Re: MPDS and Patient Assessment

January 10, 2006

Anecdotally speaking, and speaking as former field medic, I'd say you always

have a guarded suspicion.

MPDS and Patient Assessment

I'd like to pose this question particularly to the EMS educators and

QA/QI/QC folks...

Do you believe (anecdotally or empirically) that receiving MPDS/EMD call

information has any bearing on the field crews' patient assessment? For

example, if the dispatcher tells the crew that the call is a " Priority 3

respiratory, " that the crew will, perhaps subconsciously, focus on a

respiratory emergency and exclude other possibilities?

Thanks,

Wes Ogilvie, MPA, JD, EMT-B

Austin, Texas

January 10, 2006

Anecdotally speaking, and speaking as former field medic, I'd say you always

have a guarded suspicion.

MPDS and Patient Assessment

I'd like to pose this question particularly to the EMS educators and

QA/QI/QC folks...

Do you believe (anecdotally or empirically) that receiving MPDS/EMD call

information has any bearing on the field crews' patient assessment? For

example, if the dispatcher tells the crew that the call is a " Priority 3

respiratory, " that the crew will, perhaps subconsciously, focus on a

respiratory emergency and exclude other possibilities?

Thanks,

Wes Ogilvie, MPA, JD, EMT-B

Austin, Texas

January 10, 2006

Anecdotally speaking, and speaking as former field medic, I'd say you always

have a guarded suspicion.

MPDS and Patient Assessment

I'd like to pose this question particularly to the EMS educators and

QA/QI/QC folks...

Do you believe (anecdotally or empirically) that receiving MPDS/EMD call

information has any bearing on the field crews' patient assessment? For

example, if the dispatcher tells the crew that the call is a " Priority 3

respiratory, " that the crew will, perhaps subconsciously, focus on a

respiratory emergency and exclude other possibilities?

Thanks,

Wes Ogilvie, MPA, JD, EMT-B

Austin, Texas

January 10, 2006

I believe that my first thought would lean toward a respiratory

emergency. However, I would also be looking for underlying issues that

could be the cause of the respiratory emergency or something more severe

than the pt complaint.

Dan Bird, EMT-P, EM

MPDS and Patient Assessment

I'd like to pose this question particularly to the EMS educators and

QA/QI/QC folks...

Do you believe (anecdotally or empirically) that receiving MPDS/EMD call

information has any bearing on the field crews' patient assessment?

For example, if the dispatcher tells the crew that the call is a

" Priority 3 respiratory, " that the crew will, perhaps subconsciously,

focus on a respiratory emergency and exclude other possibilities?

Thanks,

Wes Ogilvie, MPA, JD, EMT-B

Austin, Texas

January 10, 2006

I believe that my first thought would lean toward a respiratory

emergency. However, I would also be looking for underlying issues that

could be the cause of the respiratory emergency or something more severe

than the pt complaint.

Dan Bird, EMT-P, EM

MPDS and Patient Assessment

I'd like to pose this question particularly to the EMS educators and

QA/QI/QC folks...

Do you believe (anecdotally or empirically) that receiving MPDS/EMD call

information has any bearing on the field crews' patient assessment?

For example, if the dispatcher tells the crew that the call is a

" Priority 3 respiratory, " that the crew will, perhaps subconsciously,

focus on a respiratory emergency and exclude other possibilities?

Thanks,

Wes Ogilvie, MPA, JD, EMT-B

Austin, Texas

January 10, 2006

I believe that my first thought would lean toward a respiratory

emergency. However, I would also be looking for underlying issues that

could be the cause of the respiratory emergency or something more severe

than the pt complaint.

Dan Bird, EMT-P, EM

MPDS and Patient Assessment

I'd like to pose this question particularly to the EMS educators and

QA/QI/QC folks...

Do you believe (anecdotally or empirically) that receiving MPDS/EMD call

information has any bearing on the field crews' patient assessment?

