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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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. Additionaldefinitions, 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.

Topics:Description Essentials|Emergency Police Dispatch (EPD)|eyewitness|Person Descriptions|Police Priority Dispatch System (PPDS)|suspect/subject

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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.

Topics:EMD|ePCR|MPDS|ProQA|Protocol 26|sick person protocol

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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

Topics:emergency medical dispatch|lights and siren|Medical Emergency Calls|Pre-alert

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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-TractorTrailer (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.

Topics:Extrication|Head-on|Mechanism of Injury|Motor vehicle accidents|MVA|SEMI|Traffic accidents

The smart city concept offers the possibility of more effective fire detection, notification and extinguishment systems. 
By Charles Werner
SOURCE: Firehouse.com
DATE: December 1, 2018
The concept of smart cities has become a worldwide discussion and trend. This is a direct result of broadband connectivity and the Internet of Things (IoTs). The IoTs refers to all the devices that can be connected via the internet or an IP network.

Wikipedia defines a smart city as, “An urban area that uses different types of electronic data collection sensors to supply information that is used to manage assets and resources efficiently. This includes data collected from citizens, devices and assets that is processed and analyzed to monitor and manage building systems, traffic and transportation systems, power plants, water supply networks, waste management, law enforcement, information systems, schools, libraries, hospitals, and other community services.”
IoT Today (iot-today.com) identified the top 5 smart cities in the world as Singapore, London, Barcelona, San Francisco and Oslo based on their use of broadband connectivity and integration of various data systems for the purpose of analyzing and increasing operational efficiencies. The scope of the smart city concept will impact city employees, buildings/infrastructure, technology, citizen engagement and community expectations.
Fire service impact ……
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By Edward Parkinson, Acting Chief Executive Officer, First Responder Network Authority
Emergencies and disasters can strike any community. From the recent devastation of Hurricane Michael to massive wildfires that swept across the West Coast, far-reaching disasters cause devastating economic, public safety and health impacts. Localized emergencies also have a major impact on a community – like flash floods or active shooter situations. In counties, cities and towns across America, emergency responders prepare for these events to help minimize the effects and aid in recovery. Now, devices and apps are helping them build resilient communities.
Over the last decade, consumer adoption of mobile technology has continued to climb, making it a prime means of communicating to the public during emergencies. Smartphones are now owned in 87 percent of U.S. homes, according to CTA’s 20th Consumer Technology Ownership and Market Potential Study.
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By Lori Stone, Region III Lead, First Responder Network Authority
The Washington County Sheriff’s office is leading the nation on transforming public safety communications and is putting FirstNet to use serving rural communities. The agency was among the first in the nation – and the very first in the State of Maryland – to subscribe to the nationwide public safety broadband network.
The Sheriff’s office serves more than 150,000 residents across 458 square miles of Western Maryland. “Washington County is shaped very similar to the state of Maryland – it’s in an L-shape with the city of Hagerstown being kind of the hub in the center,” said Washington County Sheriff Doug Mullendore. “And, to respond from one area in the county to the next, even in an emergency situation, will be well over an hour.”
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By Brent Williams, Senior EMS Advisor, First Responder Network Authority
As a former paramedic, I know that saying “reliable communications are essential” is truly an understatement. It can be all the difference in patient care. After more than 30 years in the EMS field, I joined FirstNet because I know it will revolutionize the way EMTs and paramedics serve their communities. With FirstNet, EMS practitioners can communicate effectively and efficiently, whether they are treating patients at a scene or en route to the hospital. The network’s “always-on” connection links EMS professionals and hospitals by providing public safety with asset tracking and location services, push-to-talk priority and preemption, secure data sharing, and 24/7 customer support.
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By Richard Mirgon, Public Safety Consultant
How many times do we say to friends, colleagues and people we know “How can I help”? We do that more often in public safety because helping is in our core. We are service-oriented and we care about our communities. How often do we want to help, but don’t know how to help? Let me make a small suggestion that could end up being a big idea.
FirstNet is up and running. FirstNet built by AT&T is aggressively working every day to meet the commitment they made to the FirstNet Authority and to the first responder community. One key element of that is coverage. We know it is improving everyday and will continue to improve. Coverage is King as they say and we can help improve coverage. As AT&T is building out our band 14 spectrum, they are building and modifying cell sites coast to coast. Many of these sites will need local permits and approvals. This process can be extensive and is different for each community. One element that will slow this process down is when the permitting authority doesn’t understand who or what FirstNet is.
We can help by educating and briefing our local planning departments, planning commissions and elected officials about FirstNet. I am not suggesting we bypass the process. Those processes exist for a reason, but one element that can slow down a process is not understanding the intent of the request or the impact on the community. When we educate our local officials, it allows them to make better and quicker decisions. With that said it is also my belief that asking for permits to be expedited supports the community we serve.
As we all know wireline 9-1-1 is no longer the primary mode to access public safety. It is wireless 9-1-1 that accounts for 80% of all 9-1-1 calls. Each and every cell site impact someone’s life and safety. Here is how impactful a cell site is.
There are 323,448 cell sites in the US according to statista.com
There are over 240 million 9-1-1 calls made every year, 80% via wireless according to nena.org. That is about 192 million wireless 9-1-1 calls.
Each cell site processes on an average of 593 9-1-1 emergency calls a year.
That is a significant number. Now, I realize as much as anyone that the number is an average and there are sites in major cities that see more calls, with some rural sites seeing far fewer calls. However, you can’t deny that the numbers are staggering. I can’t think of a single other technology that saves or impacts more lives.
So back to my point. As the numbers show, every cell site in the US saves lives. Sites being built for FirstNet not only save lives in our community, they protect the lives of our first responders and provide access to additional lifesaving technology and information. Our first responders have become dependent on broadband data and are becoming more dependent every day. Permitting and approving cell sites should be a national and local priority.
It is time to take action once again, but this time on a local level. Reach out to your local officials, planning departments, and permitting authorities and asked that they give priority to FirstNet sites. Writing a memo, sending an email or providing a briefing to those officials is simple and meaningful. Firstnet.gov has a number of PowerPoints and information brochures to make this task easy and painless.
Again, I am not suggesting bypassing the laws and regulations. I am asking that we support those requests for FirstNet sites. That they be given priority in the permit and request process – because it matters. It makes a difference to our community and it saves lives.
(This is a corrected version of the article. we would like to thank our readers for pointing out math errors.)
Richard Mirgon is a Public Safety consultant focused on FirstNet. He is a Past President of APCO International and has over 35 years of public safety and first responder experience. For more information about the author please go to http://www.next-paradigm.com/about/

