) does for law enforcement.“eFDs hold the pivotal role of manag-

ing fire incidents,” said Dale, who chairs the national academies of emergency Dispatch® (naeD™) Board of accredi-tation. “Their use of protocol—the interrogation through Pre-arrival Instruc-tions—decreases the potential for loss of life prior to on-scene arrival of trained fire suppression personnel.”

Just take a look at a prime example of the FPDS in action from the files of Prince George’s County (Md.) Public Safety Com-munications. eFD latica Reeves had com-pleted her FPDS training only a few weeks before answering a call in September 2008 from a woman trapped on the second floor in a house fire. Smoke was filling the hall out-side the room, and she was terrified for the life of the grandchild she held in her arms.

“oh man, I got the baby,” the caller cried. “I can’t carry the baby.”

Reeves kept them calm, providing them with the PaIs to protect against deadly smoke inhalation until help arrived directly to the scene. Six minutes into the call, firefighters arrived. The grandmother and her grandson survived. Reeves credited the FPDS for giving her the ability to “tell the grandmother what to do before help arrived.” (The Journal of Emergency Dispatch, March/april 2009).

FPDS gets its startIn the later 1990s, it was becoming more

common for multi-discipline centers using the MPDS to inquire “Why not?” to a fire or police protocol system. Jeff Clawson, M.D., inventor of the MPDS introduced in 1979, recalls one center manager giving him the following rationale: “The phone rings on a medical call. I put on my medical hat and I

have approved eMD training, certification, structured protocols with PaIs, formal Qa, CDe, and accreditation to ensure I am con-sistently excellent. The next call comes in. I change to my fire hat, and I have none of the above. It’s a free-for-all. Can’t the acad-emy do something?”

Philosophical compatibilityThe naeD, in conjunction with Pri-

ority Dispatch Corp.™ (PDC™), coalesced dozens of fire suppression and fire dis-patch experts, who spent several years in Standards Council research and devel-opment prior to unveiling FPDS version 1.0 at navigator 2000. The first training course, held concurrent with its release, stressed philosophical compatibility with MPDS. The standardized fire protocol shared the features that made MPDS the worldwide dispatch leader; after all, FPDS had the foundation of 20 years of MPDS work and experience from which to build on for a blueprint, plus the expert Stan-dards Council process, to create the first FPDS system.

“We were keeping with a unified pro-tocol approach,” Dr. Clawson said. “you have Case entry, Key Questions, Response Determinant Codes, and Pre-arrival Instructions in a configuration that works for fire emergencies as much as it did for medical emergencies.”

There are also comprehensive quality assurance requirements to monitor opera-tions and personnel associated with MPDS and FPDS use and, when necessary, improve the components through additional training and education. Dispatchers must be naeD certified, and agencies are encouraged to achieve the status of a naeD accredited Center of excellence, or aCe. Dauphin County emergency Management agency in Steelton, Pa., became the first naeD fire-accredited center in april 2004; Metro/nashville emergency Communications Center in nashville, Tenn., is the 16th and most recent fire-accredited center, having earned the title in april 2010.

Equal with slight variationThe protocol’s nuances include fire’s

typical “go now” response. For example, the eCHo level in fire protocol allows early recognition and response initiation based on specific high-priority situations such as a person on fire. In a harrowing situation like this, the dispatcher immediately transi-

Fighting Fire With Protocol. FPDS gives dispatchers the edge in

managing response and safetyB y A u D R E y F R A I z E R


“on Qa I’d hear dispatchers applying ‘if it's safe to do so’ on calls that weren’t medical,” he said. “It was interesting. Good habits rub off.”

Positive forcePiper attributes the smooth transition to

the positive reaction by field responders—“always a good thing,” he said. Because of the FPDS protocol, responders arrive at the scene with information about people that may be trapped in the burning building. The potential for rescue increases and work to extinguish the fire commences more rapidly.

The training eFDs now receive focuses on asking Key Ques-tions, which assist dispatchers in under-standing the situation to make better critical decisions based on that information. The PaIs provide advice to the caller, whether it’s getting away from the building or attaining a safer location. The key words “If it’s safe to do so” prefacing the PaIs for a structure fire are scripted to safeguard lives while those trapped await help to arrive.

a s T h o m p s o n explained, many fire departments use fire-fighters (even those new to the department) to both dispatch and rescue; however, firefighting is different from dispatching. Maybe that’s overstating the obvious, he said, but firefighters are trained to fight fires.

Training typically revolves around enter-ing the burning structure and working as a crew to rescue occupants and suppress the fire. Rescue operations for firefight-ers depend on making the scene as safe as possible for patients, bystanders, and the firefighters. as compared to the non-visual environment of the emergency dispatch center, the hands-on training firefighters receive may even work against them in that environment. Their world depends on a

visual survey; they’re hands-on with what they can see.

“People mistakenly think that by virtue of their training they know (over the phone) how to help a person stay safe in a burning building or getting out of one,” Thompson said. “They’re not dispatchers. They’re not really trained for that. It’s a completely different dynamic.”

In many ways, the fire protocol lets eFDs take on the important role of logistics coordination, Dale said.

“With all that’s going on during a fire, it’s easy to see how chaos can result without coordination,” he said. “The protocols give eFDs the power and confidence to system-atically process emergency calls.”

and as Dr. Clawson states, “no reinvent-ing the wheel every time the phone rings.”

more to FPDS than fireBut there’s more to the FPDS than

fire emergencies. For example, the arrival of spring spelled adventure for a child in Boone County. Confidence, as they say, was something the boy had until fully under-standing the situation.

“He got stuck in a tree he was climbing,” Piper said. “It’s when something like this hap-

pens that protocols are particularly important. We had a tool put together by experts to help in a situation that doesn’t often occur.”

version 5 of the fire protocol, released in october 2009, was the most extensive revi-sion to the FPDS in the past six years. naeD member users in centers using fire protocol worldwide submitted more than 200 Propos-als for Change in line with changing fire stan-dards, research, and technology. The protocol addressing bomb threats/suspicious pack-

ages was expanded to cover biological threats made through the mail in response to the anthrax biot-errorism scare. The train protocol was split into two proto-cols depending on the type of incident—derailments/colli-sions and fires. new PaIs have been added for callers trapped in tunnel fires, trench collapses, structure collapses, confined space entrapments, and those encoun-ter ing suspicious packages (suspected contamination) and b o m b s / p o t e n t i a l explosives.

S e r v i c e c a l l s added to Protocol 53 specify the reason for the call, such as bee swarms or pets caught in traps on

public lands, to track the type of service calls an agency runs and how often.

Dornseif said FPDS v5 essentially makes the protocol more user friendly.

“This new version incorporates faster dispatch points, new Pre-arrival Instruc-tions, and new protocols with more than 40 new descriptors, allowing agencies to continue dispatching the right resources at the right time,” he said.

Thompson said the real substance of protocol rests many times with the caller.

“It will take average people and prevent them from doing something that shouldn’t be done, something that very well could bring them or someone else into harm’s way,” he said.

tions from the standard script configuration to the “send” response and then returns to the designated sequence of interrogation.

In comparison, the MPDS initiates early response in situations involving noT BReaTHInG or IneFFeCTIve BReaTHInG, in contrast to fire response.

“The fire protocol does it much more often when earlier dispatch is necessary,” said Mike Thompson, naeD Fire Stan-dards Council member and Fire Cur-riculum chair. “It’s one of the features that distinguishes fire from the medical protocol.”

