The Annual Conference of the
National Academy of Emergency Medical Dispatch
August 29 - September 1, 2000
Aladdin Hotel - Las Vegas (Nev.)
The Annual Conference of the National Academy of Emergency Medical Dispatch August 29 - September 1, 2000 |
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by Gary Allen
If your car didn't get stuck in the flood waters that swamped several
Las Vegas intersections, and you managed to wake despite the fact your alarm
clock at the Aladdin Hotel & Casino went blank after several nighttime
power outages, then you found a broad range of educational topics during
the first day of the annual conference of the National Academy of Emergency
Medical Dispatch (NAEMD).
Unusual thunderstorms hit the valley at about 8 p.m., sending rainwater sweeping towards the city. Even with catch basins to prevent floods, several roadways were covered by one to two feet of water. And despite public education campaigns warning not to drive into standing water, the LV Fire Department's swift water rescue team had to pluck several motorists off the roofs of their cars when they stalled in deep water. The Aladdin Hotel went black several times during the night, but it didn't seem to cause any problems for the conference, which opened at 8:30 a.m. with a general session.
Some 530 persons were pre-registered for the conference (a record high), and more than that showed up for the first session, which began with NAEMD president Carl VanCott welcoming the crowd and reading a portion of the tribute by Steve Souder at the APCO conference. Van Cott then introduced Marc Gay, chair of the academy's accreditation committee. He presented the latest 13 Accredited Centers of Excellence were introduced, along with the existing 45 ACEs--attendees from each agency were given pins, and the new agencies also received certificates. He described the centers as being "one of the elite that achieved excellence." He said the honor allows the dispatchers to show pride in their work, and reinforces the dispatchers' link to EMS. Gay also mentioned the three agencies that renewed their certification: Clark County (Wash.) Regional Communications Agency, Shelby County (Tenn.) Fire and AMR Colorado.
Salt Lake City fire Capt. Brian Dale then took over with his presentation of "In the Line of Fire," which included old video clips of Dr. Jeff Clawson, the originator of the EMD system the academy certifies. The video included one of Oprah Winfrey giving Clawson the Heimlich maneuver during her show--presumably a demonstration and not the real thing.
New Textbook for Basic Training
Even before Wednesday's morning session began, our attention was immediately drawn to the exhibit hall, and the booth of Jones and Bartlett Publishers. On their table was a display advertising a Basic Telecommunicator training manual, including a sample chapter from the upcoming materials.
The course will consist of a trainer's manual and accompanying CD-ROM for computers ($225) and student workbooks ($24). The CD will include a PowerPoint presentation of the training materials, audio and video clips that are keyed to sections of the student workbook. Each workbook will include a tear-out form the student can complete, have signed off by a NAEMD-certified instructor, and mail in to NAEMD for a studnet certificate.
Publisher Larry Newell said the manual content was developed by NAEMD--primarily by two authors--and will be available by Jan. 2001. A Web site will appear by March 2001 to provide support for the training, including continuing education materials.
Newell said that Jones & Bartlett have an "unrestricted" license to publish the materials. That is, there are no pre-requisites for purchasing the book, such as taking a NAEMD instructor's course. You will have to use a certified instructor if you want the student's to be certified by NAEMD. However, if you wish, you can use the book as the core of your own basic dispatcher program without certification.
Alan Fletcher, president of Medical Priority Consultants (MPC), said the company has set an "aggressive forecast" for sales of the book---from 8,000 to 10,000 copies in the first 12 months. He pointed out the book is based on a 40-hour curriculum, and is compliant with APCO's Project 33 training standards. Asked if the book and training course might become a pre-requisite for the EMD course, he replied, "The essential goal is to tile (the protocols) together and have a unified training system."
Other comments from NAEMD and MPC officials emphasized that the new training materials stress a protocol-based approach to dispatching, something they say has been missing from previous training manuals. Not only will this method help dispatchers in general, but it will prepare them for EMD, which is entirely protocol-based.
I studied the sample chapter on display at the J&R booth, and found it remarkably comprehensive. It included "bullets" that refer back to the CD materials. The format is very cleanly laid out and easy to read. At key points in the text, there are references to real-life incidents that bring the material to life for the student.
