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Sub-Chief Complaints

Jeff Clawson, M.D.

Jeff Clawson, M.D.

Ask Doc

Jeff Clawson, M.D.

Brett,

I think the training point for the EMD is to ensure that they are selecting HIGH VELOCITY off of Sub-CC. If the EMD selects Protocol 29: Traffic/Transportation Incidents without a sub they would see the option under the first KQ, but when selecting Vehicle vs Vehicle off sub they will miss that as a more specific option should it be appropriate.

Do we have any documentation on Sub-Chief Complaint prioritization? I am wondering if that would assist our emergency dispatchers for these types of selections?

Thank You,

Tony Guido

Program Administrator

Fire/Medical/Quality

Priority Dispatch Corp.

Hi Tony:

The Sub-CC field is new, and EMDs are just getting used to it. Doc and the gang are working on some problem areas where uncommon complaints are coming up first and being selected accidentally, so there will be some tweaking in software land. Overall the reviews have been good, and I think EMDs will appreciate the efficiency of this new feature once they get accustomed to it.

I am not aware of any specific training document, and I’m not sure it warrants one. But perhaps an article for the Journal would be helpful. Any volunteers?

Brett Patterson

Academics & Standards Associate

Chair, Medical Council of Standards

IAED

All,

I began working on an article over the last few weeks that is geared more toward the Q side outlining Final Code Validation and leveraging these concepts for “Chief & Sub-Chief Complaint” validation. I LOVE the new Final Code Validation, and it falls right in line with ensuring protocol accuracy as well. As I have walked around many centers it is not uncommon to see an EMD/EPD or EFD fly through the Case Entry Questions and swiftly, if sometimes violently, select a protocol. With the Sub-Chief Complaints, that momentary pause to validate your selection should be a celebrated practice.

I know there has been some discussion on pulling back from the more infrequent subs in medical such as “head out” or “sickle cell.” I would want the article to fall in line with the most current direction so it may need to follow an updated release.

Thoughts?

Tony

Tony,

Thanks for the follow-up on this thing. Just before the last release, we removed the Sickle Cell Crisis and Thalassemia choices from the P-26 Sub-CC list. These should be out there now—for those that updated. They were very rare and actually are not Sub-CCs but diagnoses—although, if they were very common, we would have left them in. We didn’t change the “head” issue, as the “head visible” and “head out” are critical things that need quickest path—interestingly, this is only a problem on female cases. On those, the EMD will just have to learn that Headache requires typing in “heada” (5 characters) to get. I would just simply type in “18.”

I have been working with Irena (Weight, Vice President of Protocol, Translation, Curriculum & Instructional Design) to clean up the Sub-CC and KQ1 lists. The following was or is being done:

  1. Modified the name of “Solitary motorcycle” to “Motorcycle (solitary)” since this is fairly likely as not to be the choice, and Motorcycle would probably be what they start typing in. We’ll see.
  2. We also reordered several of the “Top 12” to make a bit more sense.
  3. We moved “HIGH VELOCITY impact” higher in the lists.
  4. We will add a comment colon after “HIGH VELOCITY impact:” to better delineate just what it is (this only happens in KQs).
  5. Per item 4, we will also have to deal with the comment colon issue on the Sub-CC choices of HIGH VELOCITY and LOW MECHANISM, as they don’t as yet pop-up a comment box in this pathway. I think they should be popped up, in essence, as the first KQ1 action. There might be others throughout the protocol. That will be a DevCore issue that we will look into this week.
I hope this gives you some guidance on your article. I will let you know as soon as the things mentioned as being imminent are done. The next planned maintenance release for ProQA® medical, etc., will be October 17th as of now …

Thanks man … Doc