For example, if the dispatcher tells the crew that the call is a

" Priority 3 respiratory, " that the crew will, perhaps subconsciously,

focus on a respiratory emergency and exclude other possibilities?

Thanks,

Wes Ogilvie, MPA, JD, EMT-B

Austin, Texas

January 10, 2006

I have no problem with the pre-arrival instruction if

they are proper. Maybe the EMD should also require

the certificant to at least be an EMT to have a better

understanding. The cards are only a guide and will

not apply to every call to the " t " . The one I cannot

stand is the 26 series, sick call/person. But when

the call is dispatched out it should be done just as

it was before, where you were told exactly what the

caller said and/or what the pt is feeling, this way

you know what to expect or what you may be walking

into.

Salvador Capuchino Jr

EMT-Paramedic

--- " Bird, P " wrote:

> I believe that my first thought would lean toward a

> respiratory

> emergency. However, I would also be looking for

> underlying issues that

> could be the cause of the respiratory emergency or

> something more severe

> than the pt complaint.

>

> Dan Bird, EMT-P, EM

>

> MPDS and Patient Assessment

>

> I'd like to pose this question particularly to the

> EMS educators and

> QA/QI/QC folks...

>

> Do you believe (anecdotally or empirically) that

> receiving MPDS/EMD call

> information has any bearing on the field crews'

> patient assessment?

> For example, if the dispatcher tells the crew that

> the call is a

> " Priority 3 respiratory, " that the crew will,

> perhaps subconsciously,

> focus on a respiratory emergency and exclude other

> possibilities?

>

> Thanks,

> Wes Ogilvie, MPA, JD, EMT-B

> Austin, Texas

>

> [Non-text portions of this message have been

> removed]

>

January 10, 2006

I have no problem with the pre-arrival instruction if

they are proper. Maybe the EMD should also require

the certificant to at least be an EMT to have a better

understanding. The cards are only a guide and will

not apply to every call to the " t " . The one I cannot

stand is the 26 series, sick call/person. But when

the call is dispatched out it should be done just as

it was before, where you were told exactly what the

caller said and/or what the pt is feeling, this way

you know what to expect or what you may be walking

into.

Salvador Capuchino Jr

EMT-Paramedic

--- " Bird, P " wrote:

> I believe that my first thought would lean toward a

> respiratory

> emergency. However, I would also be looking for

> underlying issues that

> could be the cause of the respiratory emergency or

> something more severe

> than the pt complaint.

>

> Dan Bird, EMT-P, EM

>

> MPDS and Patient Assessment

>

> I'd like to pose this question particularly to the

> EMS educators and

> QA/QI/QC folks...

>

> Do you believe (anecdotally or empirically) that

> receiving MPDS/EMD call

> information has any bearing on the field crews'

> patient assessment?

> For example, if the dispatcher tells the crew that

> the call is a

> " Priority 3 respiratory, " that the crew will,

> perhaps subconsciously,

> focus on a respiratory emergency and exclude other

> possibilities?

>

> Thanks,

> Wes Ogilvie, MPA, JD, EMT-B

> Austin, Texas

>

> [Non-text portions of this message have been

> removed]

>

January 10, 2006

I have no problem with the pre-arrival instruction if

they are proper. Maybe the EMD should also require

the certificant to at least be an EMT to have a better

understanding. The cards are only a guide and will

not apply to every call to the " t " . The one I cannot

stand is the 26 series, sick call/person. But when

the call is dispatched out it should be done just as

it was before, where you were told exactly what the

caller said and/or what the pt is feeling, this way

you know what to expect or what you may be walking

into.

Salvador Capuchino Jr

EMT-Paramedic

--- " Bird, P " wrote:

> I believe that my first thought would lean toward a

> respiratory

> emergency. However, I would also be looking for

> underlying issues that

> could be the cause of the respiratory emergency or

> something more severe

> than the pt complaint.

>

> Dan Bird, EMT-P, EM

>

> MPDS and Patient Assessment

>

> I'd like to pose this question particularly to the

> EMS educators and

> QA/QI/QC folks...