Perhaps the most interesting angle about this book is its genesis---an attempt by NAEMD to apply its previously successful efforts in preparing medical training materials, to the subject of basic dispatching. It also marks a departure for NAEMD in allowing broad distribution of their training materials without any requirement to take one of their courses, or to have the instructor certified by the academy. Of course, only students taught by a NAEMD-certified can obtain a certificate themselves.
I'm anxious to see the rest of this book, as it could become big competition for the few training courses on public safety dispatching that are out there---and perhaps the only one you could purchase on Amazon.com.
J&B's other books focus on medical care at all levels. Contact them
at (703) 729-3149 or at the Web site:
www.jbpub.com
A second big debut was held at the NAEMD booth (photo left), where the
brand-new Fire Priority Dispatch System was displayed. The cards extend
the academy's medical card system to fire and rescue types of incidents.
According to the academy, they provide, "an intuitive, logic-driven
flow with recognizable symbols to direct the calltaker throughout the call
process."
The so-called EFD system is very similar to the MPDS: it has a case entry point, chief fire complaints (20 of them), key questions to ask the caller, response descriptors and codes (based on the caller's answers), post-dispatch and pre-arrival instructions, and critical EFD information. The format, colors and graphics of the EFD cards has the same look-and-feel as the MPDS.
The cards were beta tested at the West Palm Beach County (Fla.) Fire Department and Salt Lake City (Utah) Fire Department comm centers, and are available immediately.
The academy has spun off a new name and Web site for the cards---Priority Dispatch and www.prioritydispatch.net.
Of course, the cards are accompanied by a certification training course.
A full-color brochure promotes the new EFD system, and includes a peek at portions of the cards. For example, after some initial questions, the dispatcher moves to one of the 20 fire complaints. The "key questions" card for structure fire includes the questions:
Post dispatch instructions for a structure fire include:
Still other sections give advice if someone is trapped in a structure fire (stay low, close the door immediately, search for a second exit, do not use the elevator), fire extinguishing advice (only if the fire is small should the EFD ever advise in the use of an extinguisher to put it out), and instructions for using a fire extinguisher (stay about six feet away from the fire with you back to the exit...).
I was impressed with the format of the cards and the amount of information they compress into such a small space. Without studying the cards completely, I couldn't tell if the EFD system follows current prioritization methods, or if the information on the cards was accurate or justified. We understand that now that the cards have been finalized, they will be subject to revision suggestions from various firefighting groups, and presumably by agencies that take the training and buy the cards.
Perhaps the biggest question is whether fire agencies will adopt this method of handling fire calls that have traditionally been handled with just a few questions--what address? What's on fire? Is anyone trapped?
NAEMD is obviously betting that fire agencies will jump at the chance to create some logic out of fielding fire calls. And they hope that law enforcement agencies will be right be right behind them---NAEMD's law enforcement cards will be out in time for next year's annual conference in New Orleans. (see below)
NAEMD held its first training class using the new fire protocols just before the conference. Future training sessions on the EFD will be held in Florida, Canada, Connecticut, St. Louis, northern California, and Massachusetts.
[We'll post more specifics after a Thursday seminar on the new cards.]
NAEMD Will Have Brothers & Sisters
In an interview with DISPATCH Monthly, NAEMD executive director Rob Martin revealed that the academy will evolve substantilly over the next months and years.
Within the next year, the single "National Academy" will become the "National Academies of Emergency Dispatch," consisting of EMS, fire and law enforcement entities, each with its own certification process and card set, but sharing some parts of the current NAEMD administrative structure.
There have been several tip-offs to the change--the new telecommunicator training book, the fire and police protocols, and the broadening of the annual conference to include non-medical topics (21 medical vs. 26 non-medical this year).
Martin said that during Friday's general session, Dr. Clawson himself will paint an overview of the vision for the Academy five years from now, including the new name that will encompass the three protocols.
