Remembering Ed Reynolds, a FirstNet Pioneer

By Edward Parkinson, Acting CEO

The First Responder Network Authority team is deeply saddened to hear of the passing of former Board member Ed Reynolds on New Year’s Day.  Ed was inducted into the Wireless Hall of Fame just a few months ago after an accomplished career in wireless technology spanning several decades.

Ed had the distinction of being a founding member of the FirstNet Board, serving during our startup days through the launch of the Network in early 2018.  He was a dedicated and valuable member of the Board’s Technology and Finance committees during that time.  

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Operability is the key for Fresno County Sheriff

Margaret Mims  

 Fresno County Sheriff

“When I first heard about FirstNet, I thought, ‘here’s our opportunity to fix that problem.’” – Margaret Mims, Fresno County Sheriff

Fresno County has urban areas, a valley floor and high, rugged mountains. We have sworn personnel, a mounted posse, four-wheel drive, air squadron, mountaineer and canine volunteers.

We need to be able to communicate with them when they’re in remote locations. They need to be able to talk to each other. And we need to be able to communicate with other agencies involved. So, operability is critical when it comes to our search and rescue calls.

That’s been a common theme in my nearly four decades in law enforcement when it comes to the after-action reports of major incidents. Almost every time, communication among agencies has been an issue.

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Persons Descriptions Reported to Emergency Police Dispatch

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Abstract

Introduction: Identification of persons based on verbal descriptions is one of the key skills of police work. Gathering as much description information as possible immediately following the event—for example, at the point of emergency police dispatch—could substantially improve the accuracy of suspect descriptions, the ability to locate missing persons quickly, and other key outcomes of effective police work.

Objective: The primary objective of this study was to determine what amount and type of persons description information is collected by Emergency Police Dispatchers (EPDs), both overall and by Chief Complaint Protocol.

Methods: This is a retrospective, descriptive study of the Police Priority Dispatch System (PPDS) data from five emergency communication centers in the United States of America, collected between September 2014 and May 2017.

Results: During the study period, a total of 117,160 (58.1%) calls had at least one item from the Description Essentials (DE) Tool: Person’s Description recorded. The Chief Complaint Protocols that had the highest frequency of person DE collected were Missing/Runaway/Found Person (99.0%), Suicidal Person/Attempted Suicide (97.1%), and Domestic Disturbance/
Violence (90.0%). The most commonly recorded person DE elements were the four required measures: gender, race, age, and clothing. Among non-required DE elements, the most common was name (38.7%), and the least common were demeanor and complexion (1.3% each). By far the most common type of person described was “suspect” (78.4% of cases).

Conclusions: Overall, trained and certified EPDs using the PPDS are effective at collecting information about persons and entering it correctly. Different types of events require somewhat different approaches to description gathering. EPDs appear to discriminate among these different event types while (mostly) making sure to collect required information. Additional
definitions, small changes to when and how the ProQA DE Tool appears, and possible removal of two seldom-used descriptors have been recommended based on these findings.

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Comparison of EMD Selection of Sick Person Chief Complaint Protocol with On-Scene Responder Findings

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Abstract

Introduction: The Emergency Medical Dispatcher’s (EMD’s) selection of the most appropriate Chief Complaint Protocol is one of the most important elements in emergency dispatching. Choosing the correct Chief Complaint ensures that the correct information is gathered, the correct instructions and help provided, and the right resources sent. The selection of the MPDS Sick Person Protocol is often one of the most difficult for EMDs.

Objectives: The primary objective of this study is to compare the EMD’s selection of the Sick Person Protocol with on-scene responders’ findings when patient contact is made. The secondary objective is to compare specific details gathered on the Sick Person Protocol with on-scene responders’ findings.

Methods: This is a retrospective study using data from a single, urban, highperformance emergency medical services (EMS) system in central Virginia, USA.

Results: Overall, 44,163 ProQA cases were collected for the study period, of which 6,732 (15.2%) were handled on the Sick Person Protocol. The strong majority (62.1%) of calls fell into the ALPHA Priority Level. For most of the cases, the Primary Impression type was “pain,” a “GI/GU” (gastrointestinal or genitourinary) problem, or “weakness.” However, three Key Question answers predicted another Primary Impression: “neuro,” or neurological complaint.