PDC Fire expert Jay Dornseif cites the “blanks” in FPDS, unlike anything found in the MPDS or PPDS. The blanks provide space for special definitions, response configurations, and apparatus response to the scene.

“They’re [the blanks] in the protocol for very good reasons,” Dornseif said. “They give departments the lee-way they may need in their particular response.”

Special Definitions are assigned by local fire administration and fire officials must approve them. The first Special Definition appears on the aircraft emergency Pro-tocol (51) and the definition calls for the fire service to distinguish between large and small aircraft. FPDS v5 includes spe-cial definitions for service calls, large brush/grass fires, large and small floodwaters, and body recovery.

“The service call definition was not an option in the past, but one I looked forward to when we decided to add it to the FPDS,” Dornseif said. “It allows fire departments to

add their own, ones they respond to though other departments may not.”

The response configurations and mode assignments are the decision of the local fire and emergency services administration. The fire service pre-assigns every Determi-nant Code based on in-house resources. These assignments dictate what the actual response should be when the emergency Fire Dispatcher (eFD) receives the call.

Responses based on types of appara-tus can include engines, ladders, towers, platforms, trucks, squads, brush trucks, and tankers or tenders, depending on local assignment. Many protocols require the use of special apparatus such as fireboats, foam units, Hazmat units, and confined space and/or structure collapse equipment.

The fire protocol also includes a greater number of suffix codes to delineate the type of problem for specific response and safety purposes. For examples, the H suffix

delineates a HaZMaT situation; the S suf-fix delineates smoke odor; and the Z suffix delineates a situation compounded by both HaZMaT and smoke odor.

Finding a common nomenclature was an exception unique to fire protocol dur-ing the cultural/international develop-ment phase.

“What one organization calls a lad-der truck in one region can be completely

different in another place,” Dr. Clawson said. “In keeping with a unified protocol approach, we had to arrive at terms that would be meaningful for everyone.”

Just the ticketThompson wasn’t part of the com-

mittee developing the protocol although he certainly anticipated its release. The Rapid City (S.D.) Fire Department, where Thompson now serves as battalion chief for the medical section, had been using MPDS for nearly a decade. at that time, Rapid City was providing fire dispatch at about the same level as other fire departments locally and nationally.

“We had a brief set of guidelines—not comprehensive—and nothing in the way of PaIs, except to tell people to get out of the burning house,” said Thompson, a veteran firefighter and paramedic. “What we had was really inadequate.”

Their dispatch-ers welcomed the transition, Thomp-son said, and they were adept at mak-ing the leap from fairly slack guide-lines to a standard-ized, structured protocol.

Joe Piper, manager, Columbia/Boone County (Mo.) Joint Communications, said the same about the transition for their dis-patchers, which he attributes to the use of the MPDS since its 10.3 release in 1998. Dispatchers were “unconsciously compe-tent” during police and fire calls because of their confidence with medical protocols prior to the introduction of the respective protocols at the center.

THE NATIONAL ACADEMY

Fire Priority Dispatch System

© 2003 Priority Dispatch Corp.

139 E. South Temple, Suite 500, Salt Lake City, Utah 84111

United States of America

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FPDS puts dispatchers in the driver’s seat of managing fire response, much the same way MPDS does.

Fire Evolution Similarity in outside appearance throughout the years defies the changes to a fire protocol system now used by more than 300 agencies.

FPDS ™ v2-5, NAE-std. © 2000–2010 PDC.

38 THE JOURNAL | emergencydispatch.org THE JOURNAL | March/april 2009 39

Matt Roberts is a full-time farmer work-ing the same land he has lived on all his life in rural northern Indiana. In 2008, he obtained a master’s degree from Purdue university Department of agriculture and Bioengineer-ing, hoping to do something positive for the agricultural industry, which ranks among the top three most hazardous occupations in north america. Today, Matt is a lexicon of information when it comes to farm safety.

“I wanted to do something that would help farmers,” said Roberts, who also travels the state as a part-time farm outreach coor-dinator for Purdue university. “I’ve been around farms all my life and know what can happen.”

Roberts hasn’t suffered a major injury on the farm, although there was the time he was nearly entangled in a sweep auger, an extended spiral-shaped arm that sweeps grain circularly within a bin, which was moving around the floor of the bin while he was cleaning out the remaining corn. The incident wasn’t one he talked about, and was almost forgotten until Roberts was researching grain bin accidents for William Field, a Purdue university Cooperative extension Farm Safety Specialist who main-tains a database of such incidents.

Tracking the dataField, an undisputed expert in entrap-

ment cases occurring in loose agricultural material, inherited the national Grain entrapment Database in 1977, which, at the time he arrived, was a pile of local and regional newspaper clippings dating back to 1964. Field entered the news into an elec-tronic archive and regularly updates it using newspaper articles, Internet searches, and

g firecde

g FirE CDE g uniVErSAL CDE

OnTrackTrapped by Grain. Farming bins present hazards unseen

national morbidity and mortality statistics. Research based on the collection is used to design injury-prevention strategies, includ-ing educational materials and recommenda-tions for engineering controls focused on primary causes.

“We don’t claim comprehension,” said Field, who runs a farm in Tippecanoe County in northwestern Indiana. “But we do have the largest collection of docu-mented evidence I know of in the world.”

During the past 33 years, Field and graduate assistants, like Roberts, have documented and entered nearly 800 fatal and non-fatal grain entrapment cases into the national Grain entrapment Database. The highest number they recorded was 42 in 1993, which was followed by a five-year average decrease from 29.2 entrapments per year to 18.8 in 1998 (the lowest since 1987), according to a study compiled by Roberts and Field. numbers since 1998, however, have increased steadily to 28.4 incidents per year in 2008 and 31.2 in 2009, representing an increase of nearly 66% dur-ing the course of a decade. States with the highest documented fatal and non-fatal grain entrapments in 2009 were Minnesota (nine) followed by Iowa, Illinois, and Indi-ana (each with five); overall, 42% resulted in death. of these statistics, yellow corn was the primary medium of entrapment.1

Field expects the statistic to stay near the same level in 2010 because of the simi-larity in weather conditions anticipated again this year in the Midwest.

Flowing grain presents greater hazardGenerally, stored grain presents few haz-

ards, but flowing grain increases the risk of entrapment and suffocation. That’s because people can’t compete against the force of grain flowing from high-capacity loading and unloading systems. Combines pushing several bushels a minute can quickly bury someone in a grain truck or trailer.

Roberts cites moldy or otherwise out-of-condition grain as a secondary cause behind grain entrapment. Spoiled grain can plug flow, requiring the farmer or worker to enter the bin to break up the clog. once the clog is fixed, the grain flows, and once again, entrapment becomes a real threat.

In addition to these factors, for the past two years, weather conditions have played right into the hand of potential disaster. The 2009 crop harvest was record in size, according to united States Department of

agriculture (uSDa) figures—13.15 billion bushels of corn and 3.36 billion bushels of soybeans. Due to the mere abundance, these crops were harvested under less than ideal conditions. In addition, demand for ethanol made from domestic corn resulted in the build-up of larger storage capacity for lon-ger periods of time, which also explains the shift to a higher percentage of entrapment at commercial bins compared to incidents in bins owned by farmers.

anytime inside a bin, workers risk the possibility of becoming entrapped by grain when a horizontal bridge of crusted grain collapses or if an avalanche of a vertical

grain wall occurs. These types of events can be related to neglect to precautionary mea-sures due to complacency, Roberts said.

