Emergency Dispatch Protocols

The National Highway Transportation Safety Administration creates a guide with emergency dispatch protocols for trainees. These protocols are designed to help emergency medical dispatchers (EMDs) understand and respond to medical issues over the phone and offer instruction. EMD protocol defines seven issues as Time/Life Critical Events, meaning that action must be taken immediately to protect the victim and those nearby.

Carbon Monoxide Inhalation

• Carbon monoxide (CO) is a colorless odorless gas and the most common culprit in inhalation calls. If possible, the EMD should obtain information about the patient's state of consciousness and the source of the leak. Common symptoms include headaches and nausea. Other gas leaks can cause difficulty breathing, burning in the eyes and skin, and vomiting. The caller should be told to move the victim outside away from the source and maintain an open airway. Keep the victim lying still and flat (without a pillow). Make the patient calm, warm and comfortable but do not offer any food or drink. Call back if the victim's condition changes.

Cardiac Arrest

• Cardiac arrest occurs when the heart stops pumping blood. Any unconscious person who is no longer breathing should be assumed to be in cardiac arrest. Other symptoms include agonal respirations: occasional ineffective breaths that occur after cardiac arrest. Key words to look out for are "heavy," "gasping" and "snoring." The caller should first check for airway obstructions and a pulse, then begin cardiopulmonary respiration. Early CPR administered correctly can increase the chances of survival. If the victim is a small child, it may be hard to find a pulse, so the first thing to focus on is rescue breathing.

Choking

• If someone is choking, there is rarely time for emergency services to arrive. The EMD should talk the caller through emergency procedures. Complete airway blockage is signaled by an inability to breathe, speak or cough, and unconsciousness after one to two minutes. The victim should not have his head propped up with a pillow, and if he is able to cough at all, these instructions should not be attempted. The caller should perform abdominal thrusts by standing behind the victim and using a fist just under the rib cage to quickly and forcefully push in and up. For infants, the process should begin with five back blows and move on to flat handed chest thrusts. Support the infant's head and angle it downward. After the obstruction has been cleared or help has arrived, victims should be examined to ensure the foreign body did not travel into the lungs.

Near Drowning

• If the patient is in the water and breathing, support the patient there by maintaining a clear airway until help arrives. If the patient is unconscious, however, the caller should immediately check for signs of cardiac arrest and, if necessary, begin CPR. Be aware of the possibility of a spinal injury, indicated by numbness and immobility in the extremities, and do not move the victim if that is a possibility. Common symptoms include coughing, change in skin color, vomiting and unconsciousness. Keep patients warm, by changing clothes if possible, and call if there are any changes in condition.

Electrocution

• The primary concern after an electrocution should be gathering information regarding the safety of the scene and protecting the bystanders and rescuers by instructing them to avoid the source and any electrified water. Inherent risks to the victim include long falls, cardiac arrests and internal burns, so both spinal precautions and CPR should be considered immediately. Keep the airway clear and allow the patient to lie flat and comfortably. Alert the police and fire department as soon as possible.

Childbirth/Pregnancy Complications

• Pregnancy complications in the first and second trimesters should be handled symptomatically, usually by keeping the woman calm, comfortable and warm. Do not offer food or drink. Another possibility is imminent birth, which occurs when a woman in her third trimester is having labor pains less than five minutes apart or less than two minutes apart for a first-time mother. If the woman has the urge to push or part of the baby is showing, an imminent birth situation definitely exists. In this situation, the woman should be told not to close or cross her legs in an attempt to postpone the birth. She can, however, take deep breaths to help fight the urge to push. She should be propped to a semi-seated position with pillows, in a bed if possible, and naked from the waist down. List any medications for the doctor's arrival.

Fainting

• Single fainting episodes are not considered generally to be as serious as multiple fainting episodes or sustained unconsciousness. Ask if the patient is a diabetic or suffers from seizures. Other possible causes are a stroke, cardiac arrest, overdose, poisoning, intoxication, head injury, hypoxia, shock or heart rhythm problems. For small children, the cause might be sudden shock or breath holding out of anger.The main priority is to keep airways open. The victim should be laid down on her back or to the side if vomiting occurs.