MUCH MORE THAN JUST a DISPATCHER Iaedjournal.Org New Orleans, LA•USA April 12–14, 2017

INTERNATIONAL ACADEMIES OF EMERGENCY DISPATCH NOVEMBER | DECEMBER 2016

9 | PROMOTING THE 14 | QUÉBEC CENTER HAS 20 | PROGRAM REACHES DISPATCH PROFESSION HISTORIC MOMENT OUT TO VETERANS

PAGE | 22 MUCH MORE THAN JUST A DISPATCHER iaedjournal.org New Orleans, LA•USA April 12–14, 2017

THE PREMIER CONFERENCE FOR POLICE, FIRE, AND MEDICAL DISPATCH

navigatorconference.org emergencydispatch.org 888.725.5853 801.359.6916 #iaednav17 NOVEMBER • DECEMBER 2016 | VOL. 20 NO. 6 • •• COLUMNS

ON TRACK

CASE EXIT

42 | officer-involved project

Follow IAED on social media.

The following U.S. patents may apply to portions of the MPDS or software depicted in this periodical: 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; 7,106,835; 7,428,301; 7,645,234. The PPDS is protected by U.S. patent 7,436,937. FPDS patents are pending. Other U.S. and foreign 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. Portions of this periodical come from material previously copyrighted beginning in 1979 through the present.

iaedjournal.org | THE JOURNAL 3 ••• CONTRIBUTORS

Mary is with the Washington Sherri is the training and State Patrol where, for the past operations manager for Waukesha 10-plus years, she has worked as County Communications, Wis., a dispatcher, chief training officer, a combined dispatch center in supervisor, and training program southeastern Wisconsin, just supervisor. She is certified by west of Milwaukee, a land where the International Association of the beer runs freely and locals Chiefs of Police as a Leadership proudly stack cheese on just in Police Organizations instructor. about everything and call it great. She is also a certified instructor for You can contact Sherri at 262- the Washington Criminal Justice 446-5085 or by email at sstigler@ Training Commission. waukeshacounty.gov.

MARY RANSIER SHERRI STIGLER 7 | GUEST WRITER 9 | LEAN IN

Ryan is the Communications Specialist for the 911 Wellness Foundation, a nonprofit working to optimize the overall health and well-being of emergency dispatchers. Ryan is a former Police Communications Operator and currently serves as an Adjunct Instructor at the Golden West College Criminal Justice Training follow Center in Southern California.

RYAN DEDMON us 10 | GUEST WRITER

Art is a software instructor ™ and IAED™-certified ED-Q™ Follow IAED on instructor for Priority Dispatch Corp.™ He has been a fire and social media for EMS dispatcher for 18 years and works at Union County Regional Communications in Westfield, amazing N.J. Art has been involved in 911 telecommunicator training dispatcher stories and medical quality assurance since 1999. and news, ACE

ART BRAUNSCHWEIGER 11 | TECHNICALLY SPEAKING announcements, prizes, and more!

Patrick is the Public Information Officer for the City of Corvallis, Ore. With a background in journalism and government communications, he manages the city’s official communications, from press outreach, to emergency communications, to social media.

LinkedIn: International Academies of Emergency Dispatch Twitter: @TheIAED Facebook: International Academies of Emergency Dispatch

PATRICK ROLLENS 37 | DISPATCH IN ACTION

4 THE JOURNAL | iaedjournal.org THE SKINNY •••

INTERNATIONAL INTERNATIONAL OFFICES ACADEMIES OF AUSTRALASIAN OFFICE EMERGENCY DISPATCH 011-61-3-9806-1772 110 South Regent Street, 8th Floor CANADIAN OFFICE Salt Lake City, UT 84111 USA 1-514-910-1301 USA/Canada toll-free: 800-960-6236 Intl/Local: 801-359-6916 EUROPEAN OFFICE Fax: 801-359-0996 011-43-5337-66248 www.emergencydispatch.org ITALIAN OFFICE [email protected] 011-39-011-1988-7151 MALAYSIAN OFFICE 011-603-2168-4798 U.K. OFFICE 011-44-0-117-934-9732 DISPATCH, DISPATCHERS, AND IAED JOURNAL STAFF CREATIVE DIRECTOR SENIOR DESIGNER Kris Christensen Berg Serina Nielson THE WORLD! MANAGING EDITOR PRODUCTION MANAGER Audrey Fraizer Jess Cook A worldwide focus TECHNICAL EDITOR WEB DESIGNER Brett A. Patterson Dave Tyler DIGITAL & SOCIAL MEDIA CONTENT EDITOR INTERNATIONAL TRANSLATORS Michael Rigert Victoria Cheema Giuditta Easthope Michael Rigert SENIOR EDITOR Abbas Hamed Josh McFadden Lu Huan COPY EDITOR Michel Looyé Heather Darata Marco Mora Sara Scott f we had to sum up all the great new content in the ASSISTANT EDITORS Zhang Shengdong Audrey Gonzalez Carolyn Turcotte November/December issue of the Journal into two words, we Rebecca Tuft Icouldn’t. But if we were to pull out some of the predominant ACADEMY STAFF themes, I’d have to say they would include promoting emergency ASSOCIATE DIRECTOR | U.K. DIRECTOR OF INTERNATIONAL Beverley Logan RELATIONS dispatch as a career and bringing more international flair—here’s Amelia Clawson ASSOCIATE DIRECTOR | AUSTRALASIA Peter Hamilton ASSOCIATE DIRECTOR, MEMBER looking at you, Canada—to our Journal coverage. SERVICES ACADEMICS & STANDARDS ASSOCIATE Arabella VanBeuge Brett A. Patterson The final Journal edition of 2016 kicks off with a tremendous ASSOCIATE DIRECTOR, INSTRUCTOR SERVICES feature by Managing Editor Audrey Fraizer about the changing Bonni Stockman landscape of emergency dispatch as a career focus rather than BOARDS & COUNCILS simply being the fallback position when candidates fail the ACCREDITATION BOARD CHAIR RESEARCH COUNCIL CHAIR Jerry Overton Tracey Barron firefighter physical, for example. Now, more than ever, young ALLIANCE BOARD CHAIR COUNCIL OF STANDARDS CHAIRS Keith Griffiths Brett A. Patterson (Medical/EMD) people entering the workforce are looking at emergency Gary Galasso (Fire/EFD) CERTIFICATION BOARD CHAIR Tamra Wiggins (Police/EPD) Pamela Stewart Michael Spath (ED-Q) communications as a destination rather than a detour. CURRICULUM COUNCIL CHAIRS Conrad Fivaz, MD (ECNS) Victoria Maguire (Medical/EMD Board) There’s a terrific Medical CDE by Senior Editor Josh Mike Thompson (Fire/EFD Board) Jaci Fox (Police/EPD Board) McFadden that takes a look at MPDS® Protocol 11: Choking by Susi Marsan (ETC Board) Deanna Mateo-Mih (ED-Q Board) presenting several scenarios in which children are the patients. You can also read a Fire CDE by Audrey about how recent COLLEGE OF FELLOWS CHAIR UNITED STATES American national fire standards are reconfirming the importance Marc Gay, Chair Bill Auchterlonie (Kansas) Robert Bass, MD (Maryland) AUSTRALASIA | SOUTH AMERICA Catherine L. Bishop (Michigan) and effectiveness of the FPDS® Protocol. Frank Archer, MD (Australia) Christopher W. Bradford (Florida) Andrew K. Bacon, MD (Australia) (Emeritus) Geoff Cady (California) In a Canadian twin bill, we have a Center Piece on the comm. Peter Lockie (New Zealand) Steven M. Carlo (New York) Peter Pilon (Australia) Jeff Clawson, MD (Utah) Phil Coco (Connecticut) center in Red Deer, Alberta, Canada, and an ACE Achiever piece CANADA Chip Darius, MA (Connecticut) Drew Burgwin (Br. Columbia) Kate Dernocoeur (Michigan) on Urgences-Santé in Montréal, Canada, which also debuted its Claude Desrosiers (Québec) Norm Dinerman, MD (Maine) Douglas Eyolfson, MD (Manitoba) Patricia J. Dukes, MICT (Hawaii) Martin Friedberg, MD (Ontario) James V. Dunford, MD (California) state-of-the-art new facility earlier this year. Marc Gay (Québec) (Emeritus) Conrad Fivaz, MD (Utah) Marie Leroux, RN (Québec) (Emeritus) Gary Galasso (Utah) We’ve got some cool new Your Space stories, including one Paul Morck (Alberta) Keith Griffiths (California) Wayne Smith, MD (Québec) Jeffrey R. Grunow, MSN (Utah) Darren Judd (Utah) about a Corvallis, Ore., USA, EMD who uses the MPDS’ hands-on- EUROPE Alexander Kuehl, MD, MPH (New York) André Baumann (Germany) (Emeritus) Jan de Nooij, MD (Netherlands) James Lake (South Carolina) chest compression PAIs to help a wife and her two sons save her Gianluca Ghiselli, MD (Italy) James Lanier (Florida) Jean-marc Labourey, MD (France) Stephen L’Heureux (New Hampshire) husband and their father. From the dispatcher, to the family, to Harm van de Pas, MD (Netherlands) Victoria A. Maguire (Michigan) (Emeritus) Bernhard Segall, MD (Austria) Sheila Malone (Indiana) Gernot Vergeiner (Austria) (Emeritus) Susi Marsan (Georgia) (Emeritus) first responders with an AED, to hospital staff, each segment of Christine Wägli (Switzerland) Robert L. Martin (California) UNITED KINGDOM | IRELAND Dave Massengale (California) the EMS process did its job to save a life. Trevor Baldwin (England) Jerry L. Overton (Utah) Tracey Barron (England) Eric Parry, ENP (Utah) Finally, there’s also a great new FAQ coming your way, some Michael Delaney (Ireland) Rick W. Patrick (Pennsylvania) Louise Ganley (England) Brett A. Patterson (Florida) James Gummett (England) (Emeritus) Paul E. Pepe, MD, MPH (Texas) interesting findings about the Stroke Diagnostic Tool in Academy Chris Hartley-Sharpe (England) Ross Rutschman (Oregon) (Emeritus) Andy Heward (England) Joe Ryan, MD (Nevada) Research, an insightful Technically Speaking about the ProQA® Stuart Ide (England) Doug Smith-Lee (Washington) Peter Keating (Ireland) Tom Somers (California) Ray Lunt (England) Paul Stiegler, MD (Wisconsin) override feature by Art Braunschweiger, and, as always, plenty of Andy Newton (England) (Emeritus) Michael Thompson (Utah) Janette K. Turner (England) Carl C. Van Cott (North Carolina) Arthur H. Yancey, II, MD, MPH (Georgia) great columns from our experienced contributors. Tina Young (Colorado) Check out the new issue—in print and online (at iaedjournal. The Journal of Emergency Dispatch is the official bimonthly publication of the International Academies of Emergency Dispatch® (IAED™), a nonprofit, standard-setting organization promoting safe and effective emergency dispatch services org for bonus content)—and let us know your thoughts. As always, worldwide. Comprised of three allied academies for medical, fire, and police dispatching, the IAED supports first-responder- related research, unified protocol application, legislation for emergency call-center regulation, and strengthening the J emergency dispatch community through education, certification, and accreditation. pass along stories ideas to [email protected]. General IAED 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, certified membership is provided for qualified individual applicants. Accredited Center of Excellence status is also available to dispatch agencies that comply with Academy standards. ©2016 IAED. All rights reserved.

iaedjournal.org | THE JOURNAL 5 ••• DEAR READER WHEN PANIC SETS IN Someone is there

Heather Darata

t felt like Friday the 13th. A strange, passenger seat. I wonder if she hoped park if Mr. Road Rage was still following unwanted experience haunted me that that she could become invisible as she me. I’ve heard some scary reports of IFriday morning in July. I was moving looked down. people being beaten or shot after pulling quickly to catch my usual morning train, For the next mile, he was never too far over—sometimes after getting out of and in my haste I ticked off the driver of from me. When we merged with another their vehicle. the Chevy Silverado pickup truck with lane a few signals later, I got a break. Then I also had it in my mind to call 911 the out-of-state plates not moving my I switched lanes again and made a U-turn. if he kept following me or engaged in speed in my neighborhood. To my half astonishment and happy other dangerous behavior. And that’s Passing him when he got to the final surprise, he didn’t follow me. I kept a where you and the protocol would have speed bump on our way out of the close eye as I swung into the train parking come into play. I wouldn’t need to rely complex didn’t sit well with him. When he honked, I figured that would be his only way of showing his displeasure. It was far from it. About a minute later, I saw him passing me on the two-lane secondary road I was gunning down. I was alarmed when he swerved back over in front of me and slammed on his brakes. I almost didn’t stop in time, but I managed to avoid hitting him. When he didn’t move and we both sat there just before the intersection we were going toward (I’m pretty sure he did that intentionally to upset me), I decided to cut through the retail development to get to the main road. As I made an abrupt right turn and drove away from the truck, I hoped to never see him again. Unfortunately, that wasn’t the case. He passed me on the main road just as I was about to turn out of the parking lot onto the main road. Snap! The look on his face was killer. I could only hope we could put the whole incident behind us now. lot, parked, and ran to make my train. He on myself any longer to know what to Nope. As I passed him in the middle wasn’t in sight. It was finally over. do in that situation because you would lane, he stretched his arm out his window It dawned on me that as panic set in walk me through it while sending help to flip me off. Then he switched lanes so while I experienced the worst road rage my way. That’s just what someone needs he could pull up behind me. I glanced incident I’ve been involved in, my brain when fear and panic set in—a calm voice in my rearview mirror and noticed sent up a flare with the help I needed. that cares. J a wedding ring and a woman in the My brain told me not to pull over or

6 THE JOURNAL | iaedjournal.org GUEST WRITER ••• YOUR BRAIN ON DISPATCH Roller coaster can tip the scale of efficiency

Mary Ransier

esearch shows that the oldest and a phenomenon called “auditory If a dispatcher gets to this point and part of the brain, known as the exclusion.”1 This sensory breakdown can lacks adequate training, there’s a high Rreptilian brain, is where most of alter the individual’s ability to multitask probability of the stress response taking the functions of the autonomic nervous and/or perform all the job functions over and causing the dispatcher to either system take place—the actions that needed during a critical incident. The freeze up or physically push away from keep you alive without you needing autonomic, reptilian part of the brain the console. to think about them consciously, like prepares for possible blood loss to limbs How are we as trainers, supervisors, breathing or regulating heartbeat. It is by shunting blood away from those areas managers, peers, and organizations, where the autonomic nervous system and to important organs. In a process going to deal with the physical reaction breaks down into the sympathetic called vasoconstriction, the blood moves to stress? Do we tell our employees to and parasympathetic nervous systems, away from the surface and extremities, “Suck it up buttercup” and hope they the yin and yang creating balance in which includes draining blood from the can weather the storm? Or do we shed your body. neocortex, where rational thought occurs. light on this cockroach known as stress The sympathetic nervous system The sedentary nature of a dispatcher’s and watch it skitter away into the dark allocates resources and energy; it dumps a job combined with the inability to by equipping our dispatchers with what cocktail of adrenaline, cortisol, and other fight, flight, or freeze and burn off the they need? hormones into the bloodstream to ready chemical cocktail can lead to high levels Being a good dispatcher is not an the body for challenge. Although the of exhaustion. absence of fear. Rather it is the ability sympathetic nervous system and stress According to retired U.S. Army Lt. to control fear and learn effective ways response were tools saving our ancestors Col. Dave Grossman, whose current work to cope. Coming into this field and from dangers like big saber-toothed tigers, specializes in the psychology of killing knowing how the brain works and the the tools can have an adverse effect in and ways to reduce violence in society, physiological outcomes under stress today’s world. Humans can actually think “The midbrain is in charge, and you’ll can help prevent crippling self-doubt, themselves into the stress response. do what you’ve trained to do–no more, freezing, or fear from taking over in the The parasympathetic nervous system no less. You will do what you’ve been moment. According to Grossman, “We helps the body recuperate once the programmed to do–no more, no less.”2 can educate people after the event, to perceived “danger” is passed. Recuperation help them understand and heal, but it’s can depend upon the amount of much better to do it beforehand. We chemicals and hormones dumped into want a vaccine, not penicillin. Forewarned the bloodstream. The response can range is forearmed. If you are warned that these from shutdown for maintenance to jitters things will happen to you [your body] and the urge to exercise to burn off the they won’t blindside you.”3 J residual adrenaline. Because dispatch involves constant Sources emergency, the body and brain lack the 1. Grossman D, Christensen LW. On combat: The psychology and physiology of deadly conflict in war and in time for scheduled maintenance and rest, peace. Warrior Science Pub.; Millstadt, Ill. 2008. and, in turn, the continuous cycling and 2. Grossman D. On killing: The psychological cost of surges in adrenaline and other hormones learning to kill in war and society. Little, Brown; Boston, have detrimental effects to health and Mass. 1996. 3. See note 2. well-being. When the brain shuts down, dispatchers can experience tunnel vision

iaedjournal.org | THE JOURNAL 7 ••• Academy Research ADVANCING SCIENCE New tools in protocol open avenue to further research