“There are instances when you have to go in storage structures, and most farmers are in and out of their bins at least a half dozen times a year leveling off for air flow, sampling grain, or evaluating the quality of grain,” he said. “They don’t always do things right with all the precautions.”

Field recommends keeping the grain dry, at moisture content of no higher than 14%. Roberts said they use a buddy system, mak-ing sure someone is standing outside the bin while someone is inside; associated equip-ment is turned off and shut down.

“It’s always good to have someone watching,” he said.

Calling 9-1-1While not all entrapments are fatal, the

trend is increasing unlike many other types of farm-related injuries. The records are also probably from 20–40% below actual figures because of the lack of a comprehen-sive reporting system and a reluctance to report partial entrapments. Farmers aren’t likely to share their stories or even call 9-1-1 for emergency assistance. In some locations, 9-1-1 is not a standard service, but for the

most part, farmers don’t call 9-1-1 because of the pride they take in self-reliance.

“We tell them it’s not an embarrassment to call 9-1-1,” Field said. “It won’t cost more and response will take less time than taking someone to the hospital from the back of a pickup truck.”

Mike Reschny, Saskatoon (Saskatch-ewan, Canada) Fire and Protective Services communications training coordinator, said dispatchers use the Fire Priority Dispatch System™ (FPDS™), Protocol 54: Confined Space/Structure Collapse, when dealing with the unstable environment that char-acterizes the loose grain. although grain

entrapment calls are low volume, the call-takers continuously train in anticipation of farming accidents; Saskatchewan grows 45% of Canada’s grain crops.

“We’re very geared toward agricultural rescue,” he said, “as this is a high call poten-tial in our province.”

Reschny said an emergency call com-ing in for grain entrapment demands a very specific location and directions for reaching the site, no matter if the bin is located on a farm, a rural field, or in a massive commer-cial grain complex.

“Try finding a store in a mall without knowing the best access,” he said. “We need to know the location within the location.”

Salt lake City Fire Department Deputy Chief (logistics/Support) Brian Dale said the eFD’s hardest, but most important, task is to maintain order on the scene prior to field unit arrival. Similar to the situation of grain entrapments, statistics from the occu-pational Safety and Health administration (oSHa) show that most deaths caused by trench cave-ins are would-be rescuers killed in failed attempts to rescue buried or par-tially buried victims. The eFD’s job is to instruct the caller to prevent further risk or injury.

“The eFD can do this by preventing

By Audrey Fraizer“We don’t claim comprehension, but we do have the largest collection of documented evidence I know of in the world.” –William Field


a bystander from doing something that turns an already bad situation into a fatal one—for either the bystander or an already-trapped victim who may still be alive,” he said. “With that in mind, the emergency dispatcher’s first rule is ‘Don’t take more victims to the scene.’”

Post-Dispatch Instructions (PDIs) include turning off and locking out power controls to unloading conveyers and all other equipment, except the ventilation system. Dispatchers warn those on-site not to reenter the area because of dangers asso-ciated with flowing grain. anyone else in the bin is instructed to leave immediately without collecting any of the victim’s tools since they may serve as clues to the location of the trapped individual.

Reschny said rescue response configu-rations and firefighter efforts are tailored toward incident specifics.

“It’s crucial to get the right equipment and crews to the right location, and not just a quick response,” he said.

rescue approachesThe most common rescue attempt

involves using a cutting torch, metal-cutting power saw, or air chisel to cut at least two v- or u-shaped holes on opposite sides of the bin, equally spaced around the bin below the level of grain. The bin could collapse if only one hole is made to release the flowing grain.

The field commander might decide the best approach is entering the bin to place a retaining structure around the person. If that’s the case, firefighters equip themselves to rappel in from the top of the bin wear-ing a harness tethered to a lifeline, which is secured to a weight-bearing point. a second firefighter handles the rappelling lines from the outside. If the grain is spoiled, respira-tory protection may be worn to protect the firefighter inside the bin from inhaling air-borne mold spores.

once down inside the bin, a retaining wall is formed to keep grain from flow-ing toward the person; the grain is then removed from around the individual. Removing grain without the use of a retain-ing wall is counterproductive since during unloading, grain flows downward from the top center of the bin, creating a funnel effect that draws material and objects down the auger.

Roberts said under no circumstances should anyone attempt to yank a person out from the flowing grain.

“The pressure on the body from the grain is tremendous,” he said. “Pulling on that person risks all sorts of injuries, includ-ing spinal cord separation.”

But, like most things, it’s not easy for people to accept even potentially life-saving information that might be contrary to the lessons taught by preceding generations. on top of that, even the new farming genera-tion might prefer doing things their way—or the way of the community—as opposed to the approach of a first responder.

and that, Field said, is when disagree-ment often arises.

“There’s a different understanding,” he said. “The farmers work in the bins all the time and don’t think the industrial approach firefighters take is the right one.”

Focus on preventionField prefers to concentrate on improv-

ing communication. He tends to have farm rescue forums at teachable moments—soon after an accident occurs—and takes non-farming first responders on farm tours to better orientate them to farming hazards. He stresses education, prevention, and training. He and Roberts also recommend appropriately designed storage facilities, proper use of protective equipment, and implementing safe work practices.

Roberts said taking steps to prevent an incident from occurring is key.

“There’s been a lot of focus on rescue, but rescue doesn’t keep the entrapments from happening,” he said.

The number of victims of grain bin entrapment accidents is relatively small in

comparison to statistics from the national Safety Council showing an annual loss of 1,300 lives in addition to 120,000 injuries as a result of accidents on the farm. But the incident is no less agonizing for the family involved.

Marilyn adams began a campaign to promote farm safety awareness and educa-tion after her 11-year-old son Keith algreen suffocated in a gravity flow wagon of shelled corn on the family’s Iowa farm. one year after his death in 1986, she started Farm Safety 4 Just Kids to prevent similar acci-dents from happening to other families. next year she looks forward to celebrating the organization’s 25th anniversary.

Farm Safety 4 Just Kids has since grown to include all types of potential farm hazards, including livestock, aTvs, and chemical accidents. age-appropriate materials focused on prevention—includ-ing a toy grain wagon demonstrating the power of flowing grain—are distributed through 130 chapters in the united States and Canada.

Tracy Schlater, marketing director and one of five full-time employees, said the organization keeps up-to-date on farming issues, revising materials as times change.

“Twenty-five years ago there wasn’t the aTv problem we’re seeing today, and many chapters were started because of these types of accidents,” she said. “The families want to keep it from happening to others.” g

Source 1 Roberts M, Field W. “Summary of Grain entrapments in

the united States.” Agricultural Safety and Health Program,

Purdue University. lafayette, Ind. 2010: March.

g A 63-year-old man was helping his cousin load corn into a wagon in West Allis, Wis. He was trying to break a bridge—a clump or crust of built-up corn—with a metal rod when it collapsed beneath him. He was pulled into 30,000 pounds of corn and suffocated

g A 35-year-old farmer was found buried under approximately 25 feet of corn in Mount Aubern, Iowa. He had been working alone, moving corn from a converted silo into a grain dryer. He had apparently fallen into the grain while attempting to dislodge bridged grain with a length of angle iron while the grain auger was still running.

g A 32-year-old man was found dead beneath 60,000 bushels of corn on his family's farm in Minnesota. He was loading trucks from a grain bin and had gone into the bin to check for clumping. He apparently got caught in the flow of corn and was buried beneath it.

