Emergency medical dispatcher
Indeed, during the 1950s the presence of radio dispatch was often treated as marketing inducement, and was prominently displayed on the sides of ambulances, along with other technological advances, such as carrying oxygen.
The concept of a single answering point for emergency calls to public safety agencies caught on quickly.
[3] Calling this single number provided the caller access to police, fire and ambulance services, through what would become known as a common public-safety answering point (PSAP).
Ambulance service moved from 'first come, first served' or giving priority to whoever sounded the most panicked, to prioritizing based on how severe the medical emergency was.
As it became possible for those in the ambulance to actually save lives, the process of sending the closest appropriate resource to the person in the greatest need became very important.
[6] The following year, Dr. Jeff Clawson,[7] a physician employed by the Salt Lake City Fire Department as its medical director, developed a series of key questions, pre-arrival instructions, and dispatch priorities to be used in the processing of EMS calls.
Most such systems were based on either reference cards or simple flip charts, and have been described by lay people on more than one occasion as being like a "recipe file" for ambulance dispatchers.
[16] The PSAP and, in effect the EMD, become the functional link between the public and allocation of emergency resources, including police, fire and EMS.
The National Academy of Emergency Medical Dispatchers[19] was subsequently established by Dr. Clawson as a non-profit advisory organization to develop products and services provided by PDC.
[20] In most modern EMS systems, the emergency medical dispatcher (EMD) will fill a number of critical functions.
The three most common new applications are: The next area of responsibility involves the triage of incoming calls, providing expert systematized caller interrogation, using the script provided by the Emergency Medical Dispatch system, in order to determine the likely severity of the patient's illness or injury, so that the most appropriate type of response resource may be expedited.
The trained EMD uses interpersonal and crisis management skills to sort through these distractions, taking control of the conversation, calming the caller, and extracting the necessary information.
The questioning will continue until the EMD is able to qualify a potentially life-threatening condition, at which time the closest appropriate response resource (such as a paramedic-staffed ambulance service) is notified to initiate pinpointing the call location.
The EMDs next priority is to provide and assist the layperson/caller with pre-arrival instructions to help the victim, using standardized protocols developed in cooperation with local medical directors.
Such instructions may consist of simple advice to keep the patient calm and comfortable or to gather additional background information for responding paramedics.
The instructions can also frequently become more complex, providing directions over the telephone for an untrained person to perform CPR, for example.
Examples of EMDs guiding family members through assisting a loved one with the process of childbirth prior to the arrival of the ambulance are also quite common.
This process may still consist of a symptom-based flip-card system, but is increasingly automated through computer aided dispatch software.
It may also include requests from the EMS crew to provide support resources, such as additional ambulances, rescue equipment, or a helicopter.
Finally, the EMD ensures that the information regarding each call is collected in a consistent manner, for both legal and quality assurance purposes.
Dispatch records are often a subject of interest in legal proceedings, particularly with respect to initial information obtained, statements made by the caller, and response times for resources.
As a direct result of these two factors, there is a requirement for all call information to be collected and stored in a regular, consistent, and professional manner, and this too, will often fall to the EMD, at least in the initial stages.
Another important consideration is workload; in many jurisdictions the call volume of the EMS system is 5-6 times as great as that of the Fire Department.
Such environments must strike a 'balance' between the high-tech requirements of the work, including large numbers of computers, telephone lines, and radios, and the psychological needs of the human beings operating them.
[25] The role and certification of Emergency Medical Dispatcher has its origins in the United States but is gradually gaining acceptance in many other countries.
In many respects, the development of this position is a logical sequel to the incorporation of the emergency medical dispatch system by EMS.
This training program may be offered by private companies, by community colleges, or by some large EMS systems which are self-dispatching.
Following the murder of Denise Amber Lee in 2008, new laws are being considered in the State of Florida regarding the training of all public safety telecommunicators including EMDs.
This may happen as the result of a work-related injury resulting in disability, or it may simply be that a paramedic completes training and then finds that field work is not to their taste, or that they lack the ability to perform the physical aspects of being a paramedic (e.g. heavy lifting) without fear of injury.
[33] The inequities in the sheer amount of training required for certification make advancement of EMDs to paramedic status an extremely infrequent event.