Tracey Barron

he Academy’s release of a new blood flow to the part of the brain being other than Protocol 28 to stabilize the feature in protocol is the beginning deprived of oxygen. patient for transport. However, the high Tof yet another avenue for further The three sources released data sensitivity of the SDxT could make it ideal research. Take the Stroke Diagnostic Tool from the point of dispatch, allowing the for identifying potential stroke patients (SDxT) in Medical Priority Dispatch Academy’s research team to determine coded using Protocol 26: Sick Person or System™ (MPDS®) Protocol 28 (Stroke the sensitivity, specificity, and predictive Protocol 17: Falls due to reported stroke- [CVA]/Transient Ischemic Attack [TIA]), values of the SDxT. Study results were like symptoms. for example. generated by comparing SDxT findings An EMD can start the SDxT in response Research specific to the SDxT, with both the EMS responder findings on to patient answers to six symptoms listed conducted by the Academy’s research scene and final hospital discharge diagnosis. in Key Question 3 in Protocol 28, which team, analyzed stroke data from three Specifically, the study matched hospital- the EMD selects for the conscious and sources collected using MPDS v12.2 in confirmed stroke cases with EMS-identified breathing patient and when the caller the software engine ProQA®. The study strokes and dispatch records cases collected initially reports “stroke” or the sudden onset was conducted to assess the SDxT’s between January 2011 and December of one or more of the symptoms. Once the effectiveness, with the ultimate goal 2013 and dispatch records between June tool is activated, the EMD asks the patient being to identify strokes promptly and 2012 and December 2013 (the SDxT was (or, more likely, a second-party caller) to accurately. The SDxT also provides released in 2012). Of the 830 stroke cases perform three actions in a quick test to pertinent information that comm. centers identified during the overlapping time identify CLEAR, STRONG, PARTIAL, or could use, according to local policy, for periods, 603 (72.7 percent) had dispatch No evidence of a stroke, as quantified by the early notification of an incoming stroke records that matched EMS findings on patient’s ability to perform the three tasks patient to stroke center personnel for arrival. Slightly more than 50 percent (304 on SDxT (smile, raise both arms above head, timely treatment and administration out of the 603 recorded) had been handled and say, “The early bird catches the worm”). of tissue plasminogen activator—a drug using MPDS Protocol 28. The numerical value indicating level or designed to work by dissolving the clot According to study results, the SDxT absence of stroke can be sent automatically responsible for the stroke and improving had an 86.4 percent ability to effectively to EMS responders or directly to hospitals identify strokes among as units begin response. The SDxT all the hospital-confirmed automatically presents on the computer cases (sensitivity), and a 26.6 screen during the questioning sequence of percent ability to effectively Protocol 28. The EMD has the option of identify non-strokes manually selecting the SDxT when using a among all the hospital- protocol other than 28, although, in the data confirmed non-stroke cases analyzed, the option is rarely exercised. (specificity). The study led to two interesting and There were also a mutually inclusive results. First, findings number of strokes, identified showed that the SDxT has a high sensitivity in EMS, where the SDxT in identifying strokes, confirming its value was not used. For example, for early recognition strokes and providing while stroke might be the early hospital notification. Second, research underlying cause of other determined that expanding dispatcher use situations or conditions, the of the SDxT to include cases within Sick EMD’s immediate attention Person and Falls would likely improve its would focus on a protocol sensitivity even more. J

8 THE JOURNAL | iaedjournal.org Lean In ••• WHEN I GROW UP Let’s play dispatch and promote our profession

Sherri Stigler

s a child, did you always dream program. Create an interest in the dispatch medical, fire, and police dispatching. of becoming a 911 dispatcher? profession among high school students Excellence is something to strive for. ANot me! For the longest time, and other career-seekers by taking a lesson Plan for it. Train to it. Always. I wanted to be a veterinarian. Then a from the police and fire department Recently, we hosted special visitors in hairdresser. Then a cop. I became a cop, explorer post programs across the nation. our dispatch center. Eliza and Sadie Grace then figured out I was much are nieces to Alison Lesch, who more effective on the other works in our center. We gave side of the radio—safe inside the them a tour, introduced them climate-controlled environment to the dispatchers, gave them of dispatch. I grew to love it. It treats, and watched as they became my calling. listened in awe to the radio It’s probably safe to say that traffic in the background. They most of you, when youngsters, were all smiles. never really thought about Their interest brought an pursuing a public safety immense joy to the dispatchers. dispatch career. Many of us sort It was clear that they were as of “fell” into this dispatching impressed as young children thing. Some of us may have could ever be, but we never seen an ad in the newspaper knew the incredible impact or on a bulletin board that the visit had on them until piqued our interest. Others the next week when Alison may have had some exposure to reported that her sister said the the dispatch profession because girls were absolutely driving her of involvement in other public crazy with constant requests to safety professions. That’s OK. We’re here Focus on Attitude and adjust if “play dispatcher.” now, and we have a unique opportunity to necessary. One negative attitude can be a Inspired by their enthusiasm, we introduce public safety communications cancer to the entire staff. Adopt a “believe found two headsets beyond fixing and as a profession, as a special “calling” or leave” philosophy. Mission, vision, and sent them home with Alison for the that motivates us to reach out to the values are critical; make sure you identify girls. The picture above is a result of that younger generation. and document those in your own center. simple gift. So how can we support this growth? Nurture the new employees in your I’m glad our path has led us here. Consider the following acronym and organization. Successful trainees often I am proud to serve and support the use these ideas to help ADVANCE make tremendous contributions by public safety family. We share a unique our profession! spreading the word that your organization responsibility and purpose as we seek Advocate training, standards, and is a great one to work for. to promote and advance this incredibly protocols. Join groups, write about your Focus on a Community education team. important profession. Let’s continue to experience, and offer to help educate your If your agency doesn’t have one, get started. ignite the sparks of interest we see in agency partners. Put a display together and purchase items our younger generation, like those we Dedicate your time and talents to help to give away at safety fairs, schools, nursing have seen lit in the eyes of children like make a difference. homes, service organization meetings, Sadie and Eliza. They are our promise Start a Vocation foundation to national night outs, and pancake breakfasts. and our future. J promote dispatching by starting a “sit-in” Teach people about 911 and emergency

iaedjournal.org | THE JOURNAL 9 ••• Guest Writer WHAT DO YOU LIKE ABOUT DISPATCH? Meeting people in person made my day

Ryan Dedmon

or nearly 10 years, I worked in a National Night Out, school assemblies, of several suspects who intentionally and police dispatch communication Tip-A-Cop, giving tours and explaining maliciously misused the 911 emergency Fcenter answering 911 emergency operations of the communication center, system to harass dispatchers and drain police calls. I have heard it all. It came to a point presenting at the citizen’s academy, and the resources for unfounded reports. when nothing callers would say surprised annual Project 999 Memorial Ride were As a dispatcher, I was a critical me. But then again, just when I thought I the best times of my career. I didn’t want component of the community- had heard it all, a caller would request police awards. I didn’t want a promotion. I wanted oriented and problem-solving policing assistance for the most absurd reasons that to meet people and represent my agency philosophies that were the foundation my creative imagination could not even because I took pride in the work we did. to the mission of my agency. Never did begin to fathom. I could not make this stuff I loved talking to people, telling them all I feel like I was “just a dispatcher,” good up if I tried. about my job, explaining the 911 emergency only for talking on a phone and typing on As a result, many of my friends (outside system to them, and educating them with a computer. I had a problem-solving, life- of law enforcement) thought it was really information I believed might improve their changing, working dispatcher’s Ph.D. cool when I ran in their social circles. They quality of life. It was people who kept me coming back would introduce me to their friends saying I saw priceless smiles on the faces of to the job. Sure, I have exciting stories, but something like, “This is my friend Ryan, and children as McGruff the Crime Dog danced they don’t compare to the satisfaction and you’ll never guess what his job is!” in a school auditorium teaching them enjoyment of meeting and talking to people, The game would begin with them about when to call 911. I met the parents hoping to show them that dispatchers and thinking of the most bizarre profession and families of several children we publicly police officers are ordinary people who do I might have: Do you work with tigers at recognized as “911 Heroes” with official extraordinary things to serve others. the zoo? Are you a gigolo? You do movie awards. I met a homeless Vietnam War What did I love most about being a 911 stunts? Are you in Blue Man Group? Are veteran in a wheelchair who recognized dispatcher? My answer remains, “people.” J you with the FBI or CIA? You could tell us but then you’d have to kill us? Backup singer for Justin Bieber? Many were amused when I said I worked as a 911 dispatcher. They had never met a “real-life” dispatcher before, and they would ask me this: “What do you love most about being a 911 dispatcher?” Interesting question, especially coming from people who seconds earlier thought I might be an undercover spy posing as a gigolo who trained tigers for movie stunts starring Blue Man Group while moonlighting as a backup vocalist on the Bieber “Fever” tour. My answer to them: “people” And I loved it most when I got to my name on my uniform after he called Editor’s Note: This article was interact with people in person, not over the 911 from a payphone in the rain because he originally published at http://operationt8. phone. I always jumped at the opportunity had nowhere to stay. A partner and I played com/loved-911-dispatcher/ on Ryan’s blog, to be involved in community events. pivotal roles in the investigation and arrests “ Operation 10-8.”

10 THE JOURNAL | iaedjournal.org Technically Speaking ••• GREEN VS. YELLOW The override feature in ProQA

Art Braunschweiger

n ProQA®, the Send screen appears That may seem like mere semantics, Given ProQA’s proven accuracy in when enough Key Questions have but it’s not. ProQA can’t recommend coding, overrides should be far and few Ibeen answered to identify the who or what should respond to your call, between.1 They can be further limited by appropriate Determinant Code. That because it can’t possibly know your local an agency and its medical director taking code is highlighted in green. Selecting a resources and their capabilities. For that steps to ensure the appropriate resources code highlighted in yellow, if available, reason, the override feature in ProQA are matched to each Determinant Code. allows the calltaker to override to a higher is only intended to be used when the Authority to override the ProQA code Determinant Level. When not on the calltaker does not believe the resources highlighted in green must be approved Send screen, an override code is available dispatched will be adequate to assess or and defined by agency policy and medical anytime the up/down arrows on control. To have override the Reconfigure Response button authority, calltakers should have appear in yellow. This button will in-depth knowledge of local bring the calltaker back to the resources and their capabilities. Send screen where an override Calltakers should be required can be selected. to document the reason for In ProQA training classes for overriding, and overridden Priority Dispatch®, I typically ask calls should be reviewed by the the dispatchers attending whether Quality Improvement Unit and, their agency policy permits them if necessary, the medical director. to do this. The answer is invariably (The Determinant Code “no,” often accompanied by a resulting from an override can be look that suggests I’ve proposed readily identified by a zero as the something heretical. final number, as in 10-C-0.) Many agencies aren’t Protocols are based only on comfortable giving their probabilities, and nothing can dispatchers the ability to replace the human brain. Unusual override and require the calltaker circumstances do occur from time to send the code that ProQA to time when an override might be presents. Common rationale is appropriate. Therefore, overrides that taking the subjectivity out of the care for the patient. Such a decision might shouldn’t be automatically consigned to decision is one of the reasons that they’ve be based on the patient’s condition or the the “forbidden zone” but rather given due adopted ProQA in the first place. But circumstances surrounding the call. This consideration for approval within very there’s an important point that needs to capability ensures that the needs of the specific guidelines. You never know, it just be clarified. As International Academies patient will be met, even if a determining might save a life. J of Emergency Dispatch® (IAED™) factor exists that ProQA doesn’t capture. then-Board of Accreditation Chair Brian An example might be a patient with Source Dale noted in a session at NAVIGATOR a mild headache who reports he has a 1. Clawson J, Olola CHO, Heward, A, Scott G, Patterson B. “Accuracy of emergency medical dispatchers’ subjective 2014 in Orlando, Fla., “ProQA does not condition that causes him to quickly ability to identify when higher dispatch levels are warrant- recommend anything. ProQA presents lose consciousness when this happens. A ed over a Medical Priority Dispatch System automated pro- the most likely Determinant Code based mild headache codes at the ALPHA level, tocol’s recommended coding based on paramedic outcome data.” Emergency Medical Journal. 2007; 24: 560-563. on the Key Question answers that have whereas the condition reported would been selected.” require a CHARLIE-level response.

iaedjournal.org | THE JOURNAL 11 ••• BEST PRACTICES | faq

PROTOCOL 4 AND WEAPONS Does Assault Protocol apply to Taser use?

Brett Patterson

Brett: MPDS evolved, the suffixes expanded that there is a separate suffix for assault. If law enforcement uses a Taser on to include additional complaints, often This is important for responders to know, a patient, does the call have to be coded not directly associated with the primary as the code does not imply that an officer under Medical Priority Dispatch System™ title of the protocol. For instance, while assaulted anyone; it simply notes that a (MPDS®) v13.0, Protocol 4: Assault/ the “I = Injection administered ...” or “M Stun gun injury is associated with the Sexual Assault/Stun Gun? = Medication administered …” suffixes Chief Complaint. Lt. Audrey V. Boyd, RPL of Protocol 2: Allergies (Reactions)/ Brett A. Patterson Communications Coordinator Envenomations (Stings, Bites) are Academics & Standards Associate Greenville County EMS concurrent, meaning they are associated Medical Council of Standards Chair Greenville, S.C., USA with allergies, the “E = Explosion” suffix of Protocol 7: Burns (Scalds)/Explosion Good morning Brett: Hi Audrey: (Blast) may serve as a Chief Complaint I’m a nurse, and I work at an emergency The short answer is yes, and not associated with burns, and serves to dispatch center of the Lombardy Region, here’s why. note a specific complaint on this protocol. Italy. We have a great center that serves 2.5 Note that in v13.0, the word These are two of several examples in million residents with a volume of about “Concurrent” was removed from all the MPDS. 400–500 ambulance responses a day. “Problem Suffixes” sections of Additional So while the “T = Stun gun” suffix I consider your Academy among the Information Cards. resides on Protocol 4, it may or may not best in the profession, and I would like you In an early version of the MPDS, be associated with an assault. Note that to answer the following question: the suffixes were limited to situations the title of Protocol 4 includes Stun gun, The dispatch system provides concurrent to the primary Chief which may serve as a primary complaint variability in the symptom “nausea/ Complaint Protocol. However, as the not associated with an actual assault. Note vomiting” to assess how crucial the