"We'll be looking to reach out to ally ourselves with other organizations that are established in those fields." He said NAEMD won't be setting itself up as an expert "in all things dispatch-related." Rather, the academy wants to be involved, and provide a structure whereby the unified protocol system they pioneered with EMD can be extended into law enforcement agencies.
Martin said that NAEMD has had conversations with NENA and APCO, the National Safety Council, the Red Cross and the American Heart Association on the new protocols, and offered them membership on the academy's alliance board (chaired by Steve L'Heureux) that will coordinate input.
He explained that the academy was originally founded to oversee the protocols developed by Dr. Clawson. While he didn't specifically say that NAEMD was open to recognizing other protocol systems, he implied such a thing was possible. Primarily, he said, agencies have demanded an EMD system that provided the ability to gather statistics about the performance and effectiveness of the system. "No other protocol system does that," he said, "and to broaden our recognition of other protocol systems that don't allow that, it would invalidate any our ability to be able to track or do studies, or reporting on the protocol."
When asked about the apparent broadening of NAEMD's mission and the possible head-to-head competition with NENA and APCO for the general training market, Martin simply said, "It's exciting!"
Martin said if he could emphasize one thing the academy wants to endorse or support, "It would be--unified protocol. Like NENA is 'One Nation, One Number,' the academy is one nation, one protocol." He said the academy is prepared to provide support and resources to create the unified set of protocols, and hopes that other groups, agencies and individuals participate.
On another matter, Martin confirmed that NAEMD has historically had conversations with APCO about its EMD program. He declined to characterize the most recent contact within the past six months. But he explained that APCO's interest in selling its EMD program has waxed and waned over the years, as the program's popularity rose and fell. Apparently this was one of the "sell" cycles, and NAEMD decided not to "buy."
We Witness Some of the NAEMD Process
I was able to sit in on a meeting of the Council of Standards during Monday's sessions. It was attended by 15 persons, including Gay, Clawson, Martin, and representatives from Great Britain. During this meeting, Gay outlined some recent research that has resulted in recommendations to change CPR procedures. The crux, of course, was how those recommendations should be reflected in the EMD procedures included in the NAEMD program.
Some of the discussion was straight-forward, while other exchanges were better understood by someone intimately familiar with the MPDS---those at the table.
Gay outlined how various international resuscitation councils have developed procedures for performing CPR in their own countries, and how those councils periodically meet to exchange information and consider changes.
The last such meeting was in Dallas last September, and they considered some 200 to 300 issues on the subject of emergency cardiac care and resuscitation.
Those issues that made it to the point of change include the radio of chest compressions to breathing (15:2 or 5:1?), research that suggests to cut ventilation entirely, cutting the pulse check, and no longer checking the mouth for an airway obstruction first-off.
All of these issues will be discussed by NAEMD in further meetings and other exchanges--no resolution was intended today.
But perhaps more intriguing was the process that leads to the cards and instructions that a dispatcher uses at his/her console.
It begins with research in, perhaps, a foreign country such as Denmark. It continues to a national resuscitation council (Scandinavian countries and the UK are particular organized), where it's considered and perhaps adopted by that country. The research eventually makes its way to the international meetings of the resuscitation councils, and recommendations for change that spark NAEMD's consideration of the changes.
During today's discussion, there was complex talk of entry points, loops and how one change in the MPDS would effect other parts. The talk was international, focused completely on the patient's benefit, and had no commercial tones whatsoever.
For example, on some issues, the American Heart Association has suggested that a lay person not perform an operation (pulse check, foreign object check), but medical personnel continue to do it. But Dr. Clawson took the position that this position would be "a significant step backward for (dispatch life support)," in that an EMD-trained dispatcher is a medically-trained person, simply using the hands of a lay person.
In conclusion, Malcolm Wollard of the UK asked for NAEMD support for further studies on the issue of no longer giving ventilation during EMD. He said it would be possible to construct studies to determine the relative effectiveness of giving ventilations, with chest compressions vs. just chest compressions. Council of Standards chair Marie Leroux promised assistance in the form of a sub-committee.
The meeting ended with a better understanding of the new recommended changes and how NAEMD will begin to address them for the MPDS.
Bits & Pieces...
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