Calling 9-1-1

Airdate: 10/13/2003

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The REMSA Communication Center is an internationally accredited dispatch center that operates on a system of flexible deployment referred to as System Status Management and Medical Priority Dispatching. It is staffed with EMT-Intermediates and Paramedics who are specially trained and certified as Emergency Medical Dispatchers. These dispatchers receive approximately 35,000 requests for service annually and are responsible dispatching both REMSA’s ground ambulances and Care Flight.

Medical Priority Dispatch System

Care begins the moment a call comes into the dispatch center. Using a set of advanced National Standard Physician approved protocols, REMSA’s dispatchers walk callers through a phone-based triage system to determine the scope of severity of the emergency situation. Our Quality Improvement Program monitors these calls, working with the dispatchers to ensure that they follow all protocols while providing the highest level of clinical skills and customer service possible.

When Should I Call 9-1-1?

Many people worry about calling 9-1-1 because they are not sure if their situation is an emergency. An emergency is any time there is a fire or explosion, someone needs immediate medical attention, a crime is in progress, or a chemical, biological, or radiological spill threatens the safety and health of you, your family, and/or the public.

If you are in doubt, call 9-1-1.

Guidelines for when to call 911 are:

• There is no pulse and/or the patient is not breathing.
• Patient is unconscious, but breathing. Patient has been in and out of consciousness.
• Patient is complaining of severe pain.
• Any complaints of pain in the head, back, or neck.
• Dislocations of the elbow knee or shoulder.
• Serious fractures, open/closed/angulated.
• Abdominal pain from a blow to the abdominal area.
• After a person trained in first aid has performed a primary assessment and injury assessment, and it has been determined the injury is serious.
• The person trained in first aid who is attending the patient feels, in any way, uncomfortable or unsure about the patient's condition during the primary assessment or injury assessment.

Do not move the patient unless it is absolutely necessary, i.e., fire, explosion, or gas leaks.

What Should I Expect When I Call 9-1-1 For A Medical Emergency?

• When the dispatcher answers simply state what you need; "I need an ambulance" and you will be transferred to one of REMSA’s trained and experienced Emergency Medical Dispatchers.
• REMSA’s Dispatcher will then ask you a series of questions beginning with:

• What is the address of the emergency?
• What phone number are you calling from?

The dispatcher may ask you to repeat information that you have just given to them. This is done purposely, to ensure accuracy in where to send help and to confirm a means to re-contact you should you be unexpectedly disconnected.

• Next, you will be asked exactly what is wrong followed by a series of pertinent questions regarding the medical complaint.

• This is important information too! Do not become upset that it is "taking too long", or that "they are asking too many questions".
• Remember, while one dispatcher is talking to you on the phone, another dispatcher sending help to the patient.
• Keep in mind that these questions are necessary in order to provide the best course of action for your situation.

• Answer all questions honestly, directly, and quickly. Do not embellish or fabricate information because you think it may accomplish a faster response. Reporting a false emergency or misuse of 911 is a crime and you may inadvertently prevent someone else from obtaining emergency assistance.
• The dispatcher's job is stressful and very difficult, so try not to yell, use profanity or be discourteous.
• Follow any instructions given you by REMSA’s Dispatcher, unless doing so would put yourself or others in danger. You assistance by following these instructions could be very beneficial to the patient’s outcome.
• DO NOT hang up until the dispatcher says it is okay to do so.

System Status Management

System Status Management (SSM) is a unique approach to pre-hospital care. It is an efficient and scientifically based approach to ambulance deployment. Traditionally, ambulances are stationed at different locations throughout the community and staffed 24 hours a day to handle calls within a predetermined response area. Although staffing levels remain constant, this type of deployment can prove to be rather problematic.

Demand for emergency medical services has been proven to fluctuate dramatically according to the day of the week, the time of day, and the area of the community. As a result, there are times when the system is underused, and times when it is overwhelmed by an increase in requests for service. By using a more fluid or dynamic approach to deployment, REMSA is able to balance supply or the number of ambulances available to the demand for service.

Predicting the Demand of Ambulance Requests

The essential key to System Status Management is the precise analysis of historical data. Through continuous monitoring of collected data, REMSA is able to adjust its staffing levels and posting locations. This monitoring makes deployment very dynamic, unlike the traditional station-based systems, by putting resources closer to the patients who need them.

Additional Resources

450 Edison Way Reno, Nevada 89502 (775)858-5700 Fax (775)858-5720