g A 52-year-old farmer died while making repairs inside a grain bin in Manning, Iowa. He apparently suffocated when he fell through bridged material and was buried in the grain.

g Three men were attempting to restore the flow of corn in a clogged 30,000-bushel corn bin in Iowa. After climbing one-by-one on top of the grain in the bin, the surface on which they were standing collapsed into a hollow pocket below, burying them. One worker was able to escape and call authorities, but attempts to rescue the other two workers were unsuccessful. The auger had been turned off when the incident occurred.

g A 27-year-old man from Brazilton, Kan., suffocated when the grain at the top of a milo bin collapsed under him as he was trying to break up clumped grain.

g A 30-year-old man from Redfield, S.D., suffocated in a corn bin. He and his brother were having trouble emptying a 20,000-bushel bin because of wet corn. When he went inside the bin to fix the auger, he was sucked down into the corn and completely covered. He had a safety rope tied around him at the time.

g A 75-year-old Admire, Kan., man suffocated in a 20-foot bin. He apparently fell while trying to loosen grain at the top of the bin. g

Answers to Ask the Doc quiz on page 51. Severe hypovolemia due to dis-

secting/ruptured aortic aneurysm2. Diabetic hypoglycemia3. Brain tumor with early intracere-

bral hemorrhage 4. Bacterial meningitis

5. Drug abuse in a mentally unstable patient

6. acute phase of Wernicke’s encephalopathy (thiamine vitamin B1 deficiency)

7. PCP ingestion 8. embolic stroke

Seeing The Dangers Farm Safety 4 Just Kids teaches children about ways to prevent hazards, including entrapment in bins.

1. Engulfment in a Flowing Column of GrainEntrapment or suffocation most often occurs when an individual enters a bin during the unloading process and is drawn into a flowing column of grain. As the bin empties out the bottom, a rapidly moving column of grain forms over the outlet. This vertical column of grain acts somewhat like a fluid, and it flows down through the grain mass at nearly the rate of the unloading auger. The rate of flow at the center top of a bin is so great that once a person is trapped in the flow, escape is impossible. Once engulfed in the flow of grain, the victim is rapidly drawn to the floor of the bin.

2. Collapse of horizontal Crusted Grain SurfaceEntrapments and suffocations are pos-sible when an individual enters a bin in which the surface of the grain has become caked because of wet grain, molding, or spoilage. The surface appears solid, but can, in fact, be a thin crust concealing a void that forms as the grain is removed. The victim breaks through the crust and is quickly covered by the avalanche of grain collapsing into the cavity. Often the unloading equip-ment is still operating, which causes the victim to be pulled even deeper into the grain mass.

3. Collapse of Vertical Crusted Grain SurfaceOn occasion, farmers have been buried beneath a collapsed wall of freestanding grain. Dry grain in good condition will pile at a 30-degree angle, but spoiled or caked grain can stand almost verti-cal. As grain is removed from the base of a caked mass, the potential for an avalanche and engulfment increases. This type of engulfment can also take place inside bins where the spoiled grain is clinging to the bin walls. Attempt-ing to remove these chunks of grain from below by using a long pole can be extremely dangerous.

4. Entrapment or Suffocation in Grain Transport VehiclesThe risk of engulfment is also present around any grain transport vehicle such as wagons and trucks. With the high-volume capacity of many on-farm stor-age facilities, it is not difficult to imagine someone being covered over in seconds during an unloading operation. Many of the victims of this type of suffocation, historically, have been children. g

Flowing grain entrapments fall into four primary categories:

Data available from the Kansas Farm Bureau database includes the following grain bin entrapment incidents from the past five years:


g universalcde

remain in Control. Protocol provides help for runaway vehicle

California Highway Patrol officer Mark Saylor was off duty, driving with his wife, daughter, and brother-in-law to his daugh-ter’s soccer game on the evening of aug. 28, 2009, when the unthinkable happened. The lexus sedan Saylor was driving on loan from the dealership—where his own car was in the shop—wouldn’t slow down.1

Saylor’s brother-in-law, Chris lastrella, apparently had access to a cell phone, which he used to call 9-1-1. “We’re going north (state route) 125 and our accelerator is stuck. We’re going 120 (mph). Mission Gorge. We’re in trouble. We can’t, there’s no brakes. Mission Gorge. end freeway half mile.”

“and you don’t have the ability to like turn the vehicle off or anything?” the dis-patcher asked.

lastrella didn’t reply, instead telling the dispatcher that they were approaching the intersection of Mission Gorge Road.

over the phone came their cries, “Hold on. Pray. Pray. oh shoot. oh, oh.” Then the line went dead. The call for help had lasted just less than a minute. The lexus had hit the rear of a Ford explorer at the intersec-tion. It went over a curb and through a

fence before hitting an embankment and going airborne. The sedan hit dirt in the San Diego River basin and rolled several times before bursting into flames. all four occu-pants were killed instantly.1

What happened?The accident was blamed on sud-

den acceleration, which a 1989 national Highway Traffic Safety administration (nHTSa) report defines as “unintended, unexpected, high-power accelerations from a stationary position or a very low initial speed accompanied by an apparent loss of braking effectiveness.”2 The organization said a typical incident begins at the moment the driver shifts to drive or reverse from park, and, based on reports, it’s more likely to happen with automatic transmissions.

Sudden unintended acceleration (Sua) isn’t a new phenomenon; however, it has gained renewed attention because of recent incidents, like what happened to the occu-pants in the Saylor’s rental car. Sua reports actually go back more than 20 years, and the debate of its cause has yet to be settled.

is it the driver?Richard a. Schmidt, a professor emeri-

tus of psychology at the university of

California—los angeles, determined through research conducted in the 1980s that drivers pressing the gas pedal instead of the brake often cause Sua.3 He based his findings on more than 150 cases involving the audi 5000 and found the problem typi-cally occurred when the driver entered the vehicle and started it. The driver, intending to press lightly on the brake pedal, would accidentally hit the gas instead while shift-ing from park to drive or reverse, forcing the car to leap forward or back. The car wouldn’t stop until it crashed.

It’s not a matter of driver confusion or ineptitude, Schmidt said. The limbs don’t always follow the brain’s instructions of what to do. neuromuscular processes can cause the driver’s foot to change course.3 When the vehicle unexpectedly acceler-ates, the driver typically panics and keeps pressing hard on the “brake” without trying to shut off the ignition, shift to neutral, or engage the parking brake.

according to engineering reports, the size of the vehicle or its cost mattered little, and the same goes for the absence or pres-ence of cruise or electronic engine control. The one variable in common was all cars had automatic transmissions. nHTSa couldn’t find any electro-mechanical defects

By Heather Darata

CDE-Quiz Fire Answers to the CDE quiz are found in the article “Trapped by Grain,” which starts on page 38. Take this quiz for 1.0 CDE unit.

1. Agriculture is among the top three hazardous occupations in North America.

a. trueb. false

2. The National Grain Entrapment Database documents:

a. fatal cases of grain entrapment.b. non-fatal cases of grain entrapment.c. fatal and non-fatal cases of grain entrapment.

3. The state with the highest documented cases of grain entrapment in 2009 was:

a. Arkansas.b. Indiana.c. Minnesota.d. Iowa.

4. The primary grain causing recorded entrapments in 2009 was:

a. soybeans.b. barley.c. wheat.d. yellow corn.

5. Which one of the following grain conditions increases the risk of entrapment and suffocation?

a. stored grainb. flowing grain

6. Actual cases of entrapment are probably greater than the numbers indicate because of:

a. a lack of a comprehensive reporting system.b. a reluctance to report partial entrapments.c. both a and b.