12 THE JOURNAL | iaedjournal.org faq

symptom’s role is in diagnosing myocardial The caller was a pilot operating an Entrapments (Non-Traffic) seems infarction (MI) (e.g., chest pain score) aircraft for a sky diving school. One of appropriate in the Medical Protocol, in the corollary of patients where MI his tandem teams had just exited the as it really doesn’t fit what we is suspected. aircraft for decent. Upon deplaning, the would normally consider an aircraft I did a search, and among the most pack of the tandem jumpers snagged and accident. However, this call is more significant documents I found was a caught on the bottom of the aircraft, about resources when considering an systematic review of the literature (Panju holding them in place without the emergency landing, and 29-D-1a may AA, Hemmelgarn BR, Guyatt GH, Simel ability to release the chute nor detach have a more appropriate response DL. “Is this patient having a myocardial from the craft. assigned locally. Either way, this is a infarction?” JAMA. 1998; 280 (14): 1256– In this scenario, my EFD training tells tough call for the EMD to make on 1263). The study compared the association me this would be considered an aircraft the spot. Let’s see what my firefighter/ between clinical data and diagnosis of emergency; however, within EMD, how paramedic friend, PDC™ consultant, and acute myocardial infarction expressed would we code this event? Would it ED-Q™ expert has to say. statistically in terms of the most powerful fall under the 22 card as entrapment or Ross? features that increase the probability of would it fall under a 29-D-5a, pinned and Brett MI, and their associated likelihood ratios. aircraft involved? The outcome of this What is your opinion? call was positive, as the jumpers did free Darren: Umberto Piccolo themselves and landed uninjured. Very interesting. This is an EFD 118 Soccorso Sanitario Looking for some guidance on call because you really have no patient Lombardy Region, Italy this one. as long as they are in the air. So if you Thanks, as always. dispatched resources to a landing Ciao, Umberto: Darren de Boer spot, EFD would be the first choice The standard MPDS does not contain Emergency Communications Officer for resources based on the size of the a nausea/vomiting question or response Central Communications Centre aircraft and how many other people are code in the Chest Pain Protocol. However, Edmonton, Alberta, Canada inside still (did all of the other jumpers this question, and associated code, was get out?) because this would seem like added to the U.K. version of the MPDS Darren: a difficult landing if they were to try. If as an approved, cultural variation at the Wow! That IS a unique call. all you had were EMD Protocols, then a request of the National Health Service At first blush, Protocol 22: 29-D-1 would best fit the scenario. there. We have collected cardiac arrest Inaccessible Incident/Other Ross Rutschman J frequency data on this code for several years and have not found this symptom to be a significant acuity indicator in the dispatch environment. Therefore, we have not added it to the standard MPDS, and we have recommended its removal in the U.K. version. For example, a recent sample of 4,105 chest pain calls coded with this symptom contained only one cardiac arrest (Cardiac Arrest Quotient [CAQ] = .02 percent), versus the Chest Pain Not alert code which has a CAQ of 2.4 percent. Thank you for your interest in the MPDS and for reading our professional Journal. You may also be interested in our peer-reviewed journal, Annals of Emergency Dispatch & Response. Visit aedrjournal.org to get more information. Brett

Hi Brett: I have a question regarding a fairly unique call.

iaedjournal.org | THE JOURNAL 13 ••• BEST PRACTICES | ace achievers

Lévesque-Royer coded the call 26-A-08 and forwarded it to dispatch. The woman will most likely never know the role she played in history. The calltakers in the video are ecstatic, clapping hands, giving high-fives, and smiling. The video ends on a happy note: The launch was successful, without skipping a beat. The process completed over a six-hour period resulted in the safe and reliable transfer of calltaking and dispatching operations without interruption of service to patients, Brouillard said, and was supported by a huge team effort. The organization knew ahead of time to coordinate the move and the transfer of services. The logistics of moving people and making sure the new setting met its requirements was not an easy task. Moving was more than packing boxes. A master plan and calendars were prepared to facilitate the “live transfer,” keeping staff informed in advance about any alterations to the plan. HISTORIC MOMENT The move didn’t stop at the “live transfer” date. For the employees, it meant Urgences-santé communication center reaches mile- changes in radio technology, telephone stone in operations console configuration, adaptation to a new environment, and revisions in their Audrey Fraizer transportation and routes to and from work. And no matter how busy or stressed, the team kept the high spirits going. ho will answer the first call interview. “The milestone was reached “This was a major project and a big deal and, when the call is answered, during our live transfer of operations from for our organization,” Brouillard said. “And Wwill all systems be a go? the old to the new center.” it’s all been good. Everyone came together to Those were the questions posed in a Lévesque-Royer, an EMD of one year make the transition as smooth as possible.” three-minute, 36-second video produced in June 2016, said she was surprised to take Urgences-santé implemented the to mark the opening of the Urgences- the first call, their first day, and when so Medical Priority Dispatch System™ santé new emergency communication many other people were on duty. (MPDS®) in 1991 and was among the center in Montréal, Québec, Canada. Even more amazing, she said, is the Academy’s first Accredited Centers of Staff walk through new doors and step “beautiful” center, the camaraderie, and her Excellence (April 1995). into an unfamiliar but inviting new good fortune at finding what she likes to IAED™ Consultant Marie Leroux, RN, environment. Supervisors, dispatchers, and do and plans to do far into the future. was a supervisor-instructor in Montréal’s administrators stand poised on the floor of “I love the callers,” Lévesque-Royer said. EMS communications system, when, in the center watching and waiting for the “They are all amazing people. They all have 1997, she was inducted into the Academy’s first call to come in. different ways of communicating. Some College of Fellows for reasons including At 4:18 a.m. on Feb. 16, 2016, EMD are sad, some are stressed out, and some are her involvement in bringing MPDS to the Bénédicte Lévesque-Royer answers what calm. I like their emotions and being able attention of Québec’s Ministry of Health. they were anticipating, reaching the major to help them.” The move to a larger, modern center milestone they had anxiously anticipated. The call Lévesque-Royer answered was a huge occasion, said Leroux, who along “The call represents a historic moment,” that memorable early morning was with IAED General Counsel Brent Hawkins said Vincent Brouillard, Supervisor of from an 85-year-old woman who could attended an Urgences-santé event held on Operations, Urgences-santé, during a later not move because of generalized pain. May 24 during Canadian EMS Week, among

14 THE JOURNAL | iaedjournal.org ace achievers

an enthusiastic crowd (of “who’s who”) in education. Supervisor of operations Québec’s health care system. on all shifts oversees all staff and a Did “They are passionate about the work they battalion chief supervises the chain of you do and the services they provide,” Leroux prehospital response. know said. “The new center reflects how deeply they care about the people of Québec.” Urgences-santé Urgences-santé is: Hawkins was impressed by the culture Urgences-santé is the sole public 1,400 built around use of the MPDS. organization of prehospital emergency employees “It’s institutionalized, part of their services in the province of Québec for the emergency way of thinking in an emergency,” he islands of Montréal and Laval. Urgences- medical medical dispatchers said. “They are big fans of the Academy santé covers 2.4 million people, and technicians paramedics and applauded Marie and me during the handles an annual average of 375,000 calls, formal presentation. This was great to which represents more than a third of all experience on such a large scale.” Québec medical emergency calls. 375,000 The center replaces the former space The Urgences-santé fleet of 154 260,000 calls responses at Urgences-santé headquarters where ambulances and specialized units are An area covering they had been since 1993 and could no deployed from two centers in Montréal and longer accommodate either an anticipated one in Laval. During peak hours, there are Montréal and Laval increase in personnel or changes in more than 100 ambulances on the road. Population of 2.4 technology. The 5,802-square-foot Urgences-santé falls under the million interior accommodates 35 workstations direction of Québec’s Ministry of health communications (28 operational at opening) for the 105 Health and Social Services and is the center employees scheduled on three shifts. Each largest of 10 communication centers 1 head- day, an average of 50–55 EMDs are assisted serving the province. J quarter by Interfacility Transport Agents (ITAs). operating centers EMDs and ITAs are complemented Sources 3 by a team of clinical online support to 1. Urgences-santé. Video Du Transfert Des Operation training center CCS. 2016; Feb. 29. https://www.youtube.com/ paramedics, trainers responsible for quality watch?v=LkNcRxBRMb8. assurance and EMD continuing medical 2. Urgences-santé Québec. www.urgences-sante.qc.ca (accessed July 27, 2016).

EMD ACE Barry County Emergency Services E911 Regional Emergency Medical Butler County Emergency Communications Cassville, Mo., USA Services Authority El Dorado, Kan., USA Charleston County Consolidated 911 Center Reno, Nev., USA Cripple Creek Police Department North Charleston, S.C., USA Santa Fe Regional Emergency Cripple Creek, Colo., USA Communications Center City of Memphis Fire Communications Santa Fe, N.M., USA Emergency Services Telecommunications Memphis, Tenn., USA Authority (ESTA) South Metro Fire Rescue – MetCom Victoria, Australia Confire JPA Centennial, Colo., USA Rialto, Calif., USA Hulunbuir 120 Medical Emergency Wuxi Emergency Center Command Center Emergency Medical Care Inc. Wuxi, Jiangsu, China Hulunbuir City, Hailaer District, Inner Mongolia, China Dartmouth, Nova Scotia, Canada EFD ReACE Madison County 911 Guilford Metro 9-1-1 Greensboro, N.C., USA Charleston County Consolidated 911 Center Marshall, N.C., USA North Charleston, S.C., USA Medical Transportation Coordination Centre Marion County Public Safety Communications Ocala, Fla., USA Hanover Emergency Communications Center Brandon, Manitoba, Canada Hanover, Va., USA Okaloosa County Department of Public Safety MedStar Mobile Healthcare Fort Worth, Texas, USA Lake Emergency Medical Services Niceville, Fla., USA Mt. Dora, Fla., USA Salt Lake Valley Emergency Communications Metro Communications Agency Sioux Falls, S.D., USA Lee County Division of Public Safety Center (VECC) Fort Myers, Fla., USA West Valley, Utah, USA Metro Nashville Emergency Manatee County Emergency EMD ReACE Communications Center Nashville, Tenn., USA Communications Center 144 Notruf Niederösterreich Bradenton, Fla., USA Sankt Pölten, Austria Montgomery County Hospital District Conroe, Texas, USA EPD ReACE American Medical Response Sacramento Medicine Hat Regional 911 Communications Sacramento, Calif., USA Reedy Creek Emergency Services Medicine Hat, Alberta, Canada Lake Buena Vista, Fla., USA

iaedjournal.org | THE JOURNAL 15 ••• BEST PRACTICES | center piece

HAPPENING CENTER Red Deer ramps up for the future

Audrey Fraizer

indy Sparrow will be the first to could be among the first things hung on (AHS) selection of Red Deer as an tell you. the walls of a new stand-alone building EMS satellite “borderless” dispatch C She looks forward to walking that combines the 911 center with an center in the province. Red Deer was across the stage during the Opening Emergency Operations Center (EOC). the first of three centers selected to Session at NAVIGATOR 2017 in If approved, the move could take place go live in January 2016, followed recognition of receiving approval for the sometime in late 2017, taking into account by implementations in Lethbridge, Accredited Center of Excellence Twenty construction schedules. Once ready for Alberta, and Fort McMurray, Alberta. Point application and bringing the ACE occupants, communication center staff Satellite dispatching software certificate back to the City of Red Deer will vacate quarters in Fire Station 3, makes it easier for EMDs to coordinate 911 Emergency Communications Centre which houses multiple EMS departments, location and time. They can see where in Alberta, Canada. and City Hall will absorb the space of the ambulances are, vehicles available “ACE is a true reflection of the work the exiting EOC in its building for its for the particular trip, and whether we do,” said Sparrow, the center’s director. growing staff. responders are on schedule or running “It’s symbolic of our achievement. So, yes, The consolidated EOC and 911 center behind due to traffic, weather, and this is a big deal.” would be a boon to staff and the public, related time-draining conditions. The Sparrow and her staff of 34 cross- Sparrow said. software makes it possible to transmit trained dispatchers and calltakers will “We need the space,” she said. “Our electronic messages between the EMD celebrate, the framed certificate will room is pretty full. We recently added and driver. go on the wall, and they will continue three pods and that immediately took up According to the AHS program answering 911 calls and sending response. the space we had.” finalized in 2009, an EMS call placed Depending on the Red Deer City Spacing requirements goes along anywhere in Alberta is transferred Council’s decision, the ACE certificate with the Alberta Health Service’s to the respective regional satellite

16 THE JOURNAL | iaedjournal.org center piece

PSAP, which in Red Deer involves 70 First Responders Radio Communications to PSAPs (deadline April 29) regarding the communities and counties throughout System (AFRRCS). Launched on July 1, creation of a regulatory framework for central and southern Alberta; police the province-wide, networked radio system Next Generation 911 services in Canada. and fire calls remain in the control of will connect more than 700 emergency “There’s never a dull moment,” said the local communication center. responders and government agencies during Sparrow, who started as a dispatcher at CAD-to-CAD interfacing is available serious incidents or natural disasters. the Slave Lake communication center for co-response (an incident that The willingness to accommodate in northern Alberta (now part of the requires fire and medical attention) projects that benefit the larger system Northwest Regional Communication and to share event-related information mirrors Sparrow’s approach to ACE. Center serving northwestern Alberta. instantly over network connections Sparrow and Bart Rowland, Deputy “Each morning is hit the ground running.” between linked communication centers. Chief of Support Services for Red Deer As a whole, the same applies to Red Satellite dispatching does not Emergency Services, plunged into the Deer; the city doesn’t slow down. increase call volume for Red Deer, since Twenty Points of Accreditation in it has always answered EMS calls. The fall 2015. They divided the points into system does, however, require additional graduated categories; from those they “ACE is a true reflection pods to accommodate the AHS-funded could easily pull together (center size of the work we do. satellite dispatching software. and dispatch certifications) to multi- “The technology is separate,” Sparrow step projects (quality improvement and It’s symbolic of our said. “Everyone is cross-trained, but they quality assurance processes). achievement. So, yes, are not using the same CAD system [for Sparrow said their first step in QI/ the assigned EMS or fire dispatch].” QA involved Q courses for everyone at this is a big deal.” As Sparrow explained, the transition the center, including refresher courses was more than a click of a switch. for current Qs, to bolster the existing “That’s where it all begins,” she said. Quality Improvement Unit. The century-old city, starting as a “There was still a lot ahead of us.” If ACE and issues related to mix of homesteads and trading posts on That wasn’t the only project moving space aren’t enough to fill Sparrow’s the vast Alberta prairie, boasts a thriving forward in Red Deer. schedule, there’s also the pressure of business and commercial hub. The city’s In August, the Red Deer City Council future telecommunications. In March, six key industrie are expected to add approved a radio system upgrade capital the Canadian Radio-television and more than a combined 9,800 jobs during project to complete the migration of all Telecommunications Commission the next five years. It is the third-most emergency service radios to the Alberta distributed an in-depth 12-question survey populous city in the province. Red Deer commemorated the 100,000-population mark in 2015 with a plaque and naming of the city’s 100,000th resident. The tourist season is year-round, with people from all over the province and Canada taking advantage of Red Deer’s 301 acres of protected land within the city and proximity to Banff National Park and the Red Deer River Basin. Before packing your bags and heading toward Canada, consider the single possibly bad thing about Red Deer and Alberta in general. Winters are harsh, with deep-freeze temperatures and continuous snow and wind. But take comfort because as any natives will say, “We don’t feel it; the air’s bone dry here.” And, if luck has it, you could score tickets for the Canada Winter Games Red Deer hosts in 2019. J

iaedjournal.org | THE JOURNAL 17 ••• BEST PRACTICES | award

“This is the first partnership of this type for the Academy and with an award that acknowledges our joint dedication to increasing the survival from out-of-hospital cardiac arrest (OHCA).” Ferguson was among five nominated from the Scottish Ambulance Service control centers. The service has three centers in Scotland (Edinburgh, Glasgow, and Inverness), and each uses the Academy’s Medical Priority Dispatch System™ (MPDS®). She had been notified about the nomination, and, on the day of the symposium, she was told she would be going on stage to accept the award. “I was quite shocked,” she said. “You don’t do this job because of the recognition. We are the first contact but, for the most part, the public doesn’t know what we do.” Facebook posts congratulating Ferguson prompted her to thank everyone in return: “Can I just say a massive thank you to everyone for all your kind messages today, IAED PRESENTS I’m really honored. As the saying goes, ‘There is no I in Team,’ so a special big thanks to all INAUGURAL AWARD my teammates for their support today and every day in ACC and also the nominations! Scottish symposium embraces dispatch in Go team!” OHCA survival According to her nomination: “Gillian is an outstanding dispatcher and her Audrey Fraizer whole team would love to see her get the recognition she most definitely deserves. [She is] very attentive when dealing with he recipient of the inaugural “I am very happy at the job,” she said. OHCA. Understands the process and need dispatcher award at the Scottish “We make a difference. I can go away from for allocating appropriate resources and TCardiac Arrest Symposium for my shift knowing I helped a patient and does everything she can for the patient and emergency communication had less to say in the family, and when the crew says ‘we’re crews attending. Gillian always puts patients her acceptance on stage than the presenters. glad we have you today,’ that’s nice. It’s a first and goes out of her way to ensure That’s because Gillian Ferguson is good thing.” they are getting the best possible response. accustomed to staying out of the eyes of the The Academy Award, as it’s named, is a She is a very active member of the team, public and, quite honestly, she definitely joint sponsorship between the Resuscitation supporting them when necessary, especially prefers it that way. Research Group at the University of during major incidents. She is sure to check “I’m a shy person,” Ferguson said after she Edinburgh, Scotland, and the International on a patient’s condition once the crew has received the award on June 24. “I’m not one Academies of Emergency Dispatch® cleared from the incident as she is genuinely for stages. That’s not the nature of our job. (IAED™), in Salt Lake City, Utah. It was concerned for their welfare. She is also We’re in the background.” established in recognition of the emergency conscientious to check on the welfare of her Talking to Ferguson, it’s easy to dispatch profession and partnership forged crews when dealing with difficult incidents understand why her team at the Scottish between the two organizations. and is well known by the staff across all Ambulance Control Centre (ACC) “The partnership is incredibly important east divisions as being incredibly helpful, nominated her. A dispatcher for 13 years, to the Academy,” said Jerry Overton, IAED friendly, and professional.” and a calltaker for one year before that, Accreditation Board Chair, who with Overton acknowledged the critical link she sounds genuinely enthusiastic and Dr. Jim Ward, Medical Director, Scottish that every EMD automatically assumes in conscientious about what she does. Ambulance Service, presented the award. the chain of emergency response.