Conclusions: These findings indicate that the EMDs at this agency are appropriately selecting the Sick Person Protocol and that when used correctly (by an ACE-accredited agency), the Sick Person Protocol correctly triages the few higher-acuity conditions, such as altered level of consciousness, into higher Priority Levels.

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Implications of Pre-Alerts for Medical Emergency Calls

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Abstract

Introduction: In emergency dispatching, pre-alerts are used to send responders to calls prior to getting a final dispatch code. Some studies have showed that pre-alerts can effectively reduce dispatch time for out-of-hospital cardiac arrests, potentially improving overall patient outcome. However, there is also a potential risk in running lights-and-siren on non-fully triaged calls. Although pre-alerts have been used for several years, no research studies have demonstrated its benefit, in general.

Objectives: The goal of this study was to determine the implications of pre-alerts for medical emergency calls, with regard to dispatch priorities, response units, and call cancellation and call downgrading.

Methods: This retrospective, descriptive study analyzed de-identified dispatch and EMS data from two emergency  communications centers in the USA: Johnson County Emergency Communications Center (ECC), Kansas, and Guilford County Emergency Services, North Carolina.

Results: A total of 139,815 calls were included in the study, of which 73,062 (52.3%) were downgraded, and 7,189 (5.1%) were cancelled. This indicates a waste of valuable resources and an implied increase in cost and risk. Additionally, in 20.0% of the calls, at least one response unit was cancelled, while only 1.12% were transported with high priority (lights-and-siren). A median elapsed time (-14 sec) from pre-alert to ProQA launch indicates that calls sat in the queue for median time of 14 seconds before first units were assigned.

Conclusions: The study found a significant number of cancelled units and downgraded calls. In addition, the very small percentage of calls where patients were transported with high priority indicates unnecessary pre-alerts for non-critical patients. Study findings demonstrated that calls spent a substantial amount of time in queue, and units were sent without safety/final coding information. To better establish the positive and negative impacts of pre-alerting, a controlled study

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Predicting the Need for Extrication in Traffic Accidents Reported to 911: Is Anyone Pinned/Trapped?

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Abstract

Introduction: Extrication activities at the scene of motor vehicle accidents (MVA) result in extended scene times and increase morbidity and mortality. Identifying the need for extrication-capable resources during the 911 call-taking process, and dispatching them without delay, is crucial to delivering the required response and patient care. Determining the need for extrication using the Traffic/Transport Incidents Protocol in the Medical Priority Dispatch System (MPDS®) (version 13.0 ©2000-2015, Priority Dispatch, Salt Lake City, Utah, USA) currently relies on the 911 caller’s answer to a single key question in the protocol: “Is anyone pinned (trapped)?”

Objectives: The aim of this study was to evaluate how accurate current 911 practices are in recognizing pins and entrapments resulting from MVAs. Additionally, the study sought to identify whether a Head-On (HO) MVA or an MVA with Semi-Tractor
Trailer (Semi) involvement should warrant the immediate assignment of specialized extrication resources.

Methods: This was a retrospective descriptive study of all MVA cases in three Kansas counties (Butler, Sedgwick, and Johnson), encountered from January 1, 2016, through June 30, 2017. 911 calltakers in the study population utilize the MPDS Protocols to triage MVA calls. Traffic accident data was extracted from ProQA and matched with CAD records.

Results: A total of 985 calls were analyzed, of which 218 (22.1%) required extrication and 267 (27.1%) involved Semi/HO—as documented by responders. Of the 218 cases that required extrication, 123 (56.4%) were reported pinned at dispatch and 21 (9.6%) involved Semi/head-on—15 of which were already captured by the pinned Key Question. Of the 267 cases that involved a Semi/HO, 21 (7.9%) required extrication. Of the cases that were initially reported pinned at dispatch, 123 (32.3%) required extrication by responders; and of the cases initially reported not pinned at dispatch, 59 (11.4%) required extrication by responders.

Conclusions: A “yes” answer to the protocol key question “Is anyone pinned (trapped)?” is a better predictor of extrication by responders for MVAs than is the presence of Semi/head-on involvement. Further research should examine whether High Mechanism and Major Incident determinant suffixes will capture additional extrication incidents.

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