Reevaluating response

Earlier this year, I attended a three-day class on emergency medical dispatch. Taking the course gave me a much better perspective on how the EMD process works, and on one of it's primary purposes: to ensure that the limited emergency medical resources in a community are being properly utilized. It is instructive that the organization that provides our system and training is Priority Dispatch, because that's what the process is all about: prioritizing medical emergencies so the type of response can be matched to the nature of the incident. If you can avoid it, you don't want to tie up an advanced life-support ambulance on a minor medical call, so that it is now unavailable for another incident where life hangs in the balance and time is of the essence. Neither do you want to put paramedics, firefighters, and the public at risk by responding code 3 to an incident where the slight response time difference is irrelevant to the outcome for the patient. Traffic crashes pose the greatest risk of death to emergency responders.

As I was attending the class, Lincoln's Emergency Communications Center was also beginning the transition from a card-based version of Priority Medical Dispatch to a computerized version. This was a good point in time for us to re-evaluate the Lincoln Fire and Rescue Department's response protocols. For each type of medical emergency, the responding agencies must decide what type of resources are to be dispatched (ALS, BLS, engine company, ambulance, etc.) and the response condition: code 1 or code 3, that is, normal driving or lights and siren. These response protocols hadn't been re-evaluated in over a decade. Many things have changed during that time. We have a new medical director, new Emergency Medical Oversight Authority, technology has progressed, automatic external defibrillators have proliferated, data has been collected, our ability to analyze data has progressed immensely, the number of paramedics has increased, the number of front-line medic units has increased, and medic units have been redeployed to fire stations based on GIS analysis, and more.

All of these things suggest that the time is ripe to review response. I think any changes will ultimately be subtle. I expect we are likely to see more ambulance-only and engine-only responses, more code 1 responses, more emphasis on returning resources to in-service status promptly, leveraging of emerging AVL technology, continuing emphasis on GIS analysis of data to optimize deployment decisions, more focus on spreading the emergency medical workload effectively, improved efficiency in delivering training to our providers, and more.

It's an exciting time at Lincoln Fire and Rescue, and I hope to make some small contribution to these initiatives.