7. Which FPDS Protocol is used to address confinement because of grain entrapment?

a. 53: Citizen Assist/Service Callb. 54: Confined Space/Structure Collapsec. 58: Extrication/Entrapped (Machinery, Vehicle)d. 62: high Angle Rescue (Above or Below Grade)

8. The most common rescue attempt from grain entrapment involves:

a. pulling the victim out by the shoulders.b. shoveling the grain from around the victim, then pulling the victim out manually.c. cutting at least two V- or U-shaped holes on opposite sides of the bin, equally spaced around the bin below the level of grain.d. cutting one large hole in the bin to release the grain.

9. According to the National Safety Council, accidents on the farm cause an annual loss of how many lives?

a. 13 b. 130 c. 1,300 d. 13,000

10. Farm Safety 4 Just Kids focuses on preventing:

a. grain entrapment accidents.b. ATV accidents.c. accidents related to chemicals.d. all of the above.

$

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debate. “If the reports of acceleration continue (and the smart pedals work properly), then there will be nothing and no one left to blame but the driver.”6

using the new protocolSeveral factors must exist

for a person to call 9-1-1 dur-ing an Sua situation.

“It’s kind of like the per-fect storm,” said national academies of emergency Dis-patch® (naeD™) founder Dr. Jeff Clawson. “a phone must be available, along with a good signal for placing the call. There has to be time to call and receive dispatch instructions, a linear roadway space ahead, and, ideally, little traffic congestion.”

The call for help may be brief. The lastrella call lasted about 57 seconds; there was scarce time available for dis-patch instructions, but enough in this

case, given instant

access to a well-scripted protocol. a caller needs help immediately, which is what motivates the naeD’s development of the accelerator Stuck & Can’t Stop vehi-cle Protocol.

For an Sua call, the emergency dis-patcher should bypass Case entry interroga-tion and go immediately to the accelerator Stuck & Can’t Stop vehicle Protocol. If using manual cardsets, the tab card is best placed behind the Case entry additional Information. ProQa® users can access the protocol by opening up ProQa in CaD and clicking on the accelerator Stuck (stop sign) button.

The accelerator Stuck & Can’t Stop vehicle Protocol follows a panel-logic sequence format, the same scripted meth-odology used in Pre-arrival Instructions (PaIs); the dispatcher is guided through the panels based on the caller’s answers.

Panel 1 starts with the most obvious and effective message: instructing the driver to shift into neutral, giving separate instruc-tions for automatic and manual transmis-sion vehicles. Panel 2 provides additional instructions for a driver who has an auto-matic transmission vehicle and was unable

to shift into neu-tral fol-lowing Panel 1 instruc-t i o n s . I f t h e driver of either an automatic or manual transmis-sion vehi-cle is still unable to s h i f t i n t o n e u t r a l , t h e n t h e d i s p a t c h e r m o v e s t o Panel 3, which p r o v i d e s instructions for turning off the engine. If the caller has a standard key i g n i t i o n , t h e dispatcher uses Panel 4 to tel l

the caller to “Turn the ignition key just one click back (aCC position) so that the engine shuts off but it doesn’t lock your steering wheel.” Turning the ignition to the aCC position puts the brakes and steering into manual mode. a start/stop button ignition requires slightly different instructions from Panel 5, describing the method of not just tapping the button, but firmly and steadily pushing it for at least three seconds until the engine completely stops.

once the vehicle is in neutral or the engine is turned to aCC, the dispatcher proceeds to Panel 6: “apply firm, constant pressure to your brake pedal, not all at once, until you come to a safe stop. Don’t pump the brake.” The driver is told to slow down and steer to the side of the road. The vehicle may end up, for example, on a free-way divider, traffic island, or median strip. It could be stopped on the active roadway, somewhat or completely off the roadway, on a hillside, bridge, or on the edge of an embankment or ravine.

once the vehicle is parked, the dis-patcher does not encourage its occupants to either remain inside or to exit. Instructions depend on the situation. The dispatcher proceeds to Panel 10 if the driver and pas-sengers decide to exit the vehicle; if they are staying inside the vehicle, the dispatcher gives the instructions from Panel 11.

Panel 12 lets the dispatcher gather all information about the exact location of the caller, passengers, and vehicle, which in most cases will have changed drastically for a vehicle traveling at a high rate of speed, covering a long distance. Panel 13 has the dispatcher collect a vehicle description for responder information. lastly, Panel 14 informs the caller that the dispatcher will remain on the line until help arrives. g

Sources1 Baker, D. “CHP release 911 call in officer’s fiery crash.”

Sign On San Diego. The San Diego union-Tribune. 2009; September 10. http://www.signonsandiego.com/news/2009/sep/10/bn10-911call-fatal-crash/?metro&zIndex=163775 (accessed april 2, 2010).

2 anderson, a. “a note on automobile cruise control faults and sudden acceleration.” http://www.antony-anderson.com/Cruise/5-sa.htm (accessed april 2, 2010).

3 Schmidt, R. “Braking bad.” The new york Times. 2010; March 10. http://www.nytimes.com/2010/03/11/opinion/11schmidt.html (accessed april 5, 2010).

4 See note 2 above.5 “Sudden unintended acceleration redux: the unresolved

issue.” Safety Research & Strategies, Inc. The Safety Record. 2009; June-July. http://www.safetyresearch.net/2009/07/20/sudden-acceleration/ (accessed april 6, 2010).

6 See note 3 above.

and in 1989 concluded that the inci-dents of Sua by the audi 5000 were most likely caused by pedal error.3

Perhaps audi took careful note of the studies because the company came out with an automatic shift lock that keeps the transmission in park when the vehicle is being started until the brake pedal is depressed. Despite the engineering redesign, adoption of automatic shift locks in almost all new vehicles by the mid-1990s, and a decrease in reported Sua incidents, studies show the problem hasn’t gone away. Sua continues to affect many makes and models of cars, buses, tractors, and golf carts.3

is it the vehicle?antony anderson, Ph.D., an electrical

engineering consultant and electrical expert witness who has examined many Sua crashes, believes forces beyond driver error may come into play. For example, nHTSa’s definition doesn’t consider incidents occur-ring when a vehicle is already traveling at an average speed.4 These include:

• suddenaccelerationfrom40mph–80 mph

• suddenunexplaineddeceleration

• speeddrift(increaseordecrease)inassociation with cruise control

• incipientornear-missincidentsduring which the driver stopped the vehicle by switching off the ignition or applying sufficient brake pressure

• intermittentfaultsthatdon’tleaveapparent traces

• allegedincidentsofsuddenaccel-eration in manual transmission vehicles

In addition, according to anderson, there are only two ways a throttle can open causing sudden acceleration from near standstill: 1) when the driver depresses the gas pedal to the floor (driver malfunction or “pedal error” hypothesis) or 2) when the cruise control servo or electronic throttle servo (in the case of an electronic throttle system) moves the throttle to the open posi-tion without the driver’s command (elec-tronic system malfunction hypothesis).4

anderson scoffs at the advocates who cite the lack of physical evidence such

a s a fa i l e d electronic component as

proof of driver malfunction. “In fact, ‘absence of proof is not proof

of absence,’” anderson said. “Intermittent electronic malfunctions do not necessarily leave permanent traces behind them after the event and may not be reproducible on demand.”4

additionally, if sudden acceleration and mechanical error are unrelated, the rate of sudden acceleration per 100,000 vehicles should be similar for all makes and ages of vehicles. The occurrence would be inde-pendent of make, model, year, transmis-sion style, cruise control, and electronic throttle control.4

But that isn’t the case, anderson argues. “This strongly suggests that whatever

the factors are that cause sudden accelera-tions are related to the vehicle characteris-tics rather than the driver,” he said.4

Which is it—vehicle or driver? Solutions take statistically supported

cause and effect, and for Sua that hasn’t happened. Most drivers who have lived through an Sua incident insist they are not to blame, but investigators are unable to duplicate conditions leading to a report or complaint. Simply put, it could be the vehicle or its driver that caused the sudden unintended acceleration.

