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HomeMy WebLinkAbout6000_02 Emergency Medical Dispatch Emergency Rule 202201136000.02 Emergency Medical Dispatch Emergency Rule Standard Operating Procedure Implemented: January 2022 Revised: N/A Next Review: January 2024 This procedure is for internal use only and does not enlarge an employee’s civil liability in any way. The procedure should not be construed as creating a higher duty of care, in an evidentiary sense, with respect to third party civil claims against employees. A violation of this procedure, if proven, can only form the basis of a complaint by this department for non-judicial administrative action in accordance with the laws governing employee discipline. Related Policies: Applicable HI Statutes: I. PURPOSE The purpose of this standard operating procedure (SOP) is to establish procedures for Fire Communications Control Center (FCCC) operations in situations of over-capacity in the communications center. Over-capacity from a dispatch perspective is defined as a period of high call volume and/or radio operations that exceeds the dispatcher’s ability to maintain effective operations at a given level of staffing. Refer to section IV for examples of over- capacity. II. APPLICABILITY The Emergency Medical Dispatch Emergency Rule SOP applies to all Hawai‘i Fire Department (HFD) FCCC employees. III. DEFINITIONS - As defined by Principles of Emergency Medical Dispatch, 6th Edition: Emergency Rule-From a medical-legal perspective, when one is faced with an extraordinary emergency situation, one is not held to the same standard of conduct as when not faced with such a situation. Pre Arrival Instructions (PAI) - Medically approved, scripted instructions given by trained EMDs to callers, which help provide necessary assistance to the victim and control of the situation prior to the arrival of EMS personnel. Pre-Arrival Instructions are read word for word by the EMD to the fullest extent possible. Key Questions (KQ) - Systemized interrogation questions constituting the secondary survey of the EMD. Must be written in full sentence form and address the four objectives of pre- arrival evaluation. Post-Dispatch Instructions (PDI) - PDIs are specific to each chief complaint and are designed to ensure the safety of the caller and responders and increase the overall effectiveness of the response. IV. PROCEDURE In a situation of over-capacity, FCCC personnel shall make every effort to provide Emergency Medical Dispatch (EMD) instructions to callers. FCCC personnel may suspend EMD using the Emergency Rule clause. 6000.02 Emergency Medical Dispatch Emergency Rule Standard Operating Procedure Implemented: January 2022 Revised: N/A Next Review: January 2024 In times of over-capacity, HFD recognizes the need may arise to suspend Emergency Medical Dispatch (EMD) protocols. HFD FCCC personnel may suspend or discontinue Post-Dispatch Instructions (PDI) once case entry questions and key questions are completed. Pre-Arrival Instructions (PAI) may also be suspend in situations where lifesaving instructions are not provided (Refer to section C below). The following are acceptable examples of when FCCC personnel may suspend EMD: 1. Staffing levels are not at a point where EMD-PAI can be consistently sustained. 2. Multiple additional 9-1-1 calls are being received, and waiting to be answered. 3. Extended and complex incidents requiring multiple radio communications and/or notification functions. 4. Mass casualty incident. 5. Natural disaster. 6. Fire fighter safety is in jeopardy. V. EMERGENCY RULE SHALL NOT APPLY Every attempt should be made to complete the EMD interrogation sequence. The Emergency Rule shall not apply to situations where life-saving EMD instructions are necessary. In these types of situations, the dispatcher shall stay on the line and continue to provide EMD-PAI to the caller, to the extent possible, until units arrive. These situations are: 1. Cardiac/Respiratory Arrest 2. Choking 3. Childbirth When the Emergency Rule is used by FCCC personnel, a notation will be made in the call comments of the call. The notation shall give the reason the Emergency Rule was enacted. VI. RELEASING THE CALLER When releasing a 9-1-1 call and enacting the Emergency Rule, the dispatcher will end the call by saying “I need to hang up now to take another call. If the patient gets worse in any way, call back to 9-1-1 and ask for medical for further instructions. Help is on the way.” This allows the caller to understand why the dispatcher is disconnecting the call while reassuring the caller that the appropriate help is on the way.