>

> Do you believe (anecdotally or empirically) that

> receiving MPDS/EMD call

> information has any bearing on the field crews'

> patient assessment?

> For example, if the dispatcher tells the crew that

> the call is a

> " Priority 3 respiratory, " that the crew will,

> perhaps subconsciously,

> focus on a respiratory emergency and exclude other

> possibilities?

>

> Thanks,

> Wes Ogilvie, MPA, JD, EMT-B

> Austin, Texas

>

> [Non-text portions of this message have been

> removed]

>

January 10, 2006

Two problems with your (admittedly good) solutions.

1) EMD is designed so that anyone can provide triage and prearrival

instructions. Many EMS organizations, particularly in rural areas, are not

dispatched by EMTs.

2) I have been told before that if the cards are strictly followed, the makers

of the cards will provide for the legal defense of the entity using the cards in

the event of a lawsuit.

I'd ask, though, that since the MPDS cards may constitute medical care, is there

a need for a medical director? If so, may the medical director modify the

instructions?

-Wes Ogilvie, MPA, JD, EMT-B

Austin, Texas

MPDS and Patient Assessment

>

> I'd like to pose this question particularly to the

> EMS educators and

> QA/QI/QC folks...

>

> Do you believe (anecdotally or empirically) that

> receiving MPDS/EMD call

> information has any bearing on the field crews'

> patient assessment?

> For example, if the dispatcher tells the crew that

> the call is a

> " Priority 3 respiratory, " that the crew will,

> perhaps subconsciously,

> focus on a respiratory emergency and exclude other

> possibilities?

>

> Thanks,

> Wes Ogilvie, MPA, JD, EMT-B

> Austin, Texas

>

> [Non-text portions of this message have been

> removed]

>

January 10, 2006

Two problems with your (admittedly good) solutions.

1) EMD is designed so that anyone can provide triage and prearrival

instructions. Many EMS organizations, particularly in rural areas, are not

dispatched by EMTs.

2) I have been told before that if the cards are strictly followed, the makers

of the cards will provide for the legal defense of the entity using the cards in

the event of a lawsuit.

I'd ask, though, that since the MPDS cards may constitute medical care, is there

a need for a medical director? If so, may the medical director modify the

instructions?

-Wes Ogilvie, MPA, JD, EMT-B

Austin, Texas

MPDS and Patient Assessment

>

> I'd like to pose this question particularly to the

> EMS educators and

> QA/QI/QC folks...

>

> Do you believe (anecdotally or empirically) that

> receiving MPDS/EMD call

> information has any bearing on the field crews'

> patient assessment?

> For example, if the dispatcher tells the crew that

> the call is a

> " Priority 3 respiratory, " that the crew will,

> perhaps subconsciously,

> focus on a respiratory emergency and exclude other

> possibilities?

>

> Thanks,

> Wes Ogilvie, MPA, JD, EMT-B

> Austin, Texas

>

> [Non-text portions of this message have been

> removed]

>

January 10, 2006

Two problems with your (admittedly good) solutions.

1) EMD is designed so that anyone can provide triage and prearrival

instructions. Many EMS organizations, particularly in rural areas, are not

dispatched by EMTs.

2) I have been told before that if the cards are strictly followed, the makers

of the cards will provide for the legal defense of the entity using the cards in

the event of a lawsuit.

I'd ask, though, that since the MPDS cards may constitute medical care, is there

a need for a medical director? If so, may the medical director modify the

instructions?

-Wes Ogilvie, MPA, JD, EMT-B

Austin, Texas

MPDS and Patient Assessment

>

> I'd like to pose this question particularly to the

> EMS educators and

> QA/QI/QC folks...

>

> Do you believe (anecdotally or empirically) that

> receiving MPDS/EMD call

> information has any bearing on the field crews'

> patient assessment?

> For example, if the dispatcher tells the crew that

> the call is a

> " Priority 3 respiratory, " that the crew will,

> perhaps subconsciously,

> focus on a respiratory emergency and exclude other

> possibilities?