Sudden Unintended Acceleration Redux: The Unresolved Issue, an article found in The Safety Record, examines design as a potential cause of driver error. These design features

might include floor mat interference, poor pedal place-ment, mechanical or electromechanical defects, and electronic defects.5

according to the article: “The latter—which is the most difficult to pin-point—is the more likely scenario due to increasing reliance on sophisticated computer-driven electronics. and yet, automakers and nHTSa behave as though it is perfectly rational to assume that electronics housed in the hostile automotive environ-ment—including the faulty detec-tion system—will always function as intended, and that malfunctions will be easily reproduced in a labo-ratory setting.”5

Without a consensus, what are the options? The obama administration is considering a policy requiring automakers to install smart pedals on new vehicles. The smart pedal would deactivate the vehicle’s accel-erator when the brake pedal is pressed. That way, the car can safely stop if its throttle is stuck open. If a driver’s feet are pressing both the accelera-tor and brake, only the brake would work. The mechanism would not come into play if the driver is pressing on the accelerator only.6

Schmidt said the smart pedal could answer the question under current

Protected by U.S. Patents 5,857,966; 5,989,187; 6,004,266; 6,010,451; 6,053,864; 6,076,065; 6,078,894; 6,106,459; 6,607,481

AMPDS® v12.0a, NAE-std, 100323

Exiting Car

If the car is not in a safe place and you must

get out, be very careful of passing traffic or

other hazards. Okay, turn on your hazard

lights. Now look carefully all around first,

then take your phone and get to a safer

place. Tell me when you think you are

completely safe.

10

a 12

Staying in Car

Turn on your hazard lights and wait for help

to arrive.

11

a 12

Exact Location

Okay, tell me exactly where you are now

(address, landmarks, mile marker, exit number, etc.).12

a 13

Vehicle Description

I need the description of your vehicle (color,

year, make/model, license, state/province, lights on

or off).

13

a 14

Stay on Line

Stay on the line with me, and tell me

immediately if anything changes for the

worse or if someone comes to help you. 14

End

Ac

ce

ler

ato

r St

uc

k &

Ca

n’t Sto

p Ve

hic

le

Accelerator Stuck & Can’t Stop Vehicle

CRITICAL ED INFORMATION

Q Some vehicles require pushing a button on the side of the shift handle with your thumb to allow shifting to neutral to work.

Q A standard key ignition must be turned off only as far as the ACC position, which shuts down the engine but not the lights and

accessories (like when you want the radio still on).

Q Turning off the ignition to the ACC position will change the brakes and steering to manual mode. They should still work, but

will be somewhat stiffer than normal (harder to turn and press the brake).

Q In no case advise them to remove the key from the ignition until the vehicle is stopped.

Q Do not encourage them to either exit the vehicle or remain in the vehicle.

Academy HiRISC Policy

The IAED considers any situation necessitating

the provision of these instructions to be an

extremely High Risk-Inherent Situation Case

(HiRISC), and believes that the trained Emergency

Dispatcher (certified EMD, EFD, EPD) or their agency,

making a good-faith attempt to provide these

instructions, should not be held responsible for

any bad outcomes. This should not be considered

a legal interpretation, but a strong official opinion

of the Council of Standards and the Board of

Trustees of the IAED.

For use under MPDS® license agreement only. Patent pending. © 2010 Priority Dispatch Corp. All rights reserved. AMPDS® v12.0a, NAE-std, 100323

Accelerator Stuck & Can’t Stop Vehicle Get Car into Neutral(Automatic transmission) Okay, shift into

neutral or “N” now.

(Manual/Stick Shift transmission) Okay, push in the clutch pedal first and shift into neutral or “N” now.

1

In Neutral a 6Unable to Shift a 2

In Neutral a 6Unable to Shift a 3

Can’t Shift (Automatic Transmission)Okay, put your foot on the brake first and then try shifting it into neutral again. (You may need to push the button on the side of the shift handle with your thumb to make it work.)

2

In Neutral a 6Still Unable to Shift a 3

Turn Off EngineListen, I’ll tell you how to turn off your engine. Do you have a standard key ignition or a start/stop button?

3

Standard Key a 4Start/Stop Button a 5

Standard Key IgnitionTurn the ignition key just one click back (ACC position) so that the engine shuts off but it doesn’t lock your steering wheel.Turning off the ignition will change the

power brakes and steering to manual mode. They should still work, but will be somewhat stiffer than normal (harder to turn and press the brake).

4

a 6

Start/Stop ButtonDo not just tap the start/stop button. You’ve got to push the button firmly and steadily for at least 3 seconds until the engine completely stops.Turning off the ignition will change the brakes and steering to manual mode. They should still work, but will be somewhat stiffer than normal (harder to turn and press the brake).

5

a 6

Slow and Stop CarApply firm, constant pressure to your brake pedal, not all at once, until you come to a safe stop. Don’t pump the brake. Carefully slow down and steer to the side of the road. Tell me when you are stopped or if anything else happens.

6

Stopped a 8

Not Stopped Completelya 7

Not Stopped CompletelyTry to get the car stopped as best you can. Tell me when you are stopped or if anything else happens.

7

Stopped a 8Repeat/Reassure

9 Safety InstructionsAre you parked in a safe place now?

9

Staying in Car a 11

Exiting Car a 10

* Do not encourage them to either exit the vehicle or remain in the vehicle.

Ac

ce

ler

ato

r St

uc

k &C

an’t S

top V

eh

icle

StoppedAre you completely off the road?(Automatic transmission) Okay, keeping your foot on the brake, shift into park or “P” now. Turn the ignition off completely now.(Manual/Stick Shift transmission) Okay, apply your emergency brake now. Turn the ignition off completely now.

8

Engine Off a 9

MPDS® v12, NAE-std. © 1979–2010 PDC.


CDE Quiz Mail-In Answer SheetAnswer the test questions on this form. (A photocopied answer sheet is acceptable, but your answers must be original. Please do not enlarge.)

Within six weeks, you will receive notification of your score. Once processed, a CDE acknowledgement will be sent to you. (You must answer 8 of the 10 ques-tions correctly to receive credit.)

Clip and mail your completed answer sheet along with the $5 NON-REFUNDABLE processing fee to:

The National Academies of Emergency Dispatch139 East South Temple, Suite 200Salt Lake City, UT 84111 USA (800) 960-6236 US; (801) 359-6916 Intl. Attn: CDE Processing

Please retain your CDE acknowledgement to be submitted to the Academy with your application when you recertify.

Name _________________________________

Organization ____________________________

Address _______________________________

City________________St./Prov. ____________

Country__________________ZIP ___________

Academy Cert. # _______________________

Daytime Phone ( ) ___________________

E-mail: _________________________________

PRimARy FUNCtiON

Public Safety Dispatcher (check all that apply)

_____Medical _____Fire _____Police

Paramedic/EMT/Firefighter

Comm. Center Supervisor/Manager

Training/QI Coordinator

Instructor

Comm. Center Director/Chief

Medical Director

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Other

ANSWER SHEETMay/June Journal 2010 VOL. 12 NO. 3 (Remain in Control) Please mark your answers in the appropriate box below.

