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MEDICAL CARDSET

Case Entry
The Case Entry Protocol standardizes the beginning of each call and functions as an initial caller interrogation. It directs the calltaker to collect essential information for initial processing and classifying of the incident including: the address of the emergency, the phone number the caller is calling from, the caller's name, and the Chief Complaint.

Key Questions
Key Questions provide a secondary caller interrogation. The answers to these questions help the calltaker assess scene safety, prioritize the response, select appropriate caller instructions, and provide pertinent information to responders. The calltaker uses the answers to these questions to automatically recommend the appropriate dispatch code. Individual agencies assign specific responses to each code based on local resources and needs.

Additional Information

Additional Information Protocols
Located below each Chief Complaint Protocol is an Additional Information Protocol. These protocols provide information necessary to choose a Determinant Descriptor, as well as other useful information specific to each Chief Complaint Protocol. The working part of the protocol is presented on the left side of the Additional Information Protocols, and the more general information to the right.

Determinant Classifications
Determinant Classifications group things into categories for easy reference by the EMD. For example, the Additional Information for Protocol 30 contains an "Injured Body Area Determinant Classification List" that groups injured areas of the body into NOT DANGEROUS, POSSIBLY DANGEROUS, and DANGEROUS categories. Determinant Classifications provide a readily available visual reference that assists you in Determinant Code selection.

Dispatch Definitions
Many protocols contain dispatch definitions that take into account the nonvisual nature of the EMD's environment. All-uppercase and bold words within the protocol are defined in the Additional Information Protocols. When these words are used in the Determinant Descriptors, it is vital that you understand their definitions. Otherwise, individual EMDs will define these terms differently and the protocol's standardization will be lost.

IMMINENT Delivery Definition - Protocol 24

1st full pregnancy and labor pains <=… 2 minutes apart
2nd plus full pregnancy and labor pains <=… 5 minutes apart

Rules
Rules are definitive action statements. They convey specifically how Axioms are used and provide many of the dos and don'ts of priority dispatch. The Rules contained within a particular protocol are to be considered always true in the medical dispatch environment, without exception.

Rule 4 - Protocol 10
If the caller asks whether the patient should be given their medication now, the EMD should only give instructions included in the protocol.

Axioms
Axioms are important features that are actually the basis of many of the decision-making processes in priority dispatch. They are self-evident truths that need no proof. They differ from Rules in that they tell us why, rather than how, we do things.

Axiom 1 - Protocol 21
Direct pressure will control most external bleeding and is the only control choice in the dispatch environment.

Laws
Laws set forth general medical and medical dispatch principles in an interesting and catchy form. In general medicine, they referred to as "the pearls."

Second Law of Surgical Medicine

All bleeding always stops.

Problem Lists
Some of the problems that may cause a particular Chief Complaint are listed on several Additional Information Protocols. This information is educational only, and is not to be used to make dispatch or patient care decisions.

Critical Problems - Protcol 10

Dissecting thoracic aortic aneurysm
Heart attack (myocardial infarction)

Post Dispatch Instructions (PDI)
PDI's 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.

Dispatch Life Support (DLS)
After providing PDI instructions, the calltaker selects an appropriate Dispatch Life Support (or DLS) Link. DLS Links guide the calltaker to appropriate Case Exit or Pre-Arrival Instructions.

Case Exit
Case Exit Instructions are standardized instructions designed to help calltakers effectively terminate a call.

Pre-Arrival Instructions (PAI)
Pre-Arrival Instructions (or PAI's) provide potentially life-saving, scripted instructions for callers trapped in a sinking vehicle or structure fire, water rescue incidents, a person who is on fire, a caller who is in danger but not trapped, or a situation where there is a HAZMAT danger. Collectively, these protocols and instructions are referred to as Dispatch Life Support Instructions. Dispatch Life Support Instructions make it possible for properly trained calltakers to provide a Zero Minute Response™.

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