8 slide power point on Fire Emergency Services (FES)

Washington Fire Department Service Background

Traditionally, emergency medical dispatchers utilize questions to gather information from a 911 caller and then

dispatch advanced life support (ALS) units to the incident. However, with reduced revenue and the increase of 911

incidents, this is becoming more and more difficult for the Washington Fire Department (WFD) to handle all

emergency medical services (EMS) incidents. Many of these incidents are noncritical patients and they still receive

response from the WFD as though the patient is critical. The WFD emergency medical dispatchers can identify

critical or noncritical patients by asking questions, dispatch the appropriate ALS or basic life support (BLS) units for

the appropriate vehicle response mode, and then provide basic medical instructions from written text over the

telephone. The previous fire and emergency services (FES) administrator implemented systematized caller

interrogation questions, systematized dispatch life support, and emergency medical dispatch. However, WFD

continued to utilize the same dispatch response mode as well as dispatching only ALS units for all critical and

noncritical incidents. The response mode for all emergency apparatus is responding with red lights and sirens,

even if there is no need.

Expansive growth in population has caused an increase in traffic congestion along with the increase in medical

incidents. As a result, WFD cannot continue to send emergency ALS units to noncritical medical incidents. ALS

resources are limited, and sending ALS units to noncritical incidents causes paramedic intervention delays,

response, and treatment of critical patients. As the new FES administrator, you have met with many of the

firefighters and paramedics. You have learned that they have become frustrated and dissatisfied responding with

red lights and sirens to noncritical patients—many of which are frequent users who require an emergency

response at least once a month.

WFD has been reluctant in implementing the final phase of emergency medical dispatch (EMD), which is criteria-

based dispatch, because several stakeholders from the community, the city manager, and the elected officials are

concerned that patient care will be compromised. Each of the elected officials and the city manager have received

numerous complaints from the retirement community, fearing that their lives will be placed in danger if the WFD

does not respond as an emergency to all medical incidents. As the new FES administrator, you are scheduled to

meet the community in a town hall meeting to address their concerns. You have prepared a flowchart using

assumptions and external factors to help you prepare for the meeting. Some of the community’s main questions

that must be addressed include the items listed below.

 What are the intended goals and objectives of the criteria-based dispatch program?

 What are the critical areas of concern?

 What are the desired outcomes?

 Will this compromise the level of care provided to the patient or cause further injury to patients if

responding to a nonemergency?

Background chart