1. o A o B o C o D

2. o A o B o C o D

3. o A o B

4. o A o B o C o D

5. o A o B

6. o A o B o C o D

7. o A o B

8. o A o B o C o D

9. o A o B

10. o A o B

CDE-Quiz Answers to the CDE quiz are found in the article “Remain in Control,” which starts on page 43. Take this quiz for 1.0 CDE unit.

1. The National highway Traffic Safety Administration (NhTSA) produced a report about sudden acceleration in what year?

a. 1988b. 1989c. 1999d. 2000

2. NhTSA defined sudden acceleration as:

a. unintended, unexpected, low-power accelerations from a stationary position.b. unintended, unexpected, high-power accelerations from a stationary position or a very low initial speed accompanied by an apparent loss of braking effectiveness. c. unintended, unexpected, high-power accelerations from a stationary position or a very low initial speed.d. unexpected, high-power accelerations from a stationary position or a very low initial speed accompanied by an apparent loss of braking effectiveness.

3. Sudden unintended acceleration (SUA) is a new phenomenon.

a. trueb. false

4. Which company came out with an automatic shift lock that keeps the transmission in park when the vehicle is being started until the brake pedal is depressed?

a. BMWb. Toyotac. Audid. Chrysler

5. NhTSA’s definition doesn’t consider incidents occurring while a vehicle is already traveling at an average speed.

a. trueb. false

6. Design defects that could cause driver error include:

a. floor mat interference and poor steering wheel placement.b. floor mat interference, poor pedal placement, mechanical or electromechanical defects, and electronic defects. c. poor pedal placement and poor radio dial placement.d. mechanical or electromechanical defects, electronic defects, and steering wheel placement

7. The smart pedal would deactivate the vehicle’s accelerator when the brake pedal is pressed.

a. trueb. false

8. For a SUA call, the dispatcher should:

a. continue interrogating in Case Entry before using the Accelerator Stuck & Can’t Stop Protocol.b. continue interrogating in Case Entry before asking Key Questions on Protocol 29: Traffic/ Transportation Incidents.c. bypass Case Entry and begin asking Key Questions on Protocol 29: Traffic/Transportation Incidents before using the Accelerator Stuck & Can’t Stop Protocol.d. bypass Case Entry interrogation and go immediately to the Accelerator Stuck & Can’t Stop Vehicle Protocol.

9. The Accelerator Stuck & Can’t Stop Protocol follows a panel-logic sequence format, the same scripted methodology used in Pre-Arrival Instructions (PAIs).

a. trueb. false

10. Once the vehicle is parked, the dispatcher should encourage the occupants to exit the vehicle.

a. trueb. false

$

Expires 06/30/11

To be considered for CDE credit, this answer sheet must be received no later than 06/30/11. A passing score is worth 1.0 CDE unit toward fulfillment of the Academy’s CDE requirements (up to 4 hours per year). Please mark your responses on the answer sheet located at right and mail it in with your processing fee to receive credit. Please mark your responses on the answer sheet located to the right and mail it in with your processing fee to receive credit. Please retain your CDE letter for future reference.

YOU MUST BE CERTIFIED TO TAKE THIS QUIZ.THE PREMIER CONFERENCE FOR MEDICAL DISPATCH MANAGEMENT

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Questions?001 801 359 6916


Forty-seven years of marriage to earl Strickland was not something his wife Bon-nie was willing to give up without a fight.

especially, in this round, a fight pitting the feisty Florida couple against a ham and cheese sandwich.

It was late afternoon on March 8, 2010, and earl, who has trouble getting around inde-pendently since an accident last year, was eat-ing the sandwich at their daughter’s kitchen table. He and Bonnie were the only two at home. earl made a sound Bonnie couldn’t distinguish, and when she turned to give him her full attention, that’s exactly what he got.

earl was having difficulty breathing and, by the time Bonnie reached Charlotte County (Fla.) 911 eMD Bethann alexin, he

was turning blue in the face.“My husband’s choking to death,” Bon-

nie cried.and, to make matters worse, Bonnie had

her right arm in a cast from a recent acci-dental break.

alexin went to Protocol 11: Choking and immediately shunted to the Pre-arrival Instruction (PaI) that would assist Bonnie in dislodging the piece of sandwich she was sure was causing earl’s emergency. Moments into the call, earl slid from his chair onto the floor.

Bonnie was told to straddle his hips with her legs and to place her good arm just above his belly button.

“using your weight, push quickly into his stomach, oK,” alexin instructed Bonnie over the phone.

The first push into his stomach did nothing. The second push and alexin could breathe a sigh of relief.

“a piece of cheese came out,” Bonnie told alexin.

From there, the 64-year-old caregiver to her 72-year-old husband broke into tears and alexin heard earl’s whisper.

“He told her he loved her,” alexin said.

“That’s what she said when a Tv station interviewed them.”

Bonnie also confessed to almost giving up on earl.

“She had kissed him and told him good-bye,” alexin said.

earl was breathing and talking by the time eMS arrived, and alexin was able to release the call knowing the outcome would be in his favor.

In retrospect, alexin said it was prob-ably a good thing that earl had slipped onto the floor from his chair. lying down made it easier for Bonnie to dislodge the food using her weight rather than having to rely on only her good arm.

“I was so glad to be able to help them,” alexin said.

alexin, a Charlotte County dispatcher of two years, was honored in May with a “lifesaver award” from Charlotte County Sheriff Bill Cameron for helping to save earl’s life.

alexin said the award only adds icing to the cake.

“I love this job,” she said. “every day it’s something new.” g

g DiSPATCh in ACTiOn

yourspace

The morning hours of Sept. 26, 2009, brought a domestic call unlike any other eMD eleni Garrett, york County (Pa.) 911, had taken in nearly six years of dispatching.

“I could tell she (the caller) was upset just by her voice,” Garrett said. “She tried to tell me what was going on but he (the vic-tim’s boyfriend) took the phone from her. He hung the phone up on me. I thought oK, there’s something really, really wrong.”

Garrett asked her supervisor to trace the cell phone number while she tried to reconnect. The boyfriend hung up each time she tried.

Garrett took the GPS coordinates from the caller identification on her screen and ran a cleared call search using the phone number and coordinates. not only did she come up with an address but also a history of domestic violence at the residence. The cell phone company pro-vided a third verification.

“I had the same person on the phone,” she said.

Police were dispatched to the corre-sponding address and Garrett’s concern for the victim was confirmed several days later in an e-mail the woman sent to the center.

“I truly believe that I may not have made it, and if so I would have been in critical condition,” the victim said in her e-mail. “So thank you for what you did. you truly may have saved my life. Thank you all.”

Garrett was “blown away” by the thank you note, something that rarely happens.

“I probably would have wondered forever, ‘Did she make it? Is she oK?’” Garrett said. “It (the e-mail) brought a lot of closure.”

Garrett was recognized at a Dec. 2, 2009, york County commissioners meet-ing for exemplary customer service and teamwork. She was honored among other members of her center, including four dis-patchers and a supervisor commended for their roles in handling a baby delivery and an unsuccessful hanging. g

g disPatchinaction

Closing in Eleni Garrett used GPS coordinates to help locate victim of domestic violence.