18 THE JOURNAL | iaedjournal.org award

“There is no one real winner of the responders providing defibrillation; and the Lisa Macinnes, National Program award,” Overton said. “Every dispatcher is paramedics arriving on scene. Manager, Save a Life for Scotland, and Lead a winner. This is an incredibly stressful job Gregor, who spoke at the symposium, Research Nurse, Emergency Medicine just like it is stressful for those in the field lauded Scotland’s EMS community. Research Group of Edinburgh, said delivering the care. EMS is a team approach, “I didn’t realize until later how lucky I gratitude shown to emergency dispatch and your careful use of the Protocol has was, and the first thing that struck us was at international summits, such as the saved countless lives.” the number of people involved in saving symposium, is indicative of the respect Ward echoed Overton’s remarks before my life,” said Gregor, who was accompanied the profession holds in the OHCA Chain naming the two runners-up and first-place by his wife and their children on stage. of Survival. awardee Ferguson. “There were probably 14 people, which is “They are vital people who never see “You guys do an amazing job,” he said. really humbling.” a cardiac arrest as part of their work,” “You’re not generally visible on the front Laing is Community First Responder Macinnes said. “But they hear it in the fear line but absolutely critical to the chain Coordinator, Pirnmill, Isle of Arran, of every word the caller says. They’re crucial, of survival and the successful outcomes Scotland. The community first responders and their work has saved countless lives.” of patients.” are trained volunteers responding to Overton said their role couldn’t be stated medical emergencies while the ambulance too strongly, particularly in association with is on its way and alerted through the four primary factors in early recognition and communication center. treatment of OHCA: early recognition that The symposium’s theme, SHIFT a cardiac arrest is happening; early CPR to Happens, refers to the changes happening buy time; early defibrillation to restart the in the way OHCA patients across Scotland heart; and early prehospital Advanced Life are resuscitated. Approximately 3,500 Support (ALS). people in Scotland each year undergo Overton said call handlers and attempted resuscitation after OHCA, but dispatch participate in each phase and, currently only around 1–20 survive to as part of the process, the relatively hospital discharge. The OHCA strategy for unspoken responsibility of ALS deploying Scotland includes: About the Resuscitation and redeploying. •• An increase in survival rates after Research Group at the University “I was told about one dispatcher OHCA by 10 percent across the of Edinburgh handling five cardiac arrests on one shift,” country, and saving a total of 1,000 The Resuscitation Research Group at the he said. “The dispatcher had to deploy additional lives by 2020. University of Edinburgh is a collaborative ambulances and redeploy the remaining •• An increase in the number of involving the university, the Scottish ambulances to make sure response times individuals learning CPR, with a Ambulance Service, and the Emergency were met.” projection of adding another 500,000 Department at the Royal Infirmary in Scottish Ambulance Service runners-up people with CPR skills by 2020. Edinburgh, along with other academic for the award included Robert Pearson, an According to the report outlining and industry partners. Dr. Gareth Clegg, ACC Supervisor, and Caroline Shand, an Scotland’s strategy, “The ACC is the Senior Lecturer, University of Edinburg, Emergency Call Handler. Rounding out the center of the coordination of all the and Honorary Consultant, Emergency exceptional group of nominees were Linda resources involved in the prehospital care Department at RIE, leads the RRG. Burns and Alistair Strachan, who are both of out-of-hospital cardiac arrests,”1 and call The group’s research centers on call handlers. handlers must be effectively trained and optimizing the management of critically ill A second major honoree, Fiona Laing, supported to then reliably use the triage patients and includes the physiology and received the Newton Award, established by tools available.” clinical management of out-of-hospital Gregor and Judy Newton to recognize the This was the fourth annual Scottish cardiac arrest, non-technical skills in time- outstanding work of EMS in Scotland. Cardiac Arrest Symposium hosted by critical resuscitation, the physiology of fluid In April 2014, 43-year-old Gregor its sponsoring agency, the Resuscitation resuscitation, and the psychology of critical Newton went into cardiac arrest in East Research Group at the University of interpersonal interactions during the chain Lothian, Scotland, and survived due to Edinburgh. The 19 speakers and award of survival. J several people and factors in place, including presenters featured at the one-day his wife, Judy Newton, initiating CPR; symposium included EMS physicians, Source their two children going for help; bystander paramedics, community first responders, 1. “Out-of-Hospital Cardiac Arrest: A Strategy for Scot- land.” APS Group Scotland. 2015; March. www.gov.scot assistance; call handlers coordinating and educators, and representatives from Save (accessed Aug. 10, 2016). gathering information; community first a Life for Scotland.

iaedjournal.org | THE JOURNAL 19 ••• BEST PRACTICES | boot camp

EMERGENCY DISPATCH BOOT CAMP Veterans offered fighting chance at dispatch

Audrey Fraizer

resenting professional opportunities for veterans who candidates at job fairs and military bases. They mentor the served in wars in Iraq, Afghanistan, and other areas vets, coordinate the classes, collate certifications, post job Pof the Middle East are another step toward lowering openings, and simulate job interviews. unemployment rates through a program co-sponsored by the “Getting the job is up to the vet,” Minor said. “They make International Academies of Emergency Dispatch® (IAED™), the decision.” Priority Dispatch Corp.™ (PDC™), and Troops to Firefighters. Although not meant as a cookie-cutter approach, Harris The program also offers benefits to communication centers. and Minor believe emergency dispatch is an effective and The program teams veterans who served as active duty promising career choice for transitioning military personnel, personnel in the U.S. armed forces since September 2001 particularly for vets wounded in action. But they don’t with Academy instructors to complete five emergency sugarcoat the reality of working in often-tight quarters communications certifications during a three-week emergency coordinating emergency response for typically distressed dispatch boot camp. callers. They don’t pretend everyone leaves the military at It’s basic training to prepare vets for a career when equal emotional levels. transitioning or separated from active duty military, said Dave “Not everyone’s cut out for dispatch,” Harris said. “We Harris, Troops to Firefighters Co-founder and Retired Chief, know that. But for the right person, it offers a chance to Lockheed Martin Aeronautics, Marietta, Ga. continue public service through their community.” “We owe it to our vets,” said Harris, who was with U.S. Air Opportunity for vets wounded in action grabbed Shawn Force fire protection for 30 years prior to his civilian job for Messinger’s attention when asked to coordinate the PDC side Lockheed Martin. “We must give vets the opportunity to be of the program. self-sufficient through gainful employment.” “This is quite unique to our wounded warriors who Harris and Troops to Firefighter Co-Founder Winston want to work in public service but, because of their injuries, Minor, Retired Chief, Atlanta Fire Department (Ga.), recruit require training in a different capacity,” said Messinger,

20 THE JOURNAL | iaedjournal.org boot camp

Project Manager, Utah Communications Authority and PDC Police Instructor. “This program provides an opening in a “This is quite unique to our wounded warriors great public service career.” who want to work in public service but, because Chris Knight, PDC Chief of Program Management & Implementation, is the of their injuries, require training in a different point person for the program. capacity. This program provides an opening in a Ironically, neither Harris nor Minor were familiar with the emergency great public service career.” dispatch process. They established Troops to Firefighters in 2014 to provide transitioning troops and veterans the opportunity of certifying as a Class I/ II Firefighter. “We know firefighting, and we put a comprehensive program together,” Minor said. “We also thought dispatch would be ideal, especially for vets who wanted more choices in public service. We didn’t know the specifics.” They did their homework, networked, contacted the Academy, and were met with an enthusiastic thumbs-up. “We didn’t need a lot of convincing,” said Dr. Jeff Clawson, Inventor of the Fire, Police, and Medical Protocols used in more than 3,000 emergency communication centers worldwide. “Not only is this a responsibility to our military, but it makes good business sense. Veterans bring a great work ethic, reliability, a following procedures ‘by the numbers’ attitude, and all the other qualities that made them attractive to recruitment officers in the first place.” As of August 2016, a total of 26 vets were certified through the program as EMDs, EPDs, and EFDs, and with the Active Assailant Training Course. Five more three-week courses were scheduled and are similar to earlier classes; the Academy are the instructors, Unemployment during the recession essential job skill training. About 33 and PDC is providing the materials, all hit Iraq War veterans particularly hard, percent of U.S. veterans of the Iraq and at no cost to participants. as numbers edged close to 15 percent Afghanistan wars reported having a While “obligation” and promoting in 2010 compared with just under 10 service-connected disability in August “gainful employment” are incentives for percent for the rest of the country 2015, compared with 20 percent of all veteran career development, Harris said during the same period, according veterans.1 J the greatest satisfaction comes from the to federal Bureau of Labor Statistics. vets themselves. It’s only during the past few years Source “You can see the excitement in their that rates are decreasing (from 6.9 1. “Employment Situation of Veterans Summary.” United States Department of Labor, Bureau of Labor Statistics. faces,” he said. “By giving back to them, percent in 2014 to 5.8 percent in 2015, 2016; March 22. http://www.bls.gov/news.release/vet. they know there are people back home for example) through concentrated nr0.htm (accessed Sept. 14, 2016). who truly care about them.” national efforts combined with

iaedjournal.org | THE JOURNAL 21 • FEATURE | making dispatch a career

I AM JUST A DISPATCHER I DON’T THINK SO

Audrey Fraizer

his is the way Kim Rigden describes the dispatch profession. “Nothing compares to having your A-team on, answering Phones ringing, calls piling up, using every approach at 911 calls, and talking to crews all while your fingers are flying Tcustomer service, and a huge dollop of luck to get through across the keyboard recording the information,” said Rigden, the shift. Providing Pre-Arrival Instructions (PAIs) to assist a son Commander, Communications Education and Quality giving CPR to his father. Calming the mother whose child is Improvement, Toronto Paramedic Services, Toronto, Ontario, missing. Urging scared shoppers to safety while an armed assailant Canada. “Emergency dispatch is like being part of a room full of wields his automatic weapon against a frenzied crowd. superheroes that no one knows is there.”

22 THE JOURNAL | iaedjournal.org making dispatch a career | FEATURE •

And that’s the problem: Few people know what dispatchers do. Utah high school students in a CPR WE ARE DISPATCH PROFESSIONALS study sponsored by the International Academies of Emergency Dispatch® That “just a dispatcher” quote seems to be quite common. At (IAED™) were ambivalent about a career NAVIGATOR this year, I was talking to a couple of gentlemen and in emergency dispatch. They wanted the when I introduced myself, they said they were “just dispatchers.” speed and adrenaline rush of a paramedic, That’s very sad to think they feel that way. firefighter, or police officer rushing to the We are not just Lily Thompson as Ernestine [the nosy and scene. After all, dispatch was only a desk condescending phone operator Thompson debuted on “Rowan and job. They want to be part of the action. Martin’s Laugh-In”] answering the phone with one ringy dingy, two “People don’t go through high school ringy dingys. I know the public’s perception is sometimes that the role saying ‘I want to be a 911 dispatcher,’” said of the dispatcher is that of a phone operator, but we shouldn’t feel that Karen Lord, Communications Officer, City way about ourselves. The dispatcher is such an important component of Biddeford Emergency Communications of the entire emergency process, but so often not recognized. Division, Maine. “It just doesn’t happen. Oren E. Rae Unless you have a relative in the public safety community, you are really unaware of who we are and what we do.” Here I am, a dispatcher, at one of the largest 911 centers in the United In a job that the U.S. Bureau of Labor States, looking back at what it means to be “just a dispatcher.” To me, Statistics calls good because “the stressful it means 21 years of continually moving forward, watching an industry nature of the job results in many workers change with me, learning a new technology at least yearly. It means leaving this occupation,”1 does lack of years and years of education on so many different subjects where interest and uninformed perception stress and stress management always seems to be a bullet point in the forecast the shape of things to come in lesson. It means sleepless nights AND sleepless days. It means going the emergency dispatch profession? home with that sense that I accomplished something, be it saving Presumptive, maybe, but how can a someone’s life, helping a small child find their momma, or teaching public service communication agency a colleague a new way of performing their job so that it’s easier for attract quality and dedicated individuals them. It means heartache and a sense of pride like no other. For the and encourage emergency dispatch past 10 years, I have been assigned to our Training Section, which has as a career in a mindset swirling with taught me that there is a whole other side to this dispatch thing. The misconceptions and partiality? education that goes into dispatch and 911 now is light years ahead of “You know, that’s the million-dollar where it was. Two decades ago, training consisted of two weeks in a question,” said Deanna Mateo-Mih, room looking over general orders and then a sink-or-swim mentality. IAED ED-Q™ Board of Curriculum Now, it’s academic training, structured on-the-job training, remedial Chair, National Q Advisor, and Quality training, and continuing education daily. It amazes me every day to Improvement Consultant. “Once you watch the eyes of new dispatchers and calltakers glimmer when they get a position as a dispatcher, how do you realize that what they are signing up to do REALLY impacts others. ensure longevity in the profession and avoid So, are we just dispatchers? No way! We are educated and trained burnout or, from an agency’s perspective, professionals doing a job that not everyone is cut out to do. avoid high turnover rates?” Angela VanDyke Figuring that out is the ticket. “We need to have our faces out there and not just our voices on the other end Dispatchers are hero coordinators, waiting patiently to answer a of the line,” Lord said. cry for help. They soothe pain with the sound of a calm voice, instill confidence in those who feel helpless, and make seconds count with Dispatch is a profession every compression, chemical, or conflict. They have no pause, only A profession is a vocation requiring purpose and action. There is no scene size-up, no huddle or pre-plan; specialized educational training with they must be ready with every scream or whisper knowing both carry oversight by a recognized governing body. a unique challenge. They are a hero’s hero. A person entering a profession generally Anthony Guido must pass an exam to be considered qualified. Training and education continue