>

> Thanks,

> Wes Ogilvie, MPA, JD, EMT-B

> Austin, Texas

>

> [Non-text portions of this message have been

> removed]

>

January 10, 2006

Anytime you provide medical care, even at the basic EMD level, you need

medical oversight.

MPDS and Patient Assessment

>

> I'd like to pose this question particularly to the

> EMS educators and

> QA/QI/QC folks...

>

> Do you believe (anecdotally or empirically) that

> receiving MPDS/EMD call

> information has any bearing on the field crews'

> patient assessment?

> For example, if the dispatcher tells the crew that

> the call is a

> " Priority 3 respiratory, " that the crew will,

> perhaps subconsciously,

> focus on a respiratory emergency and exclude other

> possibilities?

>

> Thanks,

> Wes Ogilvie, MPA, JD, EMT-B

> Austin, Texas

>

> [Non-text portions of this message have been

> removed]

>

January 10, 2006

Anytime you provide medical care, even at the basic EMD level, you need

medical oversight.

MPDS and Patient Assessment

>

> I'd like to pose this question particularly to the

> EMS educators and

> QA/QI/QC folks...

>

> Do you believe (anecdotally or empirically) that

> receiving MPDS/EMD call

> information has any bearing on the field crews'

> patient assessment?

> For example, if the dispatcher tells the crew that

> the call is a

> " Priority 3 respiratory, " that the crew will,

> perhaps subconsciously,

> focus on a respiratory emergency and exclude other

> possibilities?

>

> Thanks,

> Wes Ogilvie, MPA, JD, EMT-B

> Austin, Texas

>

> [Non-text portions of this message have been

> removed]

>

January 10, 2006

The answer to your question Wes is yes, a medical director is required to

sign-off on the acceptance and use of the cards.

There are a few points within the system which allow local

input/modification, but for the most part, the only local control is with

the mode of response (emergency or not).

-Thom Seeber

MPDS and Patient Assessment

>

> I'd like to pose this question particularly to the

> EMS educators and

> QA/QI/QC folks...

>

> Do you believe (anecdotally or empirically) that

> receiving MPDS/EMD call

> information has any bearing on the field crews'

> patient assessment?

> For example, if the dispatcher tells the crew that

> the call is a

> " Priority 3 respiratory, " that the crew will,

> perhaps subconsciously,

> focus on a respiratory emergency and exclude other

> possibilities?

>

> Thanks,

> Wes Ogilvie, MPA, JD, EMT-B

> Austin, Texas

>

> [Non-text portions of this message have been

> removed]

>

January 10, 2006

The answer to your question Wes is yes, a medical director is required to

sign-off on the acceptance and use of the cards.

There are a few points within the system which allow local

input/modification, but for the most part, the only local control is with

the mode of response (emergency or not).

-Thom Seeber

MPDS and Patient Assessment

>

> I'd like to pose this question particularly to the

> EMS educators and

> QA/QI/QC folks...

>

> Do you believe (anecdotally or empirically) that

> receiving MPDS/EMD call

> information has any bearing on the field crews'

> patient assessment?

> For example, if the dispatcher tells the crew that

> the call is a

> " Priority 3 respiratory, " that the crew will,

> perhaps subconsciously,

> focus on a respiratory emergency and exclude other

> possibilities?

>

> Thanks,

> Wes Ogilvie, MPA, JD, EMT-B

> Austin, Texas

>

> [Non-text portions of this message have been

> removed]

>

January 10, 2006

Sal,

Are you guys using MPDS? In the latest version The 26 card has many

new determinants that give you a better description of the call.

Contrary to your belief we use MPDS not because we are trying to hide

the call types from everyone scanning our frequencies, we have been

using it scince 1998.

We use it because it is our belief that that we provide a better

service to our community with MPDS.

Danny

Director of Communications

Med-Care EMS

>

> > I believe that my first thought would lean toward a

> > respiratory

> > emergency. However, I would also be looking for

> > underlying issues that

> > could be the cause of the respiratory emergency or

> > something more severe

> > than the pt complaint.

