Setting priorities: Computer program ranks 911 calls

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GREENFIELD — A newly adopted 911 computer program ranks the severity of medical emergencies, telling Hancock County dispatchers where to send help first.

Priority Dispatch, a $5,000 annual subscription service, guides dispatchers through a series of questions when a person calls 911 with a medical problem. The dispatcher types the initial information — trouble breathing, chest pain, unconscious person, for example — into the system, which triggers a series of computer-generated questions about those symptoms.

The system updates automatically as dispatchers log callers’ answers, with each subset of questions becoming more specific. The program then assigns the call a priority level, with Level 1 denoting the most severe cases — usually identified within a few seconds, officials said — and Level 4 the least. And should a dispatcher sense a patient’s condition has suddenly changed, they can notify medical crews, and the program will update the priority level.

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The program — used by 56,000 dispatchers across 45 countries — has drawn mixed reaction from local first-responders, who say they’re still adjusting to the new system. Some contend it helps medical personnel work more efficiently, while digitizing an outdated system of medical note cards. Others question whether an automated system is the best way to assess what kind of help a person needs.

For years, medical crews from fire departments across the county responded to single-patient medical emergencies the same way, whether the call for help followed a suspected stroke or a stomachache, said John Jokantas, the director of Hancock County’s 911 dispatch center.

No matter the circumstance, a fire engine and an ambulance were automatically assigned to the run, speeding down local streets with their lights on and sirens blaring, Jokantas said.

And that comes with risks, he said.

First, first-responders’ time and resources are too easily wasted, he said. There could be too many emergency vehicles or crews sent to a scene, which marks them as unavailable when other calls for help come in, Jokantas said. Additionally, there always is a chance of a car accident whenever a fast-moving caravan of emergency vehicles is dodging traffic.

There always will be emergencies that necessitate such a response, such as a severe burn, possible drowning, or an unconscious person, Jokantas said.

But if someone has had a minor fall or felt pain in their back for a week that finally prompted a call, that might not constitute an emergency, Jokantas said. Medical crews should have the option to take those calls at a bit slower pace or send only a single ambulance to help rather than multiple vehicles that could be directed elsewhere, he said.

Buck Creek Township Fire Chief Dave Sutherlin said it’ll take time and training for everyone to adjust to the new system.

Sutherlin admits the idea of relying on a computer to decide how to help people gives him pause. He worries about the wrong priority level being assigned to a call if the caller misunderstands the question they are asked or answers incorrectly.

That puts a lot of responsibility on the dispatchers and their training, which calls on them to upgrade changing information in real time, Sutherlin said. And while he’s certain they can handle the pressure, he worries sticking to a script leaves room for mistakes.

But the questions the computer creates are easy to understand and take the second-guessing out of dispatching, dispatcher Craig Lindsay said. The new program also helps dispatchers — who undergo a 28-hour training course in the system’s use — gather more information about patients than ever before, which helps medical crews en route prepare, he said.

The program questions were created by a panel of doctors and other medical experts. They are updated regularly to ensure dispatchers have the latest information, Lindsay said.

Before, dispatchers relied on a set of printed cards at their desks to flip through during a medical call, he said. In alphabetical order, the cards listed a symptom — abdominal pain, burns, cardiac, and so on – and examples of questions to ask about the patient, leaving the dispatcher to decide in the heat of the moment what symptoms to address first, all while trying to keep the caller calm, he said.

With the new program, there is less risk of a mistake being made or something being missed because the questions update with each answer, helping to drill down to the source of a problem, Lindsay said.

The reference cards dispatchers had been using during medical calls were rarely updated, said Dr. Stephanie Gardner, who serves as the county’s EMS coordinator, working with every fire department in the area. As medical practices change — how CPR is performed, for example — Priority Dispatch will release updates.

And while there might be a few more questions for callers to answer, help is still sent within seconds of the 911 call, Gardner said.

To ensure a smooth transition, a group of paramedics and EMTs will meet with county dispatchers monthly to address any questions or issues that might arise with the new system, Jokantas said.

In the coming years, Jokantas hopes to implement similar programs that will prioritize other fire and police calls.

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Priority Dispatch aims to help 911 dispatchers rank emergency calls, so first-responders know where to go first and how much help to send.

Priority Dispatch questions are available in 21 languages.

56,000 dispatchers in 3,000 communication centers across 45 countries use the system.

The system currently serves an estimated 80 million people.

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The Priority Dispatch system handles a 911 in four steps.

Step 1: Case entry — Dispatchers enter basic information (address, phone number, what is happening on the scene, etc.)

Step 2: Key questions — A patient’s chief complaint triggers a list of medical questions related to their ailment.

Step 3: Pre-arrival instructions — Based on a person’s answers, the computer prompts dispatchers to provide guidance (such as starting CPR) while help is on the way.

Step 5: Case exit — Once a priority level is dispatched to first-responders, the dispatcher may disconnect the call or stay on the line with the caller, depending on the circumstances of the case.

Source: Priority Dispatch

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