Week 8: CACC
- Laura Palmer
- Mar 19, 2019
- 2 min read
This week I had the opportunity to go to CACC and although it was a fairly quiet morning, it was definitely one of my favourite clinical placements so far!
Preparing for the Placement
I knew that I would be listening to a lot of 10-codes during my time at CACC, so prior to the placement I did a quick review of the 10-codes from Ambulance Operations. This was great as I was easily able to follow the dialogue between the dispatcher and medics.
I also hoped that I would have the opportunity to hear the medics patch with ER so I reviewed the 'Reporting of Patient Care to Receiving Facility Standard' in the BLS prior to the placement. I listened to a few of the patches and all of the patches were very clear and concise. There were no pauses and information was presented in a logical order. I also noticed that the paramedics only reported abnormal vital signs and if all vitals were normal they said vitals stable. This is in line with the BLS standard. During lab, I have been communicating all vitals during my patch, not just abnormal vital signs, so I am going to clarify with my lab instructors on Thursday if I should be following the BLS standard.
Dispatch Priorities
While sitting with a call taker for about an hour, I had the opportunity to observe how 9-1-1 sets priorities for calls ie. Priority 4, Priority 3. The call takers follow a strict question set on their computer that determines call priorities - syncope is an automatic Priority 4 even if the person is now fine and calling for a different reason. I have heard stories before about medics getting frustrated with CACC for being sent Priority 4 to minor calls and for not getting a lot of patient information about a call en-route. After sitting with a call taker, I now realize that they are required to follow a script and cannot ask questions on their own accord. Even if they wanted to ask more questions to better prepare paramedics, they cannot. They also have a very short period of time to talk with the caller before needing to get off the phone to keep the phone line open. As a paramedic I really want to remember this experience and not get frustrated with CACC. They are doing a very difficult job and staying within the regulations set on them.
Hi Riley,
I unfortunately don't know how long it takes to get a doc on the phone as I only heard patches to a nurse.
ACOs currently do not require medical training so giving discretion to ask more questions would certainly make the training process longer. Additionally, it seems as though ACOs try to complete the calls quickly so the phone line can be open for new calls. In general, I think a bit of discretion could be beneficial but I am not the feasibility of this.
Thanks!
Laura
Hi Jess,
I did get an answer to the vitals question! Our lab prof said that we can follow the BLS standards in our patches and only include the abnormal vital signs.
I unfortunately don't know of a better system as the majority of people calling 9-1-1 don't have any medical background and aren't able to answer complex questions to better refine call priorities. A lot of callers are also bystanders and may not have direct contact with the patient or have talked to them. I think the current system of focusing on immediate life threats, although potentially a flawed system, is probably the best way to go as an ambulance gets to the patient quickly.
Thanks for the comments!
Hey Laura.
Sounds like you enjoyed your day at CACC. Great Idea reviewing the 10 codes and reporting patient care standard before your visit, I'm sure that will be beneficial for those who have yet to have been to CACC. I am interested to know the time frame from when the medic asked for the patch and when the doctor responded. I've heard that it could be a while before the doctor has time to respond and didn't get a chance to experience a patch while I visited CACC. In addition, do you believe dispatchers should have the ability to ask questions under their own discretion to help paint a picture for the attending medics or do you believe t…
Hi Laura, I'm glad you had a great experience this week. I really enjoyed my time at CACC as well! I'd love to know the answer to your question about vitals if you get one.
I also found that the calls were very brief with select questions to determine the type of call. Do you think there could be a better system in place to filter calls? As a paramedic it has to be tough going lights and sirens to a priority 4 for a patient who is not that high of a priority. However, I totally agree with what you said about remembering what it's like in their shoes and that they're just doing their job.
Jessica Clarke