Principles of EMD

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Question

Chapter

Pages

Takes too much time

1

1.16

Reduction of responding units and lights-and-siren runs

1

1.17–1.18

EMVC/EVC study statistics

1

1.18

All you need is protocol and training

1

1.18

Spock Principle

1

1.21

EMD as an ALS professional

1

1.23

Medical vs. protocol practice models

1

1.23

Never judge the caller

2

2.3–2.4

EMD as scene commander

2

2.4–2.5

Accept all calls, even from wrong area

2

2.7

Repeat address for verification

2

2.9

Special callers: children

2

2.11

First party gone-on-arrival

2

2.14–2.17

Medical Miranda (SEND Protocol )

3

3.4–3.7

Caller party percentages

3

3.8

Four Commandments of EMD

3

3.10–3.11

ECHO determinant

3

3.12–3.16

Priority dispatch flow chart

3

3.18

Key Question objectives

3

3.18

“Sick person” call—noncomplianceexample

3

3.19

“Chest pain gone” call

3

3.21

Dispatch response determinant theory

3

3.25–3.34

Understanding determinant terminology

3

3.26–3.27

DLS is different than BLS and ALS

4

4.2–4.5

Who should give Pre-Arrival Instructions (PAIs)?

4

4.5–4.6

What’s wrong with telephone aid

4

4.9

Caller’s “implied consent”

4

4.10

Surgeon General’s statement on theHeimlich maneuver

4

4.12

DLS as national standard of practice (USA)

4

4.13–4.14

Arrival interface

4

4.20–4.23

Benefits of Dispatch Life Support (DLS)

4

4.24

Hysteria threshold

5

5.2–5.5

Repetitive persistence

5

5.3–5.8

Bring patient to phone problem

5

5.5, 5.8

Re-freak events

5

5.8–5.9

Nothing’s working phenomenon

5

5.9

Relief reaction

5

5.9

Paramedics aren’t coming notion

5

5.9, 5.11

Gap Theory

5

5.11

Customer service is patient care

5

5.11

Age factor in chest pain

6

6.6–6.8

“Hurts to breathe” is not difficulty breathing

6

6.10

little chest pain may be as bad as a lot

6

6.10

Anaphylaxis (severe allergic reaction)

6

6.28–6.29

Spider bites

6

6.27

Not considered dead until “warm dead”(hypothermia rule)

6

6.32

Poison control center (home care,OMEGA)

6

6.35

Hanging case (UK)

6

6.39

No oral sugar treatment

6

6.44

Seizures—initially no breathing

6

6.44

Tonic clonic (grand mal) seizures lastabout 60 seconds

6

6.44

Low risk of death from febrile seizure

6

6.45

Should febrile seizures be treated over the phone?

6

6.46

Seizure can be initial symptom ofcardiac arrest

6

6.47

Stroke—official Academy positionstatement

6

6.50–6.52

Mechanism of injury

7

7.2–7.3

Medical problems as cause of trauma

7

7.14

Rule of Nines

7

7.20

Head-tilt method of airway control

7

7.27

Nuchal cord (umbilical cord around neck)

8

8.4

Agonal respirations

8

8.5–8.6, 8.8

Cardiac arrest

8

8.5–8.9

Obvious death

8

8.7–8.8

MPDS increases bystander CPRpercentage

8

8.9

Choking

8

8.9–8.15

Still choking percentages

8

8.13

Cold-water drowning

8

8.16

Drowning rescue safety

8

8.17

Hyperventilation syndrome

8

8.19

Falls secondary to electrocution

8

8.21–8.22

Electrocution safety

8

8.21–8.23

Essential information for reportingHAZMAT

8

8.24

Unconscious patients and intoxication

8

8.25–8.27

Unknown problems

8

8.27–8.31

Hendon case (unknown problem)

8

8.28–8.29

De Luca’s Law

8

8.30

Relay type of location

8

8.31

Percentage of DELTA codes in unknownproblem cases

8

8.31

What is stress?

10

10.2–10.3

Stress in EMD

10

10.3–10.6

Four Hallmarks of Stress

10

10.5

Burnout and distress

10

10.6–10.7

Managing stress

10

10.7–10.10

Seven most stressful calls

10

10.10

Critical Incident Stress

10

10.10–10.11

First Law of Medical Diagnosis

11

11.2

Duty

11

11.2–11.3

Negligence

11

11.3

Emergency Rule

11

11.4–11.5

Foreseeability

11

11.5, 11.8

Maximal Response Disease

11

11.6–11.8

Dispatcher abandonment

11

11.8

Special relationship (civil rights)

11

11.8

Detrimental reliance

11

11.9

Tort of outrage

11

11.9

Dispatch danger zones

11

11.9–11.31

Failure to verify

11

11.10–11.11

No-send situations

11

11.11–11.12

Archie case (no send)

11

11.11–11.12

Dispatch diagnosis

11

11.12

Delayed response

11

11.12–11.14

More than one call for help

11

11.14, 11.16

Lam case (no send)

