Dispatch Center Determining Response Code?

[A SHIFT FF]

Hello all!

I read these forums nearly daily and rarely post. But I am little bit of a dilemma and was wondering if I could pick some of your brains?

The local dispatch center that dispatches the volunteer department that I am on is run by our local sheriff's department. There are the obvious problems that pop up from here to there, but for the most part they are "fairly" decent. Recently, however, we have had an increased problem throughout the county with them determining how to make our responses. For example, there are have been multiple call throughout the county for several different issues where the advises us that the caller has requested "no lights or sirens" for a medical emergency or the caller has requested "only one fire truck" for a stove fire. Our departments S.O.P.'s state that we respond code 3 (lights and sirens) to all responses that are not at "investigation" level. Any variation is determined by the apparatus officer or duty officer. We are currently going through all of our S.O.P.'s and determining what needs to be updated. My question is does your department or dispatch center have a policy in place for these kind of instances? The neighboring counties including the one my career department is in never dispatch us with this kind of response. We have a county chief's meeting next week and I would like to discuss this issue. I have a few concerns, please beat them up and let me know what you think.

1. What legal options do we have to predetermine that the fire department will not be dispatched along with EMS when the homeowner requests a non-emergency response.

2. What legal liability do we assume with our current S.O.P.'s if we continue to respond with our current response matrix policy.

3. Liability in case of major fire loss

4. Liability in case of death from delayed response during medical responses. (There was one case a few years ago at a neighboring dept. when they and the ambulance were told to make it a "no light or sirens" call by the caller for a difficulty breathing. The incident was at the far end of a very large territory. By the time the agencies arrived some 10 minutes later the pt was in cardiac arrest and did not make it)

5. I know there is always the option of shutting lights and sirens off when we get close but what if an apparatus has an accident running lights and sirens and the plaintiff's lawyer now has the audio tape of the dispatcher telling us not to run lights and sirens.

The main reason that we have determined that people request this is they don't want attention brought to them. What kind of things have your departments done to both satisfy our customers and not risk major legal liability if you have faced similar situations?

Thank you all in advance for taking time to read and respond!

[BoxAlarm187]

I think that a lot of your questions should be directed by your department and/or county's attorney. I know that could take time to do, but honestly, you're going to get a lot of "firehouse lawyer" answers on here...and so many times, that just another name for "bad advice."

I will give you some of my own personal experiences with this, though:

At the VFD, we're not directed by the dispatcher whether to respond emergent or not, this is at the discretion of the OIC of the vehicle.

At work, we're dispatched either Code 2 (non-emergency) or Code 3 (emergency) depending on the call type. However, the OIC of the first-due rig is also given the authority to upgrade or downgrade the response (including adding or cancelled additional equipment prior to arrival on scene) based on the additional information relayed by the dispatcher. This is written in our SOG's.

As for the "caller requests no lights and sirens," my personal opinion is that we have to judge each of those calls on it's own merits. I will NOT simply take that request at face value, as though the caller's request is my command. If I feel that a L&S response is warranted, then I'll respond that way, but give the patient the courtesy of cutting the L&S as I enter the neighborhood or street they're on.

I don't know what the exact relationship between your dispatch center, the jurisdiction, and the fire department is, but none of the department's I