iaedjournal.org | THE JOURNAL 23 • FEATURE | making dispatch a career throughout the lifetime of a career for reasons that include within the organization and encourage their dispatchers to work developing expertise and proficiency, and potential advancement. hard for a cause that’s relevant to both.” Dr. Jeff Clawson, co-founder of the IAED, recognized the important link of emergency dispatch in the EMS chain of Start in the classroom response nearly 40 years ago when starting his own profession Marco Pizana believes students should be given the in emergency medicine. But it was more than simply the opportunity to practice what teachers preach in the classroom. protocols Dr. Clawson invented putting emergency dispatch on “We’ve probably all heard kids ask ‘What’s the point in a career path. learning algebra; what’s the point of learning geometry?’” said “Protocols provide an exact script emergency dispatchers Pizana, a criminal justice instructor at Hays High School in follow when assisting a caller; however, they are only part of the Buda, Texas. “The point is to apply what you are learning to your process,” Dr. Clawson said. “Along with the protocols, we have future endeavors.” established a system that provides a best practices approach that elevates emergency dispatch to the level of professionalism.” I hear it all the time. “I’m just a dispatcher.” I ask, True to the definition of “What do you mean, just a dispatcher?” Do you think profession, the IAED requires that way because dispatch is not hands-on with the certification through passing an patient, or because a dispatcher stays out of harm’s exam tailored to the particular way and not anywhere close to the incident? Do discipline (fire, medical, police, the dispatchers asking think that what they do is or emergency communication somehow less, or that they contribute less to EMS, nurse), quality assurance because of a job that’s viewed as being behind the resulting in quality improvement, scenes? Dispatchers have to realize how important continuing dispatch education to they are to the process. They have to understand the renew certification, and ongoing difference they make, how they set the tone for the training. The quality assurance rest of the process. The job is complicated and has component keeps the process and the same types of stress that someone at the scene the dispatcher on track. experiences. It’s also rewarding and provides plenty of If that doesn’t convince you opportunity as a career. about the job’s career potential, Larry Latimer check out the partial list of requirements from MetCom 911 in Centennial, Colo.: 2 •• Retrieves information from callers and transmits information to Hays is among several public schools in Texas offering the fire/emergency service personnel. Follows prescribed protocols Emergency Telecommunicator Course (ETC) developed by the to provide emergency medical instruction to callers during high IAED. The course, introduced nearly 15 years ago to supplement risk situations until appropriate field units arrive on scene. Academy certification courses, has since expanded its reach to •• Monitors and maintains the location and status of fire, schools offering hands-on career and technical training. emergency medical, and other agency units in the field. ETC fits into public safety career tracks, and similar to other •• Operates various automated and/or communications technical programs, gives students the opportunity to try a equipment including computer‐ assisted dispatch terminal; career before graduating and, also, provides a jump start into a enters and retrieves data. profession straight out of high school. •• Monitors and operates TDD/TTY to communicate with “Kids are looking for certification,” said Larry Latimer, ETC hearing‐impaired callers. Instructor. “They can take their ETC certification to a center and •• Participates in the administration of the Communications get in the door. A good percentage stay.” Center through the development, implementation, and review The ETC class at Hays High School takes students through of procedures, policies, and training programs. 13 chapters of the ETC manual and the hands-on practice of 911 There’s also the less tangible traits that go into defining a career, emergency call-answering techniques using simulators. Students said Sherri Stigler, Training and Operations Manager, Waukesha are eligible for ETC certification through the IAED once they County Communications, Waukesha, Wis. finish the course. The Texas Public Safety Teacher Association “Professional agencies invest in their dispatchers,” Stigler said. offers ETC for teachers to go back to teach their students. “They support physical and mental health initiatives and encourage Latimer likes to emphasize the thinking part of dispatch. continual growth and development. They promote a team spirit He runs scenarios by students, asking the “what-if” and “what-

24 THE JOURNAL | iaedjournal.org making dispatch a career | FEATURE • to-do” questions. For example, “what if” know, because Dr. Clawson was the show’s been great for me. Emergency services is grandpa suffers an out-of-hospital cardiac medical adviser. a great cause. We help people and, like arrest. How much time could it take from Who wants to be “just” a dispatcher many in the field, there’s the adrenaline the time the call to 911 is made before at a “desk job” that borders on the rush I enjoy.” response arrives? tedious when there are helicopters to fly, Lord loves her job. Sure there are “If nobody does anything but wait, what ambulances to navigate, and speeding drawbacks, she admits, but name a will happen?” Latimer might ask. “Grandpa vehicles to chase? The real first responders profession that comes without quirks. has much less of a chance if the emergency (emergency dispatchers) are every bit as “Many times people will say, ‘But dispatcher doesn’t do her job right. At essential and multifaceted as the roles don’t you miss working Monday through that moment, you are the most important of paramedic/firefighter/police officer Friday?’ and I say that I do not know, as person he will never know, because you during an emergency. I have never in my life had a Monday have the instructions that can save him.” A story told at a seminar Oren Rae through Friday job,” she said. “If you Latimer was an instructional designer attended shows that one new recruit are a strong-minded person and want and the IAED Director of Curriculum knew exactly what he was taking on. fun and excitement but don’t want Design during his 14-year tenure with “A police captain told us about a class to run into burning buildings or get the organization. He now works part- of new recruits and asked what they felt shot at, this is the job for you. It can be time teaching the Academy’s ETC was their most effective weapon,” said rewarding, challenging—but stressful at certification courses. Rae, Continuous Quality Improvement the same time.” Brett Patterson, IAED Academics, Manager, San Francisco Department Standards & Research Division, emphasizes of Emergency Management/Division Mentor the importance of communications as a of Emergency Communications, San A transfer into training at Fayette prerequisite for a public safety career. He Francisco, Calif. “Many responded with County 911 gave Tonya Warr greater was a paramedic early in his EMS career and their guns, batons, or mace. One recruit, insight into new hire issues and reasons part of a system that required paramedic a little smaller in stature than the rest, many left the profession after two to certification to dispatch calls, which he did held up his portable radio. When asked three years. The day-to-day stress can be for another eight years. why, his response was, “Because with one incredibly difficult, she said, and even her “While this strategy was locally touted of these, I can get four or five of you to background in a public service family as a clinical advantage to the public, the help me.” didn’t prepare her for everything the real advantage was the personnel that Who is on the other end of that job requires. emerged,” Patterson said. “Indeed, when I radio ensuring he gets that help? The “Nothing can compare to, or prepare look at my colleagues today, some 30 years emergency dispatcher. you for, a career in emergency dispatch,” later, most are leaders who got their start in “Dispatch is not something that you said Warr, an emergency dispatcher communications. Whether one chooses to ‘just do’ if you can’t get hired as one of the in Georgia for 12 years, including as a manage responders and the scene on-line as a other three,” Rigden said. “Each segment dispatch trainer at Fayette County 911, calltaker/dispatcher, or begin with this, and of police, fire, and medical response Fayetteville, Ga. then move up the ladder into administration, is vital to the whole, yet requires very Equipped with insight from working communications experience is generally different skill sets. The conversation closely with new hires, she realized the regarded as a prerequisite for a public needs to be about which career fits the agency could do more to support an safety career.” person and particular skill set. You want individual in a way that wasn’t connected to to flourish in your chosen career path.” job performance. She hit upon the idea of Dispel misconceptions As any emergency dispatcher will tell mentoring, which she knew was successful Helicopter paramedics attempting to you, the first link in emergency response in introducing new people to a corporate or rescue a bus load of children stranded in provides every bit the adrenaline rush, other public safety landscape. a flood, police stopping a home intruder combined with the spirit of altruism, as “A mentor provides an introduction,” attempting to kill a father and his son, EMS does in the field. Warr said. “The mentor can be a cheerleader firefighters rescuing babies and a babysitter “Before I started, I was told not and adviser to a beginner but without the from an inferno at an apartment complex, everyone can do this job,” said Muskogee political strings attached. There are no ties to and highway patrol vehicles in a high-speed County EMS Communication Center employment or advancement.” chase to stop a suicidal person driving (Okla.) EMD Kandis Crespy, who was The two-tier program Warr conceived head-on into traffic—these are the scenes presented a Stars of Life Award from assigns, in the first tier, a new-hire-in-training from the popular series “Rescue 911” that the Oklahoma Ambulance Association, to a full-fledged dispatcher relatively new continue to influence generations of TV honoring her dedication to emergency to the floor. The mentor acts as a sounding viewers through reruns and DVDs. We dispatch. “That’s probably true, but it’s board for the apprentice who might want

iaedjournal.org | THE JOURNAL 25 • FEATURE | making dispatch a career to discuss an issue occurring outside of calls, the radio, how busy we are. They saw a and help create a positive atmosphere. work affecting performance. The second different picture than they had anticipated You even sometimes save lives. All this tier involves pairing a more experienced and asked so many great questions.” has tremendous value. Don’t forget it, dispatcher as the mentor to a novice who Greguski transferred from the and use it in the most appropriate way to might want to know where to go from here. ambulance into the communication support your own career.” Is the skill set relevant for advancement? Is center 12 years ago. She wanted to learn there a future in emergency dispatch? a new skill set, despite suggestions from See for yourself Mentoring allows the training to a few former co-workers that she would Warr had planned to continue a career concentrate on performance and provides not find excitement within the walls of in public safety until an opening at her an entry for the apprentice into the the communication center. daughter’s elementary school offered her center’s culture. “They think we sit around, our feet the opportunity to return to teaching. “There’s almost immediate buy-in,” up on a table, snacking, and watching The decision was difficult, she said. Warr said. “Mentoring motivates. New TV,” she said. “Nothing could be further “Dispatch is a wonderful profession,” she people feel that the agency cares about from the truth. There is so much to learn: said. “I loved being the person taking care of them. They matter to the organization.” protocols, Pre-Arrival Instructions, and the others—the guardian of guardians. It’s a very Before embarking on a mentoring psychology of DLS. We have GPS tracking validating profession for the right person.” program, Warr highly recommends and multiple screens to watch. We need Who’s the right person, and how do formalizing a plan and cultivating mentors. to feel for the caller and stay composed you find one? “Make sure your mentors know exactly what to do,” she said. “The program is there to encourage but not in any way change the way the job is performed.”

Promote value “The public always hears of a firefighter or police officer doing something heroic, but they don’t see the voice behind the scene,” Lord said. “Does anyone ask what has happened prior to their arrival? Does anyone know what the emergency dispatcher did to make it possible for the firefighter or police officer to have a positive outcome instead of the other way?” EMD Jessica Greguski, Northwell Health Center for EMS, Syosset, N.Y., had taken a back seat in the eyes of her children compared to her husband’s no matter what happens. We have to rein Lord offers the following suggestion. paramedic career. So, she brought them back in, act as their security blanket. “If you are seriously thinking about it [or her daughters, 10 and 6, into the Believe me, there’s nothing easy about know someone who might be], contact communication center on the national emergency dispatch.” your local dispatch center and ask questions, “Take Your Child to Work Day,” which Maybe the best possible motivation and ask if you can shadow a dispatcher for this year Northwell Health held on June 6. is internal to the individual, said Marie a couple hours to know if that is what you “I wanted them to see what I do,” Leroux, registered nurse, PDC™ protocol truly want to do,” she said. J Greguski said. systems implementations expert, La Greguski didn’t know what to expect, Minerve, Québec, Canada. Sources but she wanted to give her children a “Too many times, I see high- 1. “Police, Fire, and Ambulance Dispatchers.” Occupational Outlook Handbook. U.S. Department of Labor, Bureau of sense of what their mom does and the performance individuals in the field of Labor Statistics. 2015; Dec. 17. http://www.bls.gov/ooh/ impact emergency dispatch has on the emergency dispatch that don’t realize office-and-administrative-support/police-fire-and-ambu- community. She was favorably impressed their value,” she said. “Think about what lance-dispatchers.htm (accessed June 20, 2016). 2. “Emergency Services Dispatcher.” Metropolitan Area by their response. you do. Take the time to sit down; review Communications Center. 2012; April. http://www. “They loved it,” Greguski said. “My what you have done. You are certified. metcom911.org/employment/images/Emergency%20 older daughter was very excited. She was You are trained. You have an expert Services%20Dispatcher.pdf (accessed June 22, 2016). fascinated over everything going on: the protocol. Maybe you motivate colleagues

26 THE JOURNAL | iaedjournal.org fire cde | ON TRACK •••

LINK IN FIRE CHAIN National standards confirm importance of emergency dispatch

Audrey Fraizer

ven if you think emergency NFPA The 2014 edition defines nine essential dispatch has been left behind Founded in 1896, the NFPA develops positions and the associated duties of 911 Ein national standards, you can’t the codes, standards, research, training, and center personnel. The nine positions are disregard the full-speed-ahead drive to education for the fire service internationally further divided into the knowledge and catch up. and has 70,000 members worldwide. The skills necessary to satisfy the duties that NAVIGATOR presentations over NFPA emergency dispatch regulations fall under each position. For example, the past several years have emphasized apply to all disciplines (fire, police, EMS, and Chapter 10 details the knowledge and the inclusion and expanding role of critical incident management). skills required for QA/QI personnel dispatch in national regulations and to perform several tasks, including call proposed standards. The National Fire NFPA 1061, Professional review, feedback, remediation, data Protection Association (NFPA), the Qualifications for Public Safety management, continuing education, and National Fire Incident Reporting System Telecommunications Personnel maintaining certification. The training (NFIRS), Fire Suppression Rating NFPA 1061 was introduced in 1996 coordinator must have the knowledge Schedule of the Insurance Services and has been updated three times since, and skills to manage training, develop and Office (ISO), and the new kid on the for the 2002 edition, the 2007 edition, and modify curriculum, create remediation block, the National Fire Operations the 2014 edition, which was extensively strategies, schedule and document Reporting System (NFORS), impact revised to recognize the expanded roles training, evaluate the effect of training, every level of emergency dispatch, from of 911 communication centers. The and construct a performance-based job description to the time stamp of standard also addresses the qualifications instructor evaluation plan. when call processing ends. recommended for this quickly evolving IAED™ Fire Program Administrator technology-based industry. Jay Dornseif said the positions

iaedjournal.org | THE JOURNAL 27 fire cde

and descriptions in NFPA 1061 signaling systems and has gone through 31 response facilities (ERFs) or emergency add weight to the importance of revisions during the past 100-plus years. response units (ERUs) in the field.”2 The emergency dispatch. The 1999 revision was a particularly term includes “caller interrogation and “The standard defines the value each arduous task. The committee chaired resource selection [determination of position should add to the whole agency,” by Evan E. Stauffer Jr., then of the which emergency response unit (ERU) Dornseif said. “Dispatch is no longer the Naval Facilities Engineer Command, will respond], up to the start of the dumping ground. The standard is saying Pennsylvania, completely rewrote the emergency response facilities’ (ERFs’) unless you have all this, we can’t use you.” standard to reflect dramatic changes in notification process.”3 Dornseif is chair of the NFPA emergency communication: “emergence The definition means the emergency Committee for Professional of joint communication centers, the dispatch process stops when the Qualifications for Public Safety increase in technology-based information dispatcher starts the notification process, Telecommunication Personnel. He also systems that assist users in both the Dornseif said. serves on the NFPA’s 1221 Committee, communication center and the field of “You’ve done your due diligence,” which provides minimum standards for operations, and the role communication he said. “You’ve started notifying the day-to-day performance operations of plays in emergency scene operations responders that they have an emergency, emergency communication centers. within the Incident Command System.”1 and that’s where your time stamp stops.” In the 2015 revision, the NFPA 1221 The NFPA standard for Call NFPA 1221: Standards for the technical committee modified alarm Answering was revised to 95 percent Installation, Maintenance, and processing times in response to comments of alarms received on emergency lines Use of Emergency Services from dispatchers and calltakers about shall be answered within 15 seconds, and Communications Systems the additional time required (above the 99 percent of alarms shall be answered NFPA 1221 emphasizes the application existing standard) to gather information. within 40 seconds (NFPA 1221-7.4.1). of standards to all emergency dispatchers, The 2016 edition revisited alarm The NFPA Standard for Call not solely those employed by the fire processing times and definitions in several Processing (NFPA 1221-7.4.2) states that service. Similar to NFPA 1061, the sections of Standard 1221. alarm processing time is the time it takes to initiate dispatch of FIRE apparatus and personnel or the time it takes to transfer a fire alarm to another PSAP F P D S and, with the exception of the call types identified in 7.4.2.2 (listed below), 90 by the numbers percent of [fire] alarm processing shall be completed within 64 seconds and 95 percent of [fire] alarm processing shall L be completed within 106 seconds. The F AcE exceptions are: •• Calls requiring emergency medical dispatch questioning and pre-arrival medical instructions U •• Calls requiring language translation •• Calls requiring the use of a TTY/TDD device or audio/video relay services •• Calls of criminal activity that require information vital to emergency responder safety prior to dispatching units • L North American English, United Kingdom English, United States Spanish, German, French, Dutch, Brazilian Portuguese, and Malay. • Hazardous materials incidents •• Technical rescue •• Calls that require determining standard has been repeatedly updated Chapter 3 defines emergency alarm the location of the alarm due to and revised since its introduction. Not so processing/dispatching as a process insufficient information (new parallel, however, are the longevities of the “by which an alarm answered at the for 2016) two standards. NFPA 1221 was introduced communication center creates a call for •• Calls received by text message (new in 1898 as part of a general standards on service and is transmitted to emergency for 2016)

