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911 dispatchers give medical instructions


"Stay on the line . . . I'll tell you exactly what to do next."

This potentially life-saving message comes from Harford County's 911 dispatchers. They want callers, often panicked, to realize that they can help a sick or injured person if they will listen to a few simple instructions.

They also want callers to know that an ambulance is sent on an emergency no more than 30 seconds after a 911 call is received.

The new messages are part of a Harford program called Emergency Medical Dispatch, which began in April to provide better medical assistance to county residents. Under the program, trained dispatchers provide medical instructions to callers so they can begin first-response aid.

"Staying on the phone to answer vital questions has no bearing on how quickly an ambulance is dispatched," said Beverly Leftwich, the Emergency Medical Dispatch coordinator for the county's Emergency Operations Center in Hickory. She is one of only 17 instructors in the United States certified to teach courses in emergency medical dispatch.

So far, 25 Harford dispatchers have been trained in medical dispatch, Mrs. Leftwich said.

"In the fall, we expect to train the police dispatchers employed by the Harford County Sheriff's Office, because by the fall of 1997, they will be merging with us to improve 911 medical response within the county," she said.

When a caller dials 911, the dispatcher's computer flashes the location of the caller on the monitor. As soon as the dispatcher determines the medical nature and priority level of the problem, an ambulance with appropriate personnel is dispatched.

When the ambulance is on its way, the 911 dispatcher can begin giving "post-dispatch" and "prearrival" instructions, Mrs. Leftwich said. "In a 'hot,' or life-threatening situation, what happens before medical personnel arrive can truly save a life."

Some callers panic and hang up, or just leave the phone and return to the injured or sick person, but 911 dispatchers using the system want them to stay on the line to receive or pass on vital information to begin first-response treatment.

Post-dispatch questions can be as simple, for example, as asking the caller for a more precise location of the patient.

Guided by a file of medical flip cards printed with important questions according to priority, dispatchers can seek details on the medical condition of the patient: Is the patient bleeding? Breathing? Choking? Has the patient just eaten something? Does the patient have asthma?

Each answer helps paint a medical picture and allows for better patient care, Mrs. Leftwich said.

"It's almost routine anymore that our dispatchers give child birth or CPR [cardiopulmonary resuscitation] instructions to a caller at the scene before a paramedic arrives," said James W. Terrell, chief of Harford's emergency operations.

The new medical dispatch system cost about $2,000 for the card system and computer software, Chief Terrell said. "The fire chiefs' association paid $5,000 to train the dispatchers."

Emergency Medical Dispatch was started in 1978 by Dr. Jeff J. Clawson in Utah. It has a panel of 50 medical experts who will testify in defense of any trained dispatcher, should someone attempt to sue the dispatcher for the method or quality of service.

Mrs. Leftwich said the new system is used more extensively on the West Coast than in the East, but is in use in Washington, Frederick and Carroll counties in Maryland, as well as in Delaware.

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