By Audrey Fraizer and Heather Darata
If the protocols could speak for themselves—and they do in their own sort of way—they would have been elated at their NAVIGATOR reception in Orlando, Fla., marking the 35th anniversary of their introduction to the world.
“We are here celebrating 35 years of structured calltaking,” said Brian Dale, International Academies of Emergency Dispatch (IAED) Board of Accreditation chair. “All the things we have done [over the years] have made protocol stronger. We have brought other disciplines into a process to make protocol as scientifically valid as possible. Just think of the number of people impacted by a crazy doctor who had a sincere desire to find a better way.”
Dr. Jeff Clawson, creator of the dispatch protocols, took the honor in stride, turning the attention to an audience collectively holding their breath, so it seemed, to hear a few words from the “crazy doctor” they all admire.
“It’s great to see so many people gathered in the same place to talk about our successes, failures, and the future,” said Dr. Clawson, whose protocols hatched from his experience as a resident in Emergency Medicine at Charity Hospital in New Orleans, La., and as the fire surgeon of the Salt Lake City (Utah) Fire Department more than three decades ago. “And as we have learned, it’s all about the process of change and moving forward as scientifically valid as is possible.”
At the heart of NAVIGATOR is the protocol bolstered by the scientific method, professional organizations, and proposals submitted by the medical, fire, and police users that has drawn more than 3,600 centers worldwide during the past 35 years since Dr. Clawson unveiled the Medical Protocol to the world. The Academy has since followed with the fire, police, and Emergency Communication Nurse protocol systems.
It was in 1979 that Dr. Clawson introduced the Medical Protocol at the Salt Lake City Fire Department Comm. Center in answer to his experience as the department’s fire surgeon. He recognized the absence of tools available to what has become known as the “first link” in the chain of response and devised a solution that through its evolution stands as the gold standard in emergency communications.
Dr. Clawson used the analogy of process to prep his audience for v13.0 of the Medical Priority Dispatch System (MPDS) enhancements in the fast-track “Obviously NOT Breathing & Unconscious (Cardiac Arrest)” feature that dramatically reduces time to hands-on-chest, and enhances other changes with the same aim introduced in v12.2 and further shortened in v13.0.
“We operated in one of the most time-restricted environments on Earth so we have to make sure we do it right the first time and promptly,” he said in remarks met with a standing ovation during NAVIGATOR’s Opening Session on Wednesday, April 30, at Disney’s Coronado Springs Resort. ”The clock is ticking.”
The fast-track feature bypasses all questions and instructions on Case Entry, checks for AED availability, then navigates the EMD directly to the appropriate Pre-Arrival Instructions (PAIs) when a caller describes an obvious, medical cardiac arrest. This direct link was created to meet American Heart Association (AHA) scientific recommendations to reduce the time from discovery of cardiac arrest to “hands-on-chest,” which can dramatically increase a patient’s chance of survival.
In an audio clip presented during the Opening Session, a call recording was adapted from v12.2 to the soon-to-be-released v13.0 to illustrate the new fast-track feature. In the call, Jessica Lecik, of the Richmond (Va.) Ambulance Authority, a finalist for last year’s Dispatcher of the Year, answers a call from a frantic female reporting that her husband isn’t conscious and isn’t breathing. Twenty-seven seconds into the call, including getting him out of his chair, the caller has her hands to her husband’s chest following the EMD’s instructions for chest compressions. You can listen to the call here
“Twenty-seven seconds, that’s all,” Dr. Clawson said. “Time to dispatch in ProQA is only three seconds after ANI/ALI confirmation—it can’t get any faster than that. By providing CPR instructions earlier, we are emphasizing immediate care for our patients.”
The protocol’s PAIs for CPR underscore the dispatcher’s vital role as the first link in a process known as the Chain of Survival, a metaphor adopted by the AHA for the series of actions that can reduce the mortality associated with cardiac arrest, stroke, and other emergencies.