28 THE JOURNAL | iaedjournal.org fire cde

Processing times for calls not on the in the communication center at all complements the existing NFIRS. NFIRS list are 90 percent within 64 seconds and times (NFPA 1221-7.3.1) and enhanced was designed as an incident-specific 95 percent within 106 seconds. telecommunicator support during system to describe and measure the cause, The NFPA list, however, is a critical incidents such as a Mayday. origin, and severity of fires nationally. recommendation, Dornseif said. Dornseif lauded the two-per-shift NFORS is focused on describing and measuring a fire department’s availability, capability, and operational effectiveness on the outcome of a fire event. The systems work together, Dornseif said. “The systems drill down to effectively fight structure fires,” he said. “We know how well we did and what we’re capable of doing.” In addition to real-time analysis and operational application, agencies can enter data identifying new infrastructure important to fire response, including water resources and street configurations. Several national fire associations support NFORS, including the Urban Fire Forum and the Metropolitan Fire “It’s up to your agency to decide what recommendation, saying, “It’s time to have Chiefs, which released a joint statement constitutes an emergency,” he said. “If it’s two people on duty at all times. Period.” in September 2015 that advocates adding not on your agency’s list, it will not count Fire Priority Dispatch System™ NFORS to any NFPA standards involving against the performance requirements of (FPDS®) v6.1 reinforces the urgency of fire data. NFPA 1221-7.4.2. You can process this call response to structure fires. It includes the NFORS development was funded until the cows come home.” addition of ECHO-level determinants through the AFG Fire Prevention and Structure fire calls, he said, should on Case Entry for REPORTED Safety grant program. The IAED was always be on the list of every fire BUILDING/STRUCTURE FIRE. The among 25 organizations serving in an department communication center revisions allow an earlier response NFORS advisory capacity. J due to the potential and actual loss of for all structure fire incidents with a life involved. spontaneous report of smoke or flames Sources “Speed this one out the door and make while also allowing for differentiated 1. National Fire Prevention Association. Standard for the Installation, Maintenance, and Use of Emergency Ser- sure you’re sending out the right stuff,” responses and resource allocation for vices Communications Systems. 2016 Edition. http:// said Dornseif, a 20-year veteran of the fire ECHO- and DELTA-level incidents. catalog.nfpa.org/NFPA-1221-Standard-for-the-Installa- service. “Everything else can wait.” tion-Maintenance-and-Use-of-Emergency-Services-Com- munications-Systems-2016-Edition-P1420.aspx (accessed According to the NFPA, U.S. fire The National Fire Operations July 19, 2016). departments responded to 494,000 Reporting System 2. Haynes H. “U.S. Fires in the United States During 2014 structure fires during 2014, resulting in NFORS (pronounced in-fours) is a Fact Sheet.” National Fire Prevention Association. 2014. www.nfpa.org/.../FD0144A044C84FC5BAF90C0 3,275 civilian fire deaths, 15,775 civilian supplemental tool created to optimize fire (accessed July 19, 2016). fire injuries, and $9.8 billion in property operations for structural fires and reduce 3. “NFORS: Intelligent Fire Data Reducing Injury, Death, damage. The NFPA has released other firefighter and civilian injuries and deaths and Damage.” 2015. 4 4. Vision 20/20. National Strategies for Fire Loss Preven- facts about structure fires including: through local and collaborative efforts. tion. http://strategicfire.org/../2016-moore-merrell- •• One structure fire was reported The NFORS software evaluates NFORS-ppt-pdf.pdf (accessed July 19, 2016). every 64 seconds. several variables generated at data entry •• 92 percent of all structure fire to help determine the most effective and deaths resulted from home fires. efficient resource allocation available •• On average, seven people die in U.S. and whether the resources dispatched home fires per day. ultimately managed the incident. NFORS Finally, new standards in 2016 can benchmark between user agencies to recommend a minimum of two identify and promote best practices. telecommunicators on duty and present Launched in late 2015, NFORS

iaedjournal.org | THE JOURNAL 29 F | FIRE CDE QUIZ

CDE Quiz Mail-In Answer Sheet YOU MUST BE CERTIFIED TO TAKE THIS QUIZ Answer the test questions on this form. (A photocopied answer sheet is acceptable, but your answers must be original.) WE WILL NOT Answers to this quiz are found in the article “Link in Fire Chain,” which starts on page 27. Take this quiz for 1.0 CDE unit. PROCESS ALTERED SIZES. A CDE acknowledgement will be sent to you. (You must answer 8 of the 1. This organization develops the codes, standards, research, training, and education for the fire service internationally and has 10 questions correctly to receive credit.) 70,000 members worldwide. Clip and mail your completed answer sheet along with the $5 USD a. Metropolitan Fire Chiefs (U.S. currency) NON-REFUNDABLE processing fee to: b. National Fire Protection Association c. ISO The International Academies of Emergency Dispatch d. U.S. Fire Administration 110 South Regent Street, 8th Floor Salt Lake City, UT 84111 USA 2. If you wanted information about Professional Qualifications for Public Safety Telecommunications Personnel, which one of Attn: CDE Processing the following standards would provide the information? (800) 960-6236 US; (801) 359-6916 Intl. a. NFPA 1001 Please retain your CDE acknowledgement for future reference. b. NFPA 1006 c. NFPA 1061 Name ______d. NFPA 1072 Organization ______3. What is the number of essential positions in the communication center, according to NFPA standards? a. three Address ______b. six c. nine City ______St./Prov.______d. twelve Country ______ZIP______4. In the 2015 revision, the NFPA 1221 technical committee modified alarm processing times in response to comments from dispatchers and calltakers about: Academy Cert. #______a. the additional time required (above the existing standard) to gather information. b. the lack of acceptable reasons for time delays in the standard. Daytime Phone ( )______c. the one-size-fits-all application of time standards. d. categorizing the types of alarm processing in reference to maximum and minimum time allotments. E-mail ______5. Technically speaking, emergency alarm processing/dispatching is a process that involves: PRIMARY FUNCTION a. the incident, from the time of the call to the resolution of the emergency (i.e., fire is extinguished and all crew members are accounted for). Public Safety Dispatcher (check all that apply) b. the time of the call to the arrival of fire units at the scene. _____Medical _____Fire _____Police c. the initiation of response to the resolution of the emergency. d. from caller interrogation and resource selection up to the start of the emergency response facilities’ notification process. Paramedic/EMT/Firefighter 6. The NFPA standard for Call Answering (NFPA 1221-7.4.1) was revised to: Comm. Center Supervisor/Manager a. 80% within 6 secs. for all alarms received on emergency lines, and 69% answered within 10 secs. Training/QI Coordinator b. 85% within 9 secs. for all alarms received on emergency lines, and 79% answered within 20 secs. c. 90% within 12 secs. for all alarms received on emergency lines, and 89% answered within 30 secs. Instructor d. 95% within 15 secs. for all alarms received on emergency lines, and 99% answered within 40 secs. Comm. Center Director/Chief 7. According to NFPA statistics, what is the percentage of death resulting from home fires compared to other types of structure fires? Medical Director a. 45 percent Commercial Vendor/Consultant b. 68 percent Other c. 92 percent d. 100 percent 8. What is the minimum number of telecommunicators that should be in the comm. center at all times, according to NFPA ANSWER SHEET F FIRE standards released in 2016? Nov/Dec 2016 Journal “Link in Fire Chain” Please mark your answers in the appropriate box below. a. two b. three 1. o A o B o C o D c. four d. six 2. o A o B o C o D 9. NFORS is a(n): 3. o A o B o C o D a. required tool created to establish national data for wildfires. 4. o A o B o C o D b. supplemental tool created to optimize fire operations for structural fires and reduce firefighter and civilian injuries and deaths through local and collaborative efforts. 5. o A o B o C o D c. software package created to schedule and allocate resources. d. incident-specific system to describe and measure the cause, origin, and severity of fires nationally. 6. o A o B o C o D 10. NFIRS was designed as a(n): 7. o A o B o C o D a. required tool created to establish national data for wildfires. 8. o A o B o C o D b. supplemental tool created to optimize fire operations for structural fires and reduce firefighter and civilian injuries and deaths through local and collaborative efforts. 9. o A o B o C o D c. software package created to schedule and allocate resources. d. incident-specific system to describe and measure the cause, origin, and severity of fires nationally. 10. o A o B o C o D To be considered for CDE credit, this answer sheet must be received no later than 12/31/17. A passing score is worth 1.0 CDE unit toward fulfillment of the Academy’s CDE requirements. Please mark your responses Expires 12/31/17 on the answer sheet located at right and mail it in with your processing fee to receive credit. Please retain your CDE letter for future reference.

30 THE JOURNAL | iaedjournal.org medical cde | ON TRACK •••

MAKE THE RIGHT CALL Different choking scenarios require different actions

Josh McFadden

n March 2016, every caregiver’s Scenario 1 on the line and I’ll tell you exactly what worst nightmare came true for Sonia In Case Entry, the caller reports that the to do next. Do not slap her on the back.” IMelendez. Minutes after leaving a child was sitting in her car seat, choking. Having all other necessary information, you Chicago, Ill., mall, Melendez noticed The 18-month-old girl had been sucking must move to the appropriate Pre-Arrival that her 18-month-old granddaughter, on her pacifier when the choking began. Instructions. Your choice will depend Aureliana Colon, was choking. Melendez The caller also states that the girl’s eyes on the patient’s age and whether she is immediately pulled her car to the side of have rolled back into her head and she conscious. Because the caller reported the road and frantically called 911. However, appears unconscious. She is not breathing patient is not conscious, you can eliminate the grandmother was too hysterical or coughing at all. The caller says the the use of Protocol D: Choking (Conscious) to speak, so she handed the phone to a grandmother told him the child was – Adult/Child/Infant/Neonate. bystander who had pulled over to lend choking on some candy. Also, because you are working with an a hand. Steps to follow unconscious 18-month-old, you must Based on the information you have, use Protocol B: Airway/Arrest/Choking Handling the call you know the Determinant Code should (Unconscious) – Child 1–7 yrs. The good Samaritan spoke with a be 11-E-1C, COMPLETE obstruction/ This protocol has 18 panels. The dispatcher and waited on the phone until INEFFECTIVE BREATHING. Axiom 1 panels you cover and the instructions paramedics arrived. Fortunately, the child on Protocol 11: Choking, helps you make you give are contingent on the answers survived and was out of the hospital in this choice. The Axiom reads, “Victims the caller provides. For example, Panel a few days. Of course, when it comes to of COMPLETE airway obstruction are B-2 has you instruct the caller to “Lay a choking call, there are many possible unable to speak, breathe, or cough.” You her flat on her back on the floor/ground challenges to address. Let’s examine a few dispatch the call appropriately and then and remove any pillows” and then to turns this call could have taken and how give Post-Dispatch Instructions: “I’m sending “Kneel next to her and look in the mouth you would handle each scenario. the paramedics to help you now. Stay for food or vomit.” You will then ask a

iaedjournal.org | THE JOURNAL 31 medical cde

critical question: “Is there anything in the Scenario 3 to give the compressions to her newborn mouth?” If the answer is yes, you move to This time, assume Grandmother granddaughter. After clearly giving the Panel B-13, where you tell the caller how to Melendez calls in herself. During the instructions, ask, “Do you understand clear the airway by cleaning out the child’s Case Entry Questions, you learn that her me so far?” If the grandmother says mouth and nose. At this point, because the 2-week-old granddaughter has a complete that she does not, give clarification and baby is obviously not breathing, you’ll go obstruction and is unconscious. She reassurance. If she understood your to Panel B-3 without giving instructions; doesn’t know what the baby is choking on. directions, you would head back to Panel Panel B-3 will then send you to Panel B-5 You know to immediately dispatch a Code N-4 and instruct her to give the baby five to begin compressions and then go back to mouth-to-mouth instructions after CPR is administered. D Choking (conscioUs) – Adult / Child / infAnt / neonAte Adult/Child/infAnt/neonAte Scenario 2 1 (Phone to Patient) 2 Check Breathing 3 Check Position Adult/Child • Are you right by her/him now? (Look at her/him very closely. Tell me Listen carefully and I’ll tell you exactly Suppose the only information you Yes a 2 exactly what you see and hear her/him what to do next. doing.) • Is s/he standing, sitting, or lying down? have from the third-party caller is that (No) Get the phone as close to • Can s/he breathe (talk, cough, or cry) at all?

her/him as possible. Don’t hang up. a a woman had pulled her car over on a Adult/Child 9 Yes a Do it now and tell me when it’s done. Infant/Neonate a 15 a the highway because a baby inside (If I’m not here, stay on the line.) a Adult/Child 3 No a a Infant/Neonate 12 Standing/Sitting a 4 was choking. Unconscious a NABC-2 a 2 Unconscious a NABC-2 Unconscious a BC-2 Lying a 7 Steps to follow 4 Standing/Sitting Adult/Child 5 Perform Heimlich Adult/Child 6 Reassure/Continue Adult/Child Stand/Kneel behind her/him and put your In one quick motion, jerk hard, up and into Don’t give up. Keep doing it until s/he can After obtaining the location of arms around her/his waist. Make a fist and the stomach. breathe (talk, cough, or cry). grasp it with your other hand, just above the Keep doing it until s/he can breathe (talk, If s/he becomes unconscious, tell me belly button. the caller/patient, you must ask Case cough, or cry). If s/he becomes , immediately. Be sure you’re below the ribs and the unconscious Entry Question 3c: “Is she breathing or breastbone. tell me immediately. (Tell me when the paramedics (EMTs) are • Do you understand me so far? Yes a 5 • Can s/he breathe (talk, cough, or cry) at all? right with her/him.) coughing at all?” If the caller isn’t sure, No a Clarify/Reassure • Can s/he breathe (talk, cough, or cry) at all? Unconscious a BC-2 Yes a 9 Arrival a 18 Yes a 9 Obese/Visibly Pregnant a 10 a a a No/UNCERTAIN a Repeat instruct him to check and find out. If Unconscious BC-2 No/UNCERTAIN 6 Unconscious BC-2 7 Lying Down Adult/Child 8 Perform Heimlich Adult/Child 9 Monitor Breathing Adult/Child the caller reports that the patient is Make sure s/he is lying face up. (Adult) Using your weight, push quickly Just watch her/him very closely and don’t Straddle her/his hips with your legs. into her/his stomach. slap her/him on the back. breathing, you know it is a PARTIAL (Child) In one motion, push quickly into Place your hands, one on top of the other, her/his stomach. If s/he starts wheezing, making funny obstruction. It is essential here to just above her/his belly button. Keep doing it until s/he can breathe (talk, noises, or becomes unconscious, tell me • Do you understand me so far? cough, or cry). If s/he becomes unconscious, immediately. instruct him not to slap the baby on the tell me immediately. Tell me when the paramedics (EMTs) are a Yes 8 • Can s/he breathe (talk, cough, or cry) at all? right with her/him. No a Clarify/Reassure back, because, as Axiom 2 on Protocol 11: Yes a 9 Arrival a 18 Unconscious a BC-2 Unconscious a BC-2 No/UNCERTAIN a 6 Unconscious a BC-2 Stopped Breathing a 2 Choking states, “PARTIAL obstruction For use under MPDS® license agreement only. © 1979–2015 Priority Dispatch Corp. All rights reserved. AMPDS™ v13.0, NAE-std, 150529 can be made more life-threatening by attempted intervention in the breathing patient.” 11-E-1U. You have provided Post-Dispatch puffs of air. Next, you would go on to Case Entry Question 4 asks, “How Instructions and go to Protocol N: Panel N-8 and continue CPR and mouth- old is she?” In this scenario, let’s say the Airway/Arrest/Choking (Unconscious) to-mouth. caller asks the grandmother and reports – Newborn/Neonate < 30 days. If you From this point, follow Protocol N that the baby is 6 months old. The first determine from Panel N-2 questioning until emergency responders have arrived two Key Questions to ask here are, “Is she that there is nothing in the baby’s mouth, on the scene. completely alert?” and “Is she breathing how would you handle this situation? normally?” Assuming the answers to Steps to follow Customer service these Key Questions are “no” and “yes” After determining that nothing is in As with other Chief Complaints, respectively, the calltaker would skip the baby’s mouth, you would go from when dealing with a choking call, you’ll Key Question 3 “Is she able to cry?” since Panel N-2 to Panel N-5, giving instructions often be talking to frantic, panicked it is only asked if the patient is alert and and moving past Panel N-4. However, if callers whose loved one is in a life-or- breathing normally and would move on there was something in the baby’s mouth, death struggle. Even third-party callers to Key Question 4 “What did she choke the correct panel flow would be N-1, N-2, will experience a great deal of stress on?” If the caller isn’t sure what the baby N-13, N-3, and then to N-5. Once in N-5, as you instruct them on how to assist is choking on, you will select Determinant this panel instructs you to tell the caller, in the emergency. Thus, it’s vital that Code 11-D-2U, Not alert. “Listen carefully and I’ll tell you how to do you provide excellent customer service Next, give your Post-Dispatch chest compressions. Make sure the baby by reassuring the caller, clarifying Instructions and appropriate Pre-Arrival is flat on its back on the ground. Place 2 instructions, speaking calmly and directly, Instructions. In this scenario, you would fingers on the breastbone, right between and behaving in a professional way. use Protocol D since the baby, although the nipples.” Next, move to Panel N-6, Here are some ways in which you can not alert, is conscious. where you will tell the grandmother how help callers make it through this difficult