Cry For Help. Dispatcher’s pursuit of hang-up call thwarts violence

No Contest. Broken arm doesn’t deter save using Heimlich maneuver

an award given during a birthday cele-bration may be the best gift Sydney Gifford, now 10, has ever received.

after all, the recognition presented was not only a big deal, but it also signified Syd-ney could make a difference, and this time it was in an attempt to help her mother through a medical crisis.

Sydney called 9-1-1 on Sept. 28, 2009, following the instructions her parents had repeated in case of an emergency, especially

now that her mother had recently under-gone surgery to remove a brain tumor.

“My dad told me that if she ever had a seizure just to call 9-1-1, and he’s not home right now,” Sydney said during the call.

allina Medical Transportation (Minn.) dispatcher Terri Hanson immediately put Sydney on a first-name basis, something the dispatcher rarely does.

“I broke my own cardinal rule,” Han-son said.

Hanson knew using first names could provide the reassurance Sydney needed. Her mother was in crisis, and Sydney was the oldest at home.

“I have three younger siblings, and they’re all bawling and I need help,” Syd-ney said.

Sydney answered Case entry Ques-tions leading to Protocol 12: Convul-sions/Seizures. Since the background commotion could further upset Sydney, Hanson suggested she send her frightened siblings to the window to watch for the ambulance to arrive.

“What can I do with these siblings?” Hanson recalled thinking. “I had to think outside the box.”

Hanson reassured Sydney multiple times and complimented her on her bravery. But when Sydney told Hanson that her mom was crying while still seiz-ing, Hanson had to work harder to keep it together.

“That’s pretty powerful to cry dur-ing a seizure,” Hanson said. “That’s when I started having tears run down my cheeks.”

Hanson told Sydney to let her mom know that they were taking care of her.

“Mom it’s going to be oK,” Sydney said. “nothing bad is going to happen.”

The communication didn’t end when responders arrived and Hanson discon-nected the call. a letter describing Syd-ney’s great job Hanson had wanted to send the family turned into a much larger occasion. Four months after the call, in January 2010, Hanson and others from allina Medical Transportation presented Sydney with an award at her 10th birth-day party.

“I’m glad we were able to take some-thing really traumatic to her and turn it into a good memory,” Hanson said. g

Dynamic Duo. Dispatcher and nine-year-old caller team up to get mom help

Star Performance Sydney Gifford accepts honors from dispatcher Terri Hanson.

50 THE JOURNAL | emergencydispatch.org THE JOURNAL | May/June 2010 5150 THE JOURNAL | emergencydispatch.org

Retrospace

reaching Compromise. opposition to 9-1-1 wasn’t all about the number

Hard to believe switching to a three-digit emergency call number would raise such a fuss. But it did over 30 years ago when 9-1-1 was getting its start around the country.

Just take a look at Traverse City, Mich. according to an editorial in the local news-paper, Record-Eagle (July 26, 1976), city commissioners were dragging their collec-tive foot on whether to participate in a cen-tral emergency dispatch system.

and, get this: the city didn’t have to spend a dime.

Traverse City would get the full benefit of a new system without any capital invest-ment. The federal government would pay the lion’s share of the system’s cost, chip-ping in about $240,000, while $13,338 would come from state aid. Grand Tra-verse County would provide $11,000 and the state police another $2,000.

The new communications system would also give the public just one number to remember when calling for emergency aid, whether it was a fire in town, an automo-bile accident on the highway, or a boat in trouble on the bay.

So, why were Traverse City commis-sioners trying to scuttle the idea?

The new easy-to-remember telephone number 9-1-1 was threatening to come to

town, and some members of the commu-nity didn’t want to see that happen. The simplicity was all too complicated.

according to the Traverse City police chief at that time, a central system would require retraining “radio operators” when, at the present, all it took was for the dis-patcher to push a button on the radio to inform the other agencies of a fire in King-sley. Secondly, why go with only one num-ber when police officers distributed phone stickers listing the various numbers to call depending on the situation and, also, placed them in phone booths? Why mess with something that already works?

The editorial in the Record-Eagle made a different observation for the police chief’s disapproval. The real root of the city police’s objection “lies in a parochial insecurity that the creation of a central dispatch system threatens its autonomy.” This was an iden-tity issue.

But this wasn’t happening only in Tra-verse City.

The use of 9-1-1 was such a hotbed of controversy that a former professional boxing judge and wrestler filed two suits in Wayne County Circuit Court (Mich.) seek-ing $1 million for carelessly promoting the 9-1-1 emergency number to citizens as a way of getting help, according to another story in the Record-Eagle (aug. 1, 1976). The suit charged the 9-1-1 number “was a promotion-scheme to attempt to keep the citizens in a false sense of security.” The complainant had been beaten and his wife killed by an intruder; the 9-1-1 operator who received his call was fired for advising him to put the porch light on “to see who it was” when he told her there may be intrud-ers trying to break into the house through the front door.

Traverse City commissioners cited the case when it voted 4-3 against the one-num-

ber communications system for city, county, and state police. The Grand Traverse County Commission, however, wasn’t going to let the idea die in city chambers. County Commissioner Joseph Muha was adamant about the need for consolidating the center and the access for all emergencies through the use of a three-digit number because—as he reasoned—one number to remember would make it easier for citizens needing emergency help. He said the city’s vote put him in a “stew” and ruined his entire day.

Commissioner Muha climbed out of his stew fairly quickly.

The city did an about-face two days later and approved the centralized dispatch center. as it turned out, the reason police were against the new communications setup wasn’t so much about the number or parochial insecurity as it was to the play-ers involved. More to the point, the grant money was coming through the federal gov-ernment’s office of Criminal Justice, which had earlier funded a national advisory com-mission study of possible upgrades to police agencies. one of the commission’s initial goals was reorganizing Michigan’s local police agencies and putting them under the control of Michigan State Police. The goal was abandoned, but the bad taste lin-gered. each time centralizing anything even remotely affecting local police in Michigan was put on the table, police chiefs and sher-iffs tended to rally against it. The red flags went up for local control.

a subsequent editorial in the Record-Eagle called the response predictable and understandable (aug. 5, 1976).

The compromise modified the dis-patch system’s administra-tive structure.

City and county commissioners put their heads together and established an oversight committee consisting of county and city commissioners and the command structure of the Traverse City State Police Post.

The ability to hash out differences won the praise of an editorial writer for the Record-Eagle (aug. 5, 1976). Common ground was found without any agency los-ing its identity. according to concluding remarks in the editorial the debate was settled by: “reaching out in the solving of common problems that will pay dividends to both units of government for years to come.”

and it has.operations were consolidated, as

approved, and the center remains housed in the county’s complex of public service buildings. The 22 employees provide dis-patch for police (city and county), eMS, and fire. They are eMD certified and use the Medical Priority Dispatch System™ (MPDS®) versions of ProQa® and aQua™. The seven-digit telephone number that had been the emergency number for Grand Tra-verse County up until that time still rings in the dispatch center today.

Grand Traverse County Dispatch Deputy Director Jason Torrey hasn’t been around long enough to remember the events of 34 years ago, but he is a benefi-ciary of the deal commissioners intended to last into the future.

“What they did worked, and i t s t i l l works today,” he said. g

52 THE JOURNAL | emergencydispatch.org

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Documents

The National Academies of Emergency Dispatch May/June 2010 … · 2016-06-24 · The National Academies of Emergency Dispatch May/June 2010 Tone of voice commands protocol’s delivery