Orange County NC Website
Comprehensive Assessment of Emergency Medical Services 107 <br />and 911 /Communications Center Operations Study <br />Emergency Medical Dispatch (EMD) <br />Orange County is a licensee of the National Academies of Emergency Dispatch (NAED) "ProQA" <br />automated emergency medical dispatch program. NAED's EMD standard medical protocols are the <br />accepted national standard for EMD providers. <br />EMD is based on the premise that a fire engine or ambulance does not have to be the first unit on the <br />scene of a medical emergency. Once a caller reaches a Telecom municator, that Telecom municator can, <br />almost immediately, begin providing medical information and pre - arrival instructions via phone. <br />Subsequently, EMD consists of three key components: <br />First, is triaging the in- coming call request for medical assistance to determine the level of <br />response required; i.e., no response, non - emergency transport, emergency transport. <br />Second, is providing pre - arrival instructions so the caller can immediately help the victim. The <br />level of telephone assistance can vary from just simple advice to complete instructions for CPR. <br />This is the most visible component of EMD and, in the eyes of some, its most valuable feature in <br />that it can very well save a life. <br />Pre - arrival instructions are based on the concept that Telecom municators are the victim's first <br />medical contact and can provide basic first -aid via telephone, by asking specific questions and <br />giving the caller instructions. The questions and instructions - "protocols" in medical parlance -are <br />predetermined, given in a structured sequence, and specially designed to be effective when <br />given to a third party over the telephone. The intended result is a dramatic decrease in the time <br />it takes to begin administering emergency care. <br />Third, and perhaps the most critical feature of EMD, is quality assurance. State law requires that <br />each EMD program -and each aspect of the EMD protocol -must be reviewed, revised as needed <br />and approved by the local or regional EMS agency; in Orange County, that authority is the <br />Medical Director; a licensed physician. This ensures that the information and procedures being <br />given by the dispatchers is correct, and appropriate for the incident. In addition, there must be <br />an on -going review of the use of EMD protocols by Communications Center Telecommunicators <br />to ensure that the protocols are continually followed correctly, and that application of the <br />protocols contributes to a positive patient outcome. <br />Call Codes <br />In their communications regarding medical emergencies, Telecom municators will utilize call codes in <br />radio communications with responding agencies to indicate both the severity of the situation reported <br />and the associated level of response; i.e. emergency, or non - emergency. <br />The codes utilized are those approved by the National Academy of Emergency Medical Dispatch <br />(NAEMD) and range from the least severe; i.e. not life threatening: ALPHA; to the most severe; i.e. <br />"circling the drain ": ECHO, which calls for an "all units" emergency status response. <br />The table that follows identifies the Condition Identified, Agency /Unit, and Response Status protocols <br />for each of the five Response Codes. <br />Solutions for Local Government, Inc. 63 <br />