32 THE JOURNAL | iaedjournal.org medical cde situation and provide patients the help apples, and grapes are they need1: good for you, but they are •• Use repetitive persistence. second, third, and fourth, •• Repeat phrases verbatim with a steady respectively, when it tone of voice. comes to choking hazards. •• Say, “Listen to me carefully so we’re Nuts, peanut butter, sure to do it right.” marshmallows, gum and •• Use the caller’s name if possible. hard candy, and popcorn •• Give reassurance by telling the caller round out the top nine. that if the patient can talk or cough, Other foods to watch the airway is open and enough oxygen out for are chips, cheese, should be getting to the brain. pretzels, raisins, and •• Use a positive tone. ice cubes. •• Do not alter the wording from Food is hardly the only the protocols. culprit when it comes to •• Never use an offensive command. choking. Deflated balloons, •• Refrain from inappropriate behaviors batteries, bolts, coins, crayons, such as ignoring the caller’s concerns jewelry, doll accessories, toys or demeaning, judging, or insulting with small parts, small office the caller. supplies, and bottle caps •• Don’t use offensive or are other common sources confrontational language. for choking. It is essential that you maintain Children are especially control of the call. Callers will look susceptible to choking. to you to take charge and tell them One reason could be that exactly what to do. Recognize that in children have airways moments of extreme stress, some callers one-third the size of an may lose control of their emotions and adult’s. Between 2001 and say hurtful things to you. Never take 2009, an average of 12,435 these things personally. Keep your children 14 and younger own emotions in check and commit to were treated annually in complete professionalism. U.S. emergency rooms for choking problems.3 The data Another study, this one The holiday season brings family and published in the journal Pediatrics, Sources friends together for parties, celebrations, revealed that 34 children per day are 1. Clawson J, Dernocoeur K, Murray C. Principles of Emer- 4 gency Dispatch. Fifth Edition. International Academies and festivities. Where there are groups admitted to the ER due to choking issues. of Emergency Dispatch; Salt Lake City, Utah. 2014. assembling for social events, there is In Canada, choking and suffocation 2. Hutton L. “Top 9 Choking Foods.” Family Education. Sand- often food and drink. While we look are blamed for nearly 40 percent of all box Networks, Inc. 2012. http://life.familyeducation.com/ forward to these happy times, there’s unintentional deaths among babies under slideshow/safety/65468.html (accessed Aug. 8, 2016). 3. “Recent Statistics on Choking.” Be Smart Don’t Choke. 5 always the risk of choking. When you the age of 1. In Europe, an estimated BC Children’s Hospital & Pedagogy Department. 2016. picture a full room of people talking 2,000 children 14 and younger choke on http://dontchoke.ubc.ca/saving-lives/recent-statistics/ and laughing, all while eating their a toy each year, and 50,000 children in (accessed Aug. 8, 2016). 4. See note 3. favorite meal or downing their favorite this age range have some sort of choking 5. See note 3. 6 beverage, it’s easy to see why choking is a episode annually. 6. See note 3. common hazard. The elderly also are prone to 7. “Choking Prevention and Rescue Tips.” National Safety The American Academy of Pediatrics succumbing to choking hazards, largely Council. 2016. http://www.nsc.org/learn/safety-knowledge/Pages/safety-at-home-choking.aspx (accessed Aug. reports that hot dogs top the list of foods because of dentures or difficulty 8, 2016). that cause the most choking incidents. swallowng. In 2016, the National Safety One person every five days dies from Council reported that 4,684 people died choking on this popular food. Hot dogs from choking in 2013. Of this total, 2,751 are the leading cause of choking deaths were older than 75.7 J for children 14 and under.2 Carrots,

iaedjournal.org | THE JOURNAL 33 G | MEDICAL CDE QUIZ

10. o A o B o C o D To be considered for CDE credit, this answer sheet must be received no later than 12/31/17. A passing score is worth 1.0 CDE unit toward fulfillment of the Academy’s CDE requirements. Please mark your responses Expires 12/31/17 on the answer sheet located at right and mail it in with your processing fee to receive credit. Please retain your CDE letter for future reference.

34 THE JOURNAL | iaedjournal.org BLAST FROM THE PAST •••

TOOLS TO MEDICAL SUCCESS FOR LAW ENFORCEMENT SCA survival takes more than buying an AED for police

Jeff Clawson, M.D.

ho’s often first on the scene in an emergency? program. It’s essential that response agencies coordinate their Law enforcement. protocols, and continue to fine-tune procedures once officers W Police officers, sheriff’s deputies, highway with AEDs are being deployed. Survival rates suffer without patrol, and specialty police (such as search and rescue and coordinated response to cardiac emergency calls and timely SWAT) are often on scene before firefighters and EMTs/ hand-off to medical professionals who can provide advanced Paramedics arrive for reasons including proximity, safety, life support. and availability. So, it only makes sense that these same EMDs trained and certified in the use of the Medical people carry tools proven effective in medical emergencies, Priority Dispatch System™ (MPDS®) are an essential first particularly automated external defibrillators (AEDs) to give step to better ensure efficient and rapid deployment of AED- a second chance to patients of sudden cardiac arrest (SCA). equipped officers. Tied to that step is the working relationship Arriving with an AED, however, is actually down the list between the communication center and law enforcement field of actions necessary to success. Strengthening the Chain of response. EMDs are vital partners in managing the types of calls Survival requires more than purchasing AEDs, placing them that AED-equipped officers respond to, and, at a minimum, in squad cars, and training officers how to use them. After all, dispatch protocols should be specific and clearly identify medical would the Lone Ranger prove effective in uncharted territory problems that will trigger an AED response from an agency. without his astute companion Tonto providing direction? This was an issue that led to the Academy’s development As the Academy – and its founder Jeff Clawson, M.D., of the Cardiac Arrest Quotient (CAQ), as described in the has long asserted: dispatch is a critical component in an AED accompanying article. The CAQ is the number of SCAs

iaedjournal.org | THE JOURNAL 35 blast from the past

found at scene within a particular determinant descriptor Outcomes, however, are not universal in application of a divided by the total number of responses generated by that single CAQ system. Outcomes depend on data submitted to the code. The formula delineated stronger indicators, heralded the Academy and analyzed according to specific study parameters addition of several new, richer CAQs, and stimulated continuing and individual agencies taking advantage of the CAQ concept to research into establishing associations between patient outcomes establish local AED programs. J and MPDS priority levels and specific determinant codes.

36 THE JOURNAL | iaedjournal.org dispatch in action | YOUR SPACE •••

start CPR, you don’t stop until a medical professional relieves you. Karen and her sons didn’t stop. They handed the phone back and forth, staying in constant communication with Scott as he passed along instructions to them while other dispatchers relayed information to the first responders who were en route. “The dispatcher was very calm, very reassuring,” Karen recalled. “He told me where to push on the chest, and he told me to count out loud. If I stopped, he’d say, ‘I can’t hear you counting. Are you counting?’” Scott stayed on the phone as the quick response team from the Monroe Rural Fire Protection District showed up, along with two deputies from the Benton County Sheriff’s Office. He stayed on the phone as they unpacked their gear and made their way into the house. Only when the emergency responders were at Dave’s side and ready to take over chest compressions did Scott allow Karen to hang up. The quick response team used a defibrillator to shock Dave’s heart back into action. It took five shocks to get him to the point where they could transport him to Good Samaritan Regional Medical Center in Corvallis. Dave survived. Reflecting upon the situation, 911 Manager Scott Haberkorn SPOKES IN A WHEEL noted that there was no margin for error; each component of the entire emergency response had to function perfectly to save EMS is survivor’s Circle of Life Dave’s life. “The system worked,” Haberkorn said. “From the dispatcher, Patrick W. Rollens to the family, to the Monroe quick response team, to the ambulance that transported the patient to the hospital in Corvallis, everything worked just right.” n a mild, cloudy afternoon, in the comfort of his living Scott points to the family as the critical component. room and surrounded by his family, Dave Smith “If the callers don’t stay with me, if they don’t at least stay Olooked back on the remarkable confluence of events calm and coherent enough to follow instructions, it’s difficult to that saved his life back this past April after he went into cardiac help them,” Scott said. arrest while watching TV. “The family made The evening started uneventfully, with Dave and his wife the difference in AS TEY OFTEN DO RAW NUMBERS TELL Karen watching TV. But at 10:30 p.m., Dave’s head pitched back this case.” TE REMARABLE STORY. and his breathing became labored. Karen knew something was The city 1 e amon wic e sial terribly wrong. of Corvallis ae o an nesonsie eson in cadiac Karen’s 911 call reached David Scott, a dispatcher at the operates the aes dos o eac mine a oes Corvallis (Ore.) Regional Communications Center with 10 Corvallis Regional wio . years of experience on the job. Within seconds, David was Communications e aoimae nme o gathering information and delivering critical instructions over Center, which ces comessions delieed aen the phone using the center’s new ProQA® dispatch system, provides 911 and e eenae sons as Dae la which had been adopted just a few weeks prior. Karen was dispatch services for nesonsie on ei liin oom loo. joined by two of her teenage sons, and together they were able 10 Benton County 1 mines 32 seconds e amon o ime to get Dave onto the floor and flat on his back. emergency service e disace om e oallis eional Then the real work began. “Instructions are only as good as providers. Go ommnicaions ene saed on e one caell and calml idin aen the person on the other end of the line,” Scott said. “You have to totocorvallisoregon. and e sons o e liessainin have somebody on the other end willing to follow through with gov/911 for more ecnies a eled sae Daes lie. what you’re asking.” information on the 5 e nme o socs adminiseed o Corvallis Regional Scott instructed Karen and her sons to begin CPR. It’s a Dae emeenc esondes wen physically demanding technique that leaves even the sturdiest Communications e aied on e scene. firefighters winded after just a few minutes. Center. J The success of CPR depends on one critical tenet: Once you

iaedjournal.org | THE JOURNAL 37 ••• YOUR SPACE | dispatch in action

GOOD LUCK COMES IN THREES New Hampshire EMD delivers

Audrey Fraizer

n iPhone cable has more uses than simply plugging it The cord was wrapped in place and tied when paramedics in a socket to recharge a battery. At least, that’s what a arrived on scene to whisk mom and baby to the hospital in Acaller discovered when EMD Daniel Redin got to the an ambulance. part in protocol about tying off a newborn’s umbilical cord. There’s no telling what responders thought of the innovative “Listen carefully and I’ll tell you exactly what to do next,” use of a phone cable, although cutting the umbilical cord is a job Redin said, reading the scripted Childbirth-Delivery Pre-Arrival best left to the professionals. Cutting the cord can expose the Instructions (PAIs). “We’re going to watch the baby closely for baby to infection, and babies continue to get oxygen through three minutes, then tie the cord with a string (shoelace).” the umbilical cord for five to 10 minutes after birth. About There was a pause. Dad, who was the caller, watched the one-third of the baby’s blood is still in the placenta. The oxygen baby. Everything was fine, except for a minor detail. stored in the blood and fed to the baby through the umbilical Dad was wearing slip-on shoes, and mom was wearing cord can be lifesaving if the baby isn’t breathing independently slippers. There were no spare shoelaces or balls of string in the and medics have yet to arrive on scene. car, and dad couldn’t leave the car to flag down a motorist in While the phone cord is most likely a unique way to tie hopes of borrowing a stranger’s shoelace. things up, handling a baby delivery is something the New The caller had no other choice but to improvise. Hampshire Bureau of Emergency Communications EMD “He [dad] looked around the car and all he could find was the has done over the phone and in person. Redin switched to phone cord,” Redin said. emergency communications four years ago. Prior to dispatch, he The PAIs went on as scripted. Dad tied the phone cord was an EMT for 10 years. around the umbilical cord. Again, following the PAIs, dad was Assisting in a birth is not uncommon for an EMT. In told not to cut the umbilical cord. emergency dispatch, however, it’s unlikely to have Redin’s

38 THE JOURNAL | iaedjournal.org dispatch in action

track record. He assisted in three LaFortune thanked everyone deliveries in two months during the involved in saving his life, saying he past summer. owes them all of his tomorrows yet The first delivery, in May 2016, was to come. “I don’t know how to put it complicated by distance. The mother into words except thank you,” he said. lived in a small town served by a “Thank you very, very, very much.”1 volunteer ambulance service that was Redin received press coverage not close to her home, and baby was not and a commendation from the New willing to give them the extra arrival Hampshire Division of Emergency time required. Services and Communications for the “Mom was in labor, and I went “difficulty breathing” call. through the complete delivery,” The first two recent baby deliveries Redin said. didn’t make it to the news, and although The second baby, similar to the third, the third delivery did, Redin’s name was was born roadside while mom was in not stated in the coverage. transit to the hospital. That doesn’t bother him; in fact, he All babies and mothers were none prefers it that way. worse for the wear. “I saw the story in the newspaper, “They were all fine,” he said. Redin was recognized for the baby girl which was fine that it didn’t mention On Aug. 19, 2016, Redin and delivered on July 1, 2016; Cheryl Dubord me,” Redin said. “I like to stay in the three fellow EMDs from the Bureau helped deliver a baby girl on July 20; Eric background. You trust your protocol of Emergency Communications in Cleverly helped deliver a baby girl on July and everything goes the way it’s going Concord were recognized for their 23; Allison Reopel helped deliver a baby to go.” efforts to help deliver babies using girl on Aug. 7. It’s likely that Redin and fellow EMD Protocol. As is the tradition for Redin is grateful for the outcomes, of EMDs will be called upon to assist in the event, the four EMDs were officially course, and credits the successful deliveries childbirth sometime in the future. inducted into the 911 Stork Club. They to the cornerstones of his profession. Although the vast majority of all each received a “Stork Club” certificate “My job is to pay attention to callers, births (98.7 percent, according to 2011 and a stork pin. listen to what they have to say, and do statistics) in the United States are everything right using the delivered in hospitals, that leaves the protocol,” he said. “We ask balance to out-of-hospital events; the questions, give instructions, and 1.3 percent (in 2011) represented nearly stay on the line until response 50,000 births and of these, 66.2 percent gets there. We generally don’t (33,043) occurred in residences.2 meet the people.” New Hampshire has two PSAPs— Redin, however, also beats one in Concord and one in Laconia. the odds in that category. They receive a combined average of In November 2013, sudden 2,000 calls to 911 each day. Police and cardiac arrest survivor Tom fire requests are transferred to the LaFortune repeatedly thanked appropriate dispatch center. J Redin in person during an emotional visit to the dispatch Sources center. The 74-year-old 1. Sexton A. “Dublin man thanks rescuers who saved his life.” WMUR News. 2013; Nov. 14. https://www. LaFortune had experienced nh.gov/safety/divisions/emergservices/nh911/pu- breathing problems while binfo/documents/11-14-13WMURDublinCPRSave. eating dinner with his two pdf (accessed July 26, 2016). 2. Snyder S, Kivlehan S, Collopy K. “Prehospital Child- children, prompting them birth, Part 1: Without Complications.” EMS World to call 911. Redin guided Magazine. 2013; Oct. 1. http://www.emsworld.com/ LaFortune’s son, Denis, through article/11152064/prehospital-childbirth (accessed Nov. 14, 2016). CPR while his daughter, Laura, watched for the ambulance to arrive.