The three-day official conference, preceded by three days of pre-conference workshops, struck a cord immediately at the Opening Session with a 90-piece marching band from Freedom High School (Orange County Public Schools, Orlando, Fla.) playing the National Anthem as part of the presentation of the colors.
“This is so awesome,” commented Susan Feiertag, dispatcher, Los Alamos County (N.M.) 9-1-1. “This makes me realize the amazing jobs we do.”
The “amazing jobs” were celebrated through several on-stage events: the 2014 Dispatcher of the Year Award; the Dr. Jeff Clawson Leadership Award; the recognition of Accredited Centers of Excellence (ACEs)—both new and re-accrediting; presentation of the 2014 Communication Center Management (CCM) Course graduates; and the announcement of four more agencies added to the National Center for Missing and Exploited Children (NCMEC) 9-1-1 Call Center Partner program.
A new feature at NAVIGATOR was the special lanyard with the ACE logo worn by individuals from accredited centers.
Hamad Medical Corporation Ambulance Service in Doha, Qatar, was the first center from the Middle East to become an ACE, officially accredited just two weeks before the conference.
“We came running to NAVIGATOR after getting the word,” said QI Manager Sonia Bounouh, who was wearing her ACE lanyard. “We are so excited to be here and plan to have a big celebration [at the center] when we return.”
Keynote speakers included Stuart Levine, of the Disney Institute, and Pat Williams, senior vice president of the NBA’s Orlando Magic. Both speakers touched on customer service and motivation—in the magical Disney sort of way.
Similar to dispatchers using protocol, Levine said Disney cast members (employees) strive to deliver perfection in customer service.
“The power of service lies in the ability to make an emotional connection rather than purely a rational connection,” said Levine, former animal programs education manager at Disney’s Animal Kingdom Lodge. “People remember how they felt within the moment and creating those positive moments at every chance adds up to a tremendous experience.”
The exhibit hall featured 150 booths, both commercial and nonprofit, while the Opening Gala Reception events gave dispatchers a chance to mitigate the everyday stress of their profession and network.
“That’s what’s so cool about this,” said Todd Allen, from Powder Springs, Ga. “The conference helps us find ways to do things better and, at the same time, we meet people from all over the world who want to work toward that higher standard. We make lifelong contacts.”
The high note, of course, was the conference, which made its debut 15 years ago with no more than 100 people attending a one-day block of sessions. This year, a record 1,345 attendees from 14 nations participated in more than 100 educational sessions punctuated by a gala reception, an exhibit hall, special events, and guided tours of two area 9-1-1 communication centers (Osceola County Sheriff’s Office and the Reedy Creek Communication Center).
Notable changes at the conference included the continued evolution of the number and type of sessions held and a poster contest to promote the importance of continuing dispatch education sponsored by the research team (the winner was from the Yorkshire Ambulance Service, National Health Service Trust, U.K.).
For 2014, NAVIGATOR introduced Power Sessions, which were modeled after the European style of professional conferences. The four held—Research, National 9-1-1 Issues, 9-1-1 Data and Analytics, and ACE—brought together IAED panels of experts taking turns at the “podium” covering four to six related topics.
The amount of rainfall in Orlando during the week was about the only record NAVIGATOR was not pleased to exceed. A line of thunderstorms walloping central Florida resulted in three inches of rain falling in southwest and northwest Orange counties, according to the National Weather Service. Drenching rainfall forced the outdoor Beach Party at Disney’s Typhoon Lagoon Water Park and the ACE Reception at Cabanas Beach to halls inside.
The rain, lightning, and carpet rather than sand underfoot, however, did not dampen the spirits of dispatchers (at least not for long).
“I don’t care what happens, once you go to NAVIGATOR, you never want to go anywhere else,” said Virginia Szatkowksi, EMD-Q, EFD-Q, and ETC instructor. “This is my third, and I’m still star-struck by the opportunity to meet the best people in the profession. It’s an amazing place to be.”