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New Regulations to Improve How Mass. Dispatchers Handle 9-1-1 Medical Emergencies

OXFORD, Mass. -- Alan R. Jeskey recalls the time he dispatched a regular ambulance with oxygen to an emergency call from a man complaining of being unable to breathe.

While the ambulance was en route, Mr. Jeskey, Oxford police and fire communications center supervisor, returned to the caller who then provided more information about his predicament.

"It's burning," the man said. "It's really burning."

Mr. Jeskey then learned that the man had accidentally burned himself while trying to light a cigarette. "He had severe burns on his upper arms and body," he said, which prompted him to dispatch firefighters as well.

Mr. Jeskey uses the story to illustrate how the quality of information dispatchers receive influences the efficiency of the emergency response.

And now new state regulations will improve the way all dispatchers handle 911 medical emergencies. The dispatchers have until July 1 to become certified in the State 911 Department Emergency Medical Dispatch which will establish certification requirements and standardize 911 emergency medical call handling by dispatchers throughout the state.

"The level of care will be better," said Mr. Jeskey, a dispatcher for 15 years. "And the response time will be the same."

Some towns are already fully trained and using the new call-handling procedures, and many others are in the process. What 911 callers will notice is that dispatchers will be asking for a lot more information about the nature of a medical emergency using scripted questions and software programs. The answers will help dispatchers send the most appropriate ambulance, equipment and personnel, update responders on their way to the emergency, provide pre-ambulance arrival instructions to the caller and provide standardized CPR, airway obstruction, basic First Aid and patient comfort instructions over the phone.

Dispatchers typically ask basic questions, dispatch an ambulance, police or fire crew, and hang up as the caller waits for help to arrive. Under the new regulations, call-takers will dispatch the proper response, and then return to the caller.

"On any call that requires medical assistance," said Frank Pozniak, executive director of the State 911 Department. "They will be given that assistance by a certified call-taker. It's all part of our goal to enhance public safety."

Most public safety dispatch centers in Central Massachusetts, including Worcester, are going to have state-certified emergency medical dispatchers in house, according to Mr. Pozniak. The training is funded through state grants, and most departments have filed grant applications.

The re-vamping of the state's public safety statues began in 2008, and the new July 1, 2011 regulations are an extension of the wide-ranging legislation. Mr. Pozniak said the push in the state to "professionalize" 911 call-takers has been a long time coming.

"The goal is to have highly-trained call-takers," Mr. Pozniak said. Mr. Jeskey said all the dispatchers in Oxford currently are being trained in the new procedures.

"Reading off a card," Mr. Jeskey said. "That's going to be the biggest challenge."

Dispatchers will have 20 double-sided flip cards at their ready, for all the most frequent medical emergencies. Mr. Jeskey explained the new system to senior citizens two weeks ago.

"We're basically six minutes away from anyone in any part of Oxford," Mr. Jeskey said. "That was their main concern. That was the one point they really wanted to be assured of. My main message is that the ambulance doesn't have to be the first one on the scene to provide care. We're going to do that over the phone."

At the Rutland Regional Dispatch Center, located on Main Street in Rutland, all 10 dispatchers are certified, according to Nathan P. Kenney, who will serves as the director of emergency communications for Rutland, Oakham, Hubbardston and Barre starting July 1.

"We went live Sept. 1," Mr. Kenney said. "The feedback from fire services is good; their pre-arrival instructions improved greatly."

Mr. Kenney said if a 65-year-old called with chest pains, the dispatcher in the past would broadcast to the ambulance with really no more medical updates. Now the dispatcher will be able to go back to the caller and provide more in-depth medical instructions.

"The new system means that no matter what town you live in, the level of care will be the same," Mr. Kenney said, and the medical response is streamlined. Dispatchers are staying on the phone with the scene more and responders are bringing the equipment they need, while the callers on the phone are more informed on what's going on."

Ricci W. Hall, a part-time dispatcher and paramedic in Oxford, said training has been well-received and there is much more understanding now on the "whys" of a medical call.

"Anytime you change someone's job description, there's a little bit of nervousness," Mr. Hall said. "In many ways, I think the new system will assuage anxieties because of the guide cards."



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