By Tom Gagnon
With state and locality budgets facing increased pressure, the prospects of transitioning equipment purchased and maintained with grant funds to a budget line item can appear bleak. However, with the correct approach, the odds of a successful transition can be greatly increased.
Following September 11, 2001, states and localities received unprecedented federal grant funding, which resulted in major acquisitions of public safety communications equipment. While greatly enhancing public safety entities’ (PSE) effectiveness, these acquisitions were often made without establishing long-term sustainment plans.
Sustainment funding became an afterthought, as states and localities hurried to secure use-or-lose grant opportunities or assumed grant funding would remain sufficiently adequate to perform sustainment. Facing myriad competing priorities, state and locality governments often accepted risk by assuming equipment maintenance, upgrade, and replacement could be accomplished—in part or completely—with grant funds.
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Abstract

Introduction: Risk management is an area of critical importance for emergency services and public safety agencies, including emergency communication centers. However, almost no information currently exists regarding litigation against, or involving, emergency dispatch.
Objectives: The primary objective in this study was to characterize the most common types of adverse events, actions, and omissions of action that lead to lawsuits against emergency dispatchers and their agencies.
Methods: The study was a systematic literature review. Research and legal document databases were searched systematically for terms relating to emergency dispatch and litigation. The only data collected were publically available records, including legal documents from state, local, and federal case files, and documents pertaining to dispatch litigation obtained from research and news databases.
Results: 84 dispatch-related legal cases were reviewed, of which five were excluded for various reasons. Multiple (two or more) calls was the most common dispatch problem named as the issue in the suit, followed by delayed dispatch or response, customer service issues or mishandled calls, and failure to provide pre-arrival/post-dispatch instructions. A median $1 million settlement or decision was awarded to plaintiffs.
Conclusions: This study identified a number of common and preventable dispatch errors that characterize the majority of lawsuits brought against emergency communication centers. Such problems increasingly leave emergency communication centers open to serious legal liability. Our findings indicate that there exists a clear, expected, and enforceable standard of practice for emergency dispatching, and that this standard is increasingly applied by both the courts and the public in judging the actions of emergency communications centers and individual dispatchers.

Topics:Abandonment|Adverse Incidents|Allegations|Defendant|Emergency Dispatch Protocols|Lawsuits|Legal Obligations|Litigation|Negligence|Plaintiff|Pre-Arrival Instructions (PAIs)|Priority Dispatch

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Abstract

ABSTRACT
In medical emergencies involving out-of-hospital cardiac arrests (OHCAs), bystanders reasonably but sometimes incorrectly expect a call to 911 will result in a dispatcher guiding the caller through the steps of cardiopulmonary resuscitation (CPR). For the public safety answering points (PSAPs) providing dispatcher-assisted telephone-CPR (tCPR), data was collected in an attempt to evaluate the effectiveness of tCPR and its role in patient survival. Three PSAPs, one emergency medical service (EMS) department, and sixteen fire departments from the Des Moines, Iowa, metropolitan area were surveyed. Many were eliminated from the final evaluation due to their status as volunteer departments or lack of available data. In all, one PSAP, one EMS department, and one fire department could be analyzed. Together they reported only 84 OHCAs, 13 instances of tCPR, and one surviving patient. While the data was insufficient for evaluation of the effectiveness of tCPR, it was valuable in exposing a need for the creation of a standardized data collection database.

Topics:Des Moines|Iowa|OHCA|PSAP|TCPR|telephone-CPR