iaedjournal.org | THE JOURNAL 39 ••• YOUR SPACE | dispatch in action

PROOF IS IN EMILY Immediate CPR leads to girl’s survival

Audrey Fraizer

911 call Kim Rigden answered 10 years ago, and its Aconsequences, still resonates with the longtime protocol devotee and strengthened the resolve of her future career. The date was July 11, 2006, and Rigden was answering 911 calls during the morning at the British Columbia Ambulance Service (BCAS). She was a certified Emergency Medical Dispatcher (EMD), but for the last year she’d usually worked as an ED-Q™ assessing 911 calls. After 11 years as a BCAS paramedic and seven years in dispatch, she figured she was ready for anything coming in over the phones. This call was different, and Rigden knew it was incredibly serious from the first words the caller, Cynthia Cox, said to her. “My granddaughter has had an electrical shock,” Cynthia said. “She’s not conscious.” an emergency, she could react in a way the phone down and turned her attention Rigden jumped into Pre-Arrival the situation demanded. to them. Rigden could hear her explaining Instructions for CPR Dispatch Life “Everything else fades,” she said. “I can to the paramedics what had happened, and Support (DLS) while BCAS EMD Dan focus on what needs to be done.” Rigden disconnected the call, not knowing McCleod dispatched the paramedic crew And that’s exactly what Cynthia did for whether Emily would live or die. and launched a helicopter. the next eight minutes as Rigden coached BCAS transported Emily to Peace Cynthia’s granddaughter, 7-year-old her through lifesaving CPR while waiting Arch Hospital in White Rock, B.C., Emily Cox, was electrocuted when she for response to arrive. and from there, thanks to McCleod’s stuck a metal file into an open extension Rigden remembers literally putting her foresight, airlifted her by medical cord plugged into a circuit conductor. finger on each panel of the Medical Priority helicopter to B.C. Children’s Hospital, a The bolt of electricity traveled up her Dispatch System™ (MPDS®) cardset to medical facility that specializes in care for right arm, across her heart, and exited out follow the script verbatim. the most seriously ill or injured children. her left armpit. She was in cardiac arrest Cynthia remembers trying to get one Emily’s mother, Lianne Cox, and for 28 minutes. message across to her granddaughter. She father, James Cox, recall everything Cynthia had never administered CPR kept repeating, “Emily, don’t you dare die about the day. Both were at work when to anyone. But she had something else on on me. Emily, don’t you die on me,” while called and told about an injured “family her side bigger than experience in CPR: providing the compressions and breaths. member.” James persisted in questioning Cynthia had raised four children, and in When paramedics arrived, Cynthia put the caller for more information and was

40 THE JOURNAL | iaedjournal.org dispatch in action

asked to pull over his car en route to the the accident when asked about the scar, arrives. A helicopter takes her to the B.C. hospital when told the family member and she likes getting the story out to raise Children’s Hospital. She is still here because was his daughter. Lianne wasn’t sure what awareness of electrical danger. She’s a of everything happening the way it did.” to expect. senior in high school, and once graduated Emily and her younger sister, Ashli, “I knew it was Emily, but I did not plans to pursue college degrees in business live a 15-minute drive from their know the severity of her injury,” Lianne and photography. Her portfolio of nature grandparents, and Cynthia can probably said. “It was a very trying 30-minute drive photos shares a view few take the time count on one hand the number of weeks to the hospital.” to observe. either has failed to visit. Emily’s heart was restarted twice. She “I get down to bug level and take “They come on different days once was put in a drug-induced coma for two pictures in the grass,” she said. “They give a a week so I can give each one all my days. She stayed in the Intensive Care different perspective of what you look at attention,” she said. “I feel very close to Unit (ICU) for three days and then spent every day.” them. They are like an extension of my another seven days in the children’s burn As far as the accident goes, “It’s own children.” ward. Lianne and James spent days never something that happened,” she said. Ten years to the day after the accident, leaving the hospital, stationed on July 11, 2016, Lianne posted a at their daughter’s bedside, LinkedIn message to Rigden: watching Emily shiver on a chill “Hi Kim, thanks to you I blanket (used to reduce body have a beautiful and healthy temperature and prevent brain 17-year-old daughter. It was 10 injury) for two days and holding years ago today that you came their breath, awaiting results of into my life in a big way. I can successive brain scans. never thank the powers that be “At first, it was wait and enough that you were the one see,” James said. “No one knew. who took Cynthia’s call that day. After the fact, I heard that they Thank you for all you did and thought she wouldn’t make it know that you will always be in through the night. It wasn’t until our hearts.” she woke up and recognized Rigden was thrilled and, at things that I was willing to the same time, humbled. accept that she was going to “I can’t even explain how make it.” wonderful it was to receive this Lianne and James were in the message,” she said. “The call was a room when Emily opened her gift, something very stressful but eyes on day two to see a familiar also a privilege to be there and figure standing at the edge of give guidance in saving Emily. her bed. What we do matters ... a lot, but “Grandma,” Emily said. I don’t think we realize how “What are you doing here?” Lianne and James said the accident much it continues to matter to the people By day three, Emily was sitting up in remains fresh in their memory. They we help.” bed and eating a bowl of Jell-O. still tear up and choke back words when Electrocution calls involving Emily doesn’t remember any of the describing the day referred to as Emily’s adults are rare, Rigden said, but the events of the day she was electrocuted, “second” birthday. possibility of receiving an accidental and little from her hospital stay. She “This made me realize you can’t always electrocution call involving a child is doesn’t remember greeting her grandma. hold on to what you love,” Lianne said. practically unprecedented. She does recall a play date in the “You start looking at life as the way you Cynthia credits Rigden for afternoon with a friend two days before want it to be, not what you expect it preventing what could have been an the accident occurred. to be.” extraordinary loss. “I know what people have told me,” she James said it’s a reminder of how life “It was Kim who saved Emily,” she said. “My grandpa heard a yelp, and they depends on the help of others. said. “If Kim hadn’t been there, I couldn’t took me into the bedroom and called 911.” “My daughter survived because of a have done what I needed to do.” Emily bears the scar on her left collection of people coming together,” BCAS honored Cynthia in August 2008 armpit as a reminder of that day and the he said. “My mom does CPR with Kim for performing CPR that saved a life. J fragility of life. She likes talking about coaching her through it. The ambulance

iaedjournal.org | THE JOURNAL 41 ••• CASE EXIT

OFFICER-INVOLVED PROJECT Use of deadly force changes perspective

Audrey Fraizer

white police officer’s shooting of an unarmed African- hearing the trial without jury, pronouncing that the shooting was American man on April 7, 2001, in Over-the-Rhine, a a “split-second reaction to a very dangerous situation created by Aneighborhood in Cincinnati, Ohio, sparked three nights Timothy Thomas.”3 The trial had commenced less than two weeks of rioting and some of the worst racial violence since the 1968 after the terrorist bombings of the Twin Towers in New York assassination of the Rev. Martin Luther King Jr. City, N.Y. A month later, when a grand jury handed down a misdemeanor Roach, who did not testify during the trial, left the indictment against Police Officer Stephan Roach, activists, courtroom holding hands with his wife, Erin. “Unfortunately, accompanied by clergy, most notably Black United Front President this is a tragedy for everybody involved,” he said. “I would give the Rev. Damon Lynch III, again took to the streets of what was at anything to change the outcome of what happened that night, the time the eighth-most segregated city in America.1 but unfortunately I can’t.”4 “Stephan Roach, you can’t hide; we charge you with genocide,”2 Jump ahead 13 years, and Roach still carries the weight of the marchers chanted in protest of charges deemed prejudiced and incidents. For a long time, he took responsibility for the three merely a slap on the officer’s wrist. days of total chaos on the streets, and he resents the media for his Roach, 27, was a firefighter and police dispatcher in Oxford, portrayal as a careless police officer exhibiting reckless behavior. As Ohio, before becoming a Cincinnati police officer in 1997. Roach of 2014, he had yet to talk to his children about the incident. shot and killed 19-year-old Timothy Thomas while trying to arrest “It’s kind of a hard thing to tell your kids,” said Roach, who him on 14 outstanding misdemeanor charges. He thought Thomas left the Cincinnati Police Department in January 2002 for the was reaching for a gun in a pursuit that took them down a dark Evendale Police Department (Ohio). “The incident changed the alley. He shot Thomas in the chest. course of my life, and someday I have to tell them before they find Roach faced up to nine months in jail if convicted on charges out from someone else.” of negligent homicide and obstructing official business. Municipal Roach was among nearly a dozen police officers and behavioral Judge Ralph E. Winkler acquitted Roach of both charges after experts interviewed in the documentary “Officer Involved,”

42 THE JOURNAL | iaedjournal.org CASE EXIT ••• written and produced by Patrick Shaver, perception following media coverage, Rolniak was Riverdale’s first officer a police officer in Georgia, and his wife, emotional issues of dealing with the killed in the line of duty. Carla Shaver. The couple traveled more incident, and the way officers are “The services were numbing,” than 30,000 miles in two years filming treated within their departments after Dempsey said. “I don’t remember a lot of and creating the resulting two-hour, an incident. The film explains why an it. Everything about the incident revolves 40-minute movie that since April 2016 has officer seldom shoots to wound (training, around my life. It’s very difficult to been shown through private screenings in movement dynamics, ballistics, tactics, process my partner’s death and the anger theaters across the country. and the challenges officers face on and guilt I felt afterward.” On July 21, the Shavers brought the street). The use of lethal force is life changing, their film to an audience of nearly 150 Wilmington (N.C.) Police Officer Ian said Police Psychologist Lawrence Blum, people in Salt Lake City, Utah. The event Lovell talked about a police confrontation who has spent nearly 30 years evaluating was sponsored by the Unified Police in 2014 with a young woman who was and treating police stress. Department of Greater Salt Lake City, Salt alone in her parked SUV. The woman’s “The incident pierces an officer’s Lake Valley Law Enforcement Association, boyfriend had called police after she sent callouses,” he said. “It’s an infection of the and the Utah Transit Authority mind, soul, and heart.” Police Department. Carla Shaver said the experience of Patrick Shaver said the idea grew making the film affected her perspective. exponentially from a conversation. A “Every time [Patrick] leaves, I think friend wanted his view of why police about what could happen and then put it officers tend to use deadly force during away,” she said. “Even as a police spouse, a potentially violent confrontation, I didn’t understand what [Patrick] goes rather than shooting to simply injure or through, but hearing what can potentially immobilize the suspect. happen time and time again integrates “Police are always asked that question,” the reality. It has made me respect the Patrick Shaver said. “Why can’t officers profession even more.” shoot the tires off a car or aim their gun at For Patrick Shaver, the adventure into an arm or a leg? So much more goes into filmmaking enforced what he already a situation, and there was nothing I could knew about the profession. find that adequately explained what police him messages about harming herself. “Police work is dangerous in every officers go through. They are looking at When police arrived on scene, Lovell saw aspect, and there’s a lot more we should making a judgment to save their life, their the woman raise the gun up from her lap be doing to prepare police officers for partner’s life, or a citizen’s life in a moment.” toward him and his partner with her hand what happens afterward,” he said. J “Officer Involved” documents the on the trigger. He shot her, perceiving that Editor’s Note: Go to officerinvolvedproject. emotional, psychological, and social his life and that of a fellow officer were com/officer-involved/ for more information aftermath of officers who have been part of in grave and imminent danger.5 She later about the “Officer Involved” project and film. a deadly force incident but without fully died from the wound. The officers were describing the situation prompting the cleared of any charges. Sources action (the Roach story was an exception). “There’s not a day that goes by without 1. “Text of Rev. Lynch’s response.” Cincinnati.com. 2001; Dec. 4. http://enquirer.com/editions/2001/12/04/ More than 150 officers contacted the me seeing her face and wanting to help loc_lynch_response.html (accessed July 22, 2016). Shavers in response to a posting about the her,” Lovell said. “That girl wanted to die. 2. “Activists Take Cincy Center Stage.” The Elyria Chronicle project and a volunteer request on their The only thing I walked away with was Telegram. 2001; May 9. http://newspaperarchive.com/ us/ohio/elyria/elyria-chronicle-telegram/2001/05-09/ “Officer Involved” Facebook page. my life. Everything else was a loss.” page-19?tag=stephen+roach+timothy+thomas&rt- “We didn’t want to get into the why,” Riverdale (Ill.) Police Detective Sgt. serp=tags/timothy-thomas?ndt=by&py=2001&pey- Patrick Shaver said. “The film does not Dan Dempsey talked about losing his =2005&pf=stephen&pl=roach (accessed July 22, 2016). 3. “Officer acquitted in shooting that sparked Cincinnati pass judgment. We have tried to show the partner, Detective William Rolniak Jr., riots.” 2001; Sept. 27. http://newspaperarchive.com/ process even when things go bad as they in 2004. Dempsey and Rolniak had been us/florida/fort-walton-beach/northwest-florida-dai- did in Cincinnati. People can finally see he questioning a suspect before the Cook ly-news/2001/09-27/page-8?tag=stephen+roach+- timothy+thomas&rtserp=tags/timothy-thom- has emotion, that he [Roach] did struggle County state attorney’s office approved as?ndt=by&py=2001&pey=2005&pf=stephen&pl=roach after the incident and is still trying to charges of aggravated kidnapping, (accessed July 22, 2016). make peace with himself.” attempted first-degree murder, and 4. See note 3. 5. Norton F. “Wilmington police officers cleared in Jan. 28 The film is divided into sections, home invasion. The suspect took Rolniak officer-involved shooting.” Star News Online. 2014; March including how do you tell your spouse/ hostage and shot him in the head before 14. http://www.starnewsonline.com/news/20140314/ children about the incident, public Dempsey could reach them. wilmington-police-officers-cleared-in-jan-28-officer-involved-shooting (accessed July 22, 2016).

iaedjournal.org | THE JOURNAL 43 international academies of emergency dispatch®

EMERGENCY DISPATCH RESEARCH WORKSHOP Monday, April 10–Tuesday, April 11, 2017

Join us at NAVIGATOR 2017 in New Orleans, Louisiana, USA, Bring your question—we’ll help you find the answers! for the inaugural Emergency Dispatch Research Workshop, • Introduction to Research hosted in partnership with the UCLA Center for Prehospital Care. • Data Analysis This workshop promotes a hands-on approach to learning about • Small-Group Project and Literature Review research. Participants work in small groups to identify a research question, decide on methods, and craft their abstracts. Statis- • Creation and Mock Presentation of an Abstract ticians, programmers, and editors are on-site to immediately provide step-by-step support, assisting participants in obtaining Email [email protected] for more data, performing a statistical analysis, and constructing an ab- information and to register for the workshop. stract ready for submission or presentation. * No prior research experience required.

SOMEWHERE, SOMETHING INCREDIBLE IS WAITING TO BE KNOWN.

–Carl Sagan Request for Inventory Bar Code

Full Item Description: Journal November December 2016

COME PRESENT YOUR SOMETHING INCREDIBLE AT THE NAVIGATORCategory: 2017 POSTERPUBLICATION PRESENTATION.

PDC (D) / IAED (I) / PSI (S) / REGENT (R) / BOTH (B) / FIRE (F) / POLICE (P) / MEDICAL (M) /AQUA (AQA) / EDQ / ANNALS (ANLS) / PROQA (PQA) Discipline: / New Discipline ______You’re invited to submit research abstracts for the poster Submissions will be reviewed byIAED the IAED’s Research & presentation exhibit that will be displayed at NAVIGATOR 2017 Informatics Division. Accepted abstracts will be announced no in New Orleans, Louisiana, USA, April 12–14! later thanLanguage: Feb. 28, 2017. PDFs of NAE the accepted posters are due

by MarchSimplified 10, 2017. Item Description: JRNL Topics include any subject relevant to dispatch research in any discipline—published or unpublished. Abstract submissions Go to https://www.aedrjournal.org/cfpp/Reverse Date (assigned by Erin): ND2016 to submit your must be received by Feb. 17, 2017. Research Poster Abstracts. Inflow Code: I-NAE-JRNL-ND2016

BARCODE IMAGE: *I-NAE-JRNL-ND2016* I-NAE-JRNL-ND2016 *All submissions must be in English.