> >

> > Dan Bird, EMT-P, EM

> >

> > MPDS and Patient Assessment

> >

> > I'd like to pose this question particularly to the

> > EMS educators and

> > QA/QI/QC folks...

> >

> > Do you believe (anecdotally or empirically) that

> > receiving MPDS/EMD call

> > information has any bearing on the field crews'

> > patient assessment?

> > For example, if the dispatcher tells the crew that

> > the call is a

> > " Priority 3 respiratory, " that the crew will,

> > perhaps subconsciously,

> > focus on a respiratory emergency and exclude other

> > possibilities?

> >

> > Thanks,

> > Wes Ogilvie, MPA, JD, EMT-B

> > Austin, Texas

> >

> > [Non-text portions of this message have been

> > removed]

> >

January 10, 2006

Good point, and yes it could.

However, would it be better to send them in to every call blind?

Tater

ExLngHrn@... wrote:

I'd like to pose this question particularly to the EMS educators and QA/QI/QC

folks...

Do you believe (anecdotally or empirically) that receiving MPDS/EMD call

information has any bearing on the field crews' patient assessment? For

example, if the dispatcher tells the crew that the call is a " Priority 3

respiratory, " that the crew will, perhaps subconsciously, focus on a respiratory

emergency and exclude other possibilities?

Thanks,

Wes Ogilvie, MPA, JD, EMT-B

Austin, Texas

January 10, 2006

Good point, and yes it could.

However, would it be better to send them in to every call blind?

Tater

ExLngHrn@... wrote:

I'd like to pose this question particularly to the EMS educators and QA/QI/QC

folks...

Do you believe (anecdotally or empirically) that receiving MPDS/EMD call

information has any bearing on the field crews' patient assessment? For

example, if the dispatcher tells the crew that the call is a " Priority 3

respiratory, " that the crew will, perhaps subconsciously, focus on a respiratory

emergency and exclude other possibilities?

Thanks,

Wes Ogilvie, MPA, JD, EMT-B

Austin, Texas

January 10, 2006

Good point, and yes it could.

However, would it be better to send them in to every call blind?

Tater

ExLngHrn@... wrote:

I'd like to pose this question particularly to the EMS educators and QA/QI/QC

folks...

Do you believe (anecdotally or empirically) that receiving MPDS/EMD call

information has any bearing on the field crews' patient assessment? For

example, if the dispatcher tells the crew that the call is a " Priority 3

respiratory, " that the crew will, perhaps subconsciously, focus on a respiratory

emergency and exclude other possibilities?

Thanks,

Wes Ogilvie, MPA, JD, EMT-B

Austin, Texas

January 11, 2006

Wes,

I feel that the dispatch information to the crews should be very

limited, I do not like the idea of the dispatcher diagnosing the

call over the phone, I've seen it too many times that the dispatcher

gets bad information and have seen crews get tunnel vision on the

call due to the dispatchers diagnosis.

Now let me say this there are some very good dispatchers out

there. I seen Thom Seber reply to this and I believe he is one of

the greats. Unfortunatly the world is not full of dispatchers like

Thom who have years and years and years etc. of experience as a

paramedic to back up his dispatch experience.

I do have solution to the problem though:

Make all dispatcher be EMD trained seasoned paramedics and require

all patients who call 911 to be well trained EMT's with lots and

lots of common sense really this is a bad idea cause we probably

would not have a job due to the drastic drop in call volume.

oh well have a good day

and just to make note these are only my opinions and do not reflect

on any employer or associate.

sorry for the spelling

Ross Bradley, EMT-P

>

> I believe that my first thought would lean toward a respiratory

> emergency. However, I would also be looking for underlying issues

that

> could be the cause of the respiratory emergency or something more

severe

> than the pt complaint.

>

> Dan Bird, EMT-P, EM

>

> MPDS and Patient Assessment

>

> I'd like to pose this question particularly to the EMS educators

and

> QA/QI/QC folks...

