Please correct me if I am wrong on this point.So the question for discussion is...
Does it make sense to send all three responders to each call for help?
I would say that I can easily make a case for both sides in this case.
1) ASSESS THE SITUATION AND SEND ONLY WHAT IS NECESSARY:
This is called triage in the emergency rooms of every hospital (or if you remember that TV show M.A.S.H.) - where by someone listens to the person making call for help, asks questions to determine the need and then they send those services that they see as being necessary to solve the problem.
This would probably work in 99% of the cases involving a call for help to 9-1-1. A professional who is trained in emergency triage would need to be on duty 24/7... and maybe not just one. This might be yet another good reason to consider regional 9-1-1 emergency call centers (but that is yet another debate/discussion topic).
The worry is in that 1%... nobody is willing to have the dropped ball happen when it is your spouse or child's life on the line. In that case... send them all... send the Marines too!
However, as a cost saving move it might end up reducing the need for so much redundancy as well as reducing the load on all members of the 'rescue' teams (only sending 1 or 2 when needed, instead of all 3 all the time.)
2) SEND ALL THREE ALL THE TIME:
When someone calls 9-1-1 it is usually in an emotionally charged state. Something is very wrong, someone is hurt or dying, someone just crashed into their car, the house is on fire, etc. etc. etc. They may or may not be fully aware of the severity of the situation... they may be confused or simply not know how good or bad the situation is.
Also, there might be a large time delay if the wrong rescuer is sent when another is needed. What if the car accident simply looks minor, but in fact, someone is hurt badly or fuel is leaking out in an obscure location that no one sees... until it is too late? Or a smell of smoke in an apartment might bring the fire fighters, only to discover the apartment next door has an unconscious occupant due to smoke inhalation.
Lives are precious and can not be replaced. Vehicle engines, transmissions, tires... these can be repaired or replaced.
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Perhaps the best solution is a middle ground... where we do some minor level of triage in order to reduce the time, effort and expense on all three groups... but we also lean towards sending MORE rather than less in any case that possibly warrants it. This would probably only reduce the number of responders in 10-20% of the cases... so the question is would this small savings be worth the additional risk of harm to the public in need?
And... what happens when a call is made and someone later sues the City for not sending all 3 in the first place and they suffer some horrible loss?
I look forward to your comments and thoughts.
13 comments:
You can not triage over the phone. The operaters are not trained to make this call.
Here in Peabody one name comes to mind of why all three should respond (Brophy).
Brophy is perhaps one reason we need a new system of call center staffing.
Why does a manual phone call need to come from the Police to awaken the fire fighters?
Why not a centrally manned Emergency Responder Center serving a larger area (think Essex County?) which has direct alerts to each facility in each City and Town?
A call comes in and a trained person assesses the situation and determines that an ambulance and fire engine are needed... they push two buttons and all the info is immediately transfered to the proper Peabody ambulance and fire locations where the location(s) are automatically fed into the system.
So instead of needing these professionals in each and every City and Town we only need a team to serve a region? That makes some sense to me.
But then again... are you willing to risk a mistake by one of these folks when your (or your family members) life is one the line?
PI you are talking about a lot of $$$$$$$$$$$$$$$.
Until you have listened to someone on the phone screaming that their (insert loved one here) is not breathing and turning blue you have no clue. No one knows what the situation is going to become. Let’s say the Ambulance arrives and it turns out to be a domestic and the family feels they are not moving fast enough or not doing enough to help their loved one. Or the victim’s family show up and want to go after the suspected person. If the Police were dispatched as well they can handle that while the EMT's handle what they are trained for? How about the Firefighter shows up to a house call and a family member wants to go in and interferes with them. Again if the Police were there they could deal with that person (anyone come to mind) and the firefighters could do their job. A call comes in for a MVA do we not want all three responding? 1. The Police to investigate the cause. 2. The fire fighters just in case someone needs to be extracted. 3. The EMT's just in case the victims need to be seen at the Hospital. What button would the dispatch hit then?
There is no debate on this issue, the system is not broken, so don't fix it. This issue came up out of a comment to not use the trucks as much. Well take a car and park it in the garage and don’t use it for a little while see what happens. Not using something is worse it is like a house that is not lived in it just dies same thing with the trucks.
Anon:
Please don't get my comments wrong.
I was simply stating that I could see the point on both sides here.
I actually think that the current system, while sometimes dispatching more services than necessary, is the best one for the health and safety of the community.
I was offering other possibilities because IF (and I do mean IF) some people are calling 9-1-1 for frivolous reasons (such as the aforementioned skinned knees, etc.) those calls need to be screened out and, perhaps, an appropriate level of response delivered.
I posted on the Patriot that the idea of triage was worthy of discussion but not the topic at hand (purchase of a new fire engine).
That is why I brought the discussion on this topic here.
Thanks for your comments and participation.
Why not just one dispatch center. One with Police Fire and Ambulance dispatchers in the same room? That way they can actually work together and not double up responces if nessasary.
OG says...
why not one dispatch center? UNIONS !!!!!!!!!!
Not true, OG. The unions have absolutely nothing to do with the location, staffing or operation of the 911 dispatch center.
I thought that there was only one dispatch center in the City, and that it was in the police station.
PLEASE... correct me if I am wrong here!
I thought that these civilians take the calls and then alert the police, fire and ambulance.
Is this correct?
You are correct, PI. There is but one dispatch center for Peabody and it is indeed located at police headquarters and is manned by civilians and police. This gives the police a bit of a "jump" on the other agencies in response time because while the civilian dispatcher is alerting the fire department and ambulance company, the police officer at the dispatch center has already alerted the cruiser in the area. That is one reason why more often than not, the police are the first ones at a call. Another reason that the police get there first is because the police cars aren't parked in a station like the fire trucks and ambulances are. They are out there, moving about their areas of patrol, making it more likely that they will be nearby when an emergency occurs. Sometimes you may find a police officer working one of those dreaded road details is closer than anyone else to an emergency and that officer is able to get to the scene even faster. It can and has happened, but having flagmen is a better idea, right? Not always!
OG says...
let me ask all you diehard union supporters in the fire or police brotherhood out there this question...would you be open to the notion of REGIONALIZING emergency dispatch centers ? would you be willing to consider that approach to save money so long as we maintain safety? and on the subject of 'saving money' do you have any ideas as to how we can save, and not spend, money?
OG I think that you will find that the unions are actually FOR regionalization not only for the dispatch center but for the departments themselves. This would actually increase their numbers as a single regional union, would eliminate having to deal with a mayor that may have a personal grudge against them, and would likely mean an increase in salary and benefits for their membership. It is the chiefs of the individual departments that are against the regionalization idea because none of them wants to give up being chief!
OG says..
well that's the best news I've heard all day...let's get moving on this concept then !!!
I would also like to see this idea of a regional approach discussed. I am not saying I am all for it... but it seem intriguing and might offer possible benefits to all concerned parties (Unions, Cities/Towns and the general public).
And now... just thinking out loud here... I might think that the City would actually be against such a move!? Because they would need to give up the ability to individually bargain with the local responders and would be locked into an agreement brokered by others. Think more of an arbitration hiring each time the contract comes up for renewal... and then the idea of how to split the costs... Households? Persons? Area? Road Surfaces? This can get to be a rather complex matrices very quickly. And from my experience... City government (and the general public) has trouble getting their hands wrapped around complex issues.
Thanks to Anon (March 25, 2009 9:25 PM) for all your information!
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