11

11.13–11.15

No protocols to follow

11

11.16

Failure to follow protocol

11

11.16–11.23

Dale case (more than one call for help)

11

11.17–11.18

Requiring caller’s permission before giving instructions

11

11.23–11.24

Omission of Pre-Arrival Instructions(failure to give)

11

11.24

Brooke Hauser case

11

11.25–11.26

Ellis case

11

11.26

Boff case (talk to patient and failure tosend)

11

11.27–11.28

PANDA (Parents Against NegligentDispatch Agencies)

11

11.24

Let me talk to the patient

11

11.28–11.29

Attitude problems

11

11.29

Preconceived notions and negativeimpressions

11

11.29–11.31

Misinterpretation of the caller’scomplaint

11

11.31

Problems at shift change

11

11.31

Insurance aspects of EMD

11

11.31–11.32

Emergency Vehicle Collisions (EVCs)

11

11.32–11.34

State EMD rules and regulations

11

11.34–11.36

National Academy immunity position

11

11.36

Not call screening

11

11.36

Eleven components of qualityimprovement

12

12.2

Selection and implementation of protocol

12

12.3

EMD candidate selection and evaluation

12

12.3–12.4

ASTM EMD selection criteria

12

12.3

Initial EMD training

12

12.4

EMD certification

12

12.4

Medical Control and Medical Directorinvolvement

12

12.4–12.5

First Law of Medical Control at Dispatch

12

12.5

ASTM on medical control and direction

12

12.5

Continuing Dispatch Education (CDE)

12

12.5–12.6

EMD recertification

12

12.6

Case reviewquality assurance

12

12.7

Academy case review volume standards

12

12.7

Measuring compliance to protocol

12

12.7–12.9

Real Tough Time Breathing” case

12

12.8

Compliance improves Determinant Codeselection correctness

12

12.9–12.10

Compliance improves caller emotion

12

12.10–12.11

Medical Dispatch Review Committee (MDRC)

12

12.11

Steering Committee

12

12.11

Data collection, analysis, and feedback

12

12.11–12.12

Quality management improvescompliance

12

12.12

Suspensiondisciplinedecertification,termination

12

12.12

How EMD works best

12

12.12

When to go on-line

12

12.15

Feedback process

12

12.15–12.18

Risk management

12

12.16–12.18

Goals of quality management

12

12.18–12.19

First Rule of Quality Management

12

12.19

Corollary of First Rule of Quality Management

12

12.19

History of EMD

13

13.2–13.4

How I “discovered” the protocols—Clawson

13

13.3

Criteria-based dispatch—guidelines

13

13.2, 13.4

Selection of an EMD program

13

13.4–13.9

Protocols vs. guidelines

13

13.4–13.12

Unstructured DiscretionaryInterrogation case

13

13.7–13.8

Does field work equal phone work?

13

13.8–13.9

CBD (guidelines) vs. MPDS (protocol): Sheffield study  

13

13.9

Evolutionary dead end—protocol withoutprocess

13

13.9–13.12

How to compare protocols

13

13.10–13.12

Evolution of organized standards for EMD

13

13.12

DNA of dispatch—origins of the College of Fellows

13

13.12–13.13

Unified protocol model

13

13.13–13.18

National Academy organization chart

13

13.19

National Academy membership growth

A

A.2

National Academy Code of Ethics

A

A.2

Academy Accredited Centers of Excellence to date

A

A.4–A.5

Remediation Actions Policy—SLCFD

A

A.3

Proposal for Change form

A

A.6

Determinants per Chief Complaint Protocol

B

A.7

Key Questions per Chief Complaint Protocol

B

A.7

Letter of denial for 911 liability insurance

C

A.8

COLD response on BRAVO calls—SLCFD

C

A.9

Legal documentation—James O. Pageletter to Aurora, CO

C

A.10–A.12

California Liability Limitation Statutes

C

A.12–A.14

Salt Lake City EMS Abuse Ordinance

C

A.13

State of Utah EMS Act (Abuse Section)

C

A.14

Emergency numbers from around the world

D

A.14

Acute myocardial infarction data (heart attack frequency)

E

A.14–A.15

EMSA (Tulsa/Oklahoma City) Master Dispatch Analysis

F

A.16–A.30

Derbyshire Ambulance Services Master Dispatch Analysis, 1995

G

A.31–A.41

9-1-1 Transfers to Utah Poison Control Center, 1994

H

A.42–A.44

EMD Position PaperNational Institutes of Health

I

A.45–A.60

EMD Position Paper: Emergency Medical Dispatch for Children

J

A.61–A.64

Unnecessary Lights-and-Siren Use: A Public Health Hazard

K

A.65–A.68

Model EMD Legislation

L

A.69–A.80

Modified CPR Instruction Protocols

N

A.81–A.88

References of works cited

Appx

A.89–A.94

Glossary of terms

Appx

A.95–A.106

Index

Appx

A.107–A.113

Field Feedback Report

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Medical Dispatch Case EvaluationRecord

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