>

> Do you believe (anecdotally or empirically) that receiving

MPDS/EMD call

> information has any bearing on the field crews' patient assessment?

> For example, if the dispatcher tells the crew that the call is a

> " Priority 3 respiratory, " that the crew will, perhaps

subconsciously,

> focus on a respiratory emergency and exclude other possibilities?

>

> Thanks,

> Wes Ogilvie, MPA, JD, EMT-B

> Austin, Texas

>

January 11, 2006

Wes,

I feel that the dispatch information to the crews should be very

limited, I do not like the idea of the dispatcher diagnosing the

call over the phone, I've seen it too many times that the dispatcher

gets bad information and have seen crews get tunnel vision on the

call due to the dispatchers diagnosis.

Now let me say this there are some very good dispatchers out

there. I seen Thom Seber reply to this and I believe he is one of

the greats. Unfortunatly the world is not full of dispatchers like

Thom who have years and years and years etc. of experience as a

paramedic to back up his dispatch experience.

I do have solution to the problem though:

Make all dispatcher be EMD trained seasoned paramedics and require

all patients who call 911 to be well trained EMT's with lots and

lots of common sense really this is a bad idea cause we probably

would not have a job due to the drastic drop in call volume.

oh well have a good day

and just to make note these are only my opinions and do not reflect

on any employer or associate.

sorry for the spelling

Ross Bradley, EMT-P

>

> I believe that my first thought would lean toward a respiratory

> emergency. However, I would also be looking for underlying issues

that

> could be the cause of the respiratory emergency or something more

severe

> than the pt complaint.

>

> Dan Bird, EMT-P, EM

>

> MPDS and Patient Assessment

>

> I'd like to pose this question particularly to the EMS educators

and

> QA/QI/QC folks...

>

> Do you believe (anecdotally or empirically) that receiving

MPDS/EMD call

> information has any bearing on the field crews' patient assessment?

> For example, if the dispatcher tells the crew that the call is a

> " Priority 3 respiratory, " that the crew will, perhaps

subconsciously,

> focus on a respiratory emergency and exclude other possibilities?

>

> Thanks,

> Wes Ogilvie, MPA, JD, EMT-B

> Austin, Texas

>

January 11, 2006

Dr. Willoughby-DeJesus:

Then would it be just as effective to merely give the patient's complaint/reason

for calling? (Or the caller's version of what's wrong with the patient?)

Thanks!

-Wes Ogilvie, MPA, JD, EMT-B

Austin, Texas

Re: MPDS and Patient Assessment

Wes

Several issues, yes it might give them a focus or a " heads up " but

-dispatch information is imperfect by definition, we are abstractiong medical

conclusions from nonmedical people giving the information that know not what

they see or what to look for. This leads to imperfect conclusions and

dispatches, the call may not be what it seems so they may not end up with what

they think.

-60% of our calls are cell phone and don't really know what's going on

accurately and don't want to participate in all of our questions

-Our patients are dynamic by their very definition, they change and when we get

there it is not what it started as.

The most I think we can hope for is a very definite maybe!

What do you think?

a

a Willoughby DeJesus, DO, MHPE

EMS Medical Advisor

Chicago Fire Department

1338 S. Clinton Street

Chicago, IL 60607

O:

F:

P:

pwilloughby@...

>>> exlnghrn@... 1/10/06 2:29 PM >>>

Sent via the EMS-L mailing list and never sent unsolicited.

Please see message footer for unsubscribe directions.

===========================================================

I'd like to pose this question particularly to the EMS educators and QA/QI/QC

folks...

Do you believe (anecdotally or empirically) that receiving MPDS/EMD call

information has any bearing on the field crews' patient assessment? For

example, if the dispatcher tells the crew that the call is a " Priority 3

respiratory, " that the crew will, perhaps subconsciously, focus on a respiratory

emergency and exclude other possibilities?

Thanks,

Wes Ogilvie, MPA, JD, EMT-B

Austin, Texas

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January 11, 2006