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Comprehensive Assessment of Emergency Medical Services 64 DRAFT REPORT and 911/Communications Center Operations Study Emergency Medical Dispatch (EMD) Orange County is a licensee of the National Academies of Emergency Dispatch (NAED) "ProQA" automated emergency medical dispatch program. NAED's EMD standard medical protocols are the accepted national standard for EMD providers. EMD is based on the premise that a fire engine or ambulance does not have to be the first unit on the scene of a medical emergency. Once a caller reaches a Telecommunicator,that Telecommunicator can, almost immediately, begin providing medical information and pre-arrival instructions via phone. Subsequently, EMD consists of three key components: First, is triaging the in-coming call request for medical assistance to determine the level of response required; i.e., no response, non-emergency transport,emergency transport. Second, is providing pre-arrival instructions so the caller can immediately help the victim. The level of telephone assistance can vary from just simple advice to complete instructions for CPR. This is the most visible component of EMD and, in the eyes of some, its most valuable feature in that it can very well save a life. Pre-arrival instructions are based on the concept that Telecommunicators are the victim's first medical contact and can provide basic first-aid via telephone, by asking specific questions and giving the caller instructions. The questions and instructions-"protocols" in medical parlance-are predetermined, given in a structured sequence, and specially designed to be effective when given to a third party over the telephone.The intended result is a dramatic decrease in the time it takes to begin administering emergency care. Third, and perhaps the most critical feature of EMD, is quality assurance.State law requires that each EMD program-and each aspect of the EMD protocol-must be reviewed, revised as needed and approved by the local or regional EMS agency; in Orange County, that authority is the Medical Director; a licensed physician. This ensures that the information and procedures being given by the dispatchers is correct, and appropriate for the incident. In addition, there must be an on-going review of the use of EMD protocols by Communications Center Telecom municators to ensure that the protocols are continually followed correctly, and that application of the protocols contributes to a positive patient outcome. Call Codes In their communications regarding medical emergencies, Telecommunicators will utilize call codes in radio communications with responding agencies to indicate both the severity of the situation reported and the associated level of response; i.e. emergency, or non-emergency. The codes utilized are those approved by the National Academy of Emergency Medical Dispatch (NAEMD) and range from the least severe; i.e. not life threatening: ALPHA; to the most severe; i.e. "circling the drain": ECHO,which calls for an "all units"emergency status response. The table that follows identifies the Condition Identified, Agency/Unit, and Response Status protocols for each of the five Response Codes. Solutions for Local Government,Inc. 62