By Greg Scott
Neighbors Saving Neighbors demonstrates a pragmatic use of the ECHO Determinant in the Medical Priority Dispatch System (MPDS).
ECHO—the highest priority level in all three Priority Dispatch Systems (MPDS, FPDS, PPDS)—was first added to MPDS v11.0 in 2000 (and shortly after to the FPDS and PPDS). It provides for early notification of, and rapid response to, the most critical of life-threatening conditions—typically for cases of ineffective breathing or confirmed sudden cardiac arrest, or respiratory arrest in the MPDS.
If you’ve been an MPDS user for some years, you might recall that in MPDS versions prior to v11.0, the EMD always assigned the Determinant Code after completing all Key Questions.
In more recent versions, the ECHO coding is assigned during Case Entry, either after the caller’s initial description of the problem is provided, or after the final Case Entry question is answered. In addition to creating an early notification process for the professional responders, ECHO provides a simple and easy to understand method for mobilizing non-traditional responders—those that would not go to more routine EMS calls but can help save a life by providing early CPR and/or defibrillation in those few cases where the absolute closest available trained hands and equipment are needed.
Since ECHO responses are few in number, typically between 1 percent to 2 percent of total cases handled using the MPDS, those non-traditional responders are used judiciously, and, therefore, unlikely to be exhausted at any given time of day. This makes ECHO responses even more valuable during peak call-load hours for paramedic ambulances and first responder crews.
The ECHO code also optimizes the concept of sending a special response based on locally defined and available resources, with Neighbors Saving Neighbors serving as an example of community-based assistance that can be provided while waiting for EMS to arrive on scene.
As with all MPDS codes, the ECHO response does not require a response that is different from DELTA, nor does it prevent the correct use of Case Entry. The ECHO level is simply one more tool to give local medical control authorities the ability to do what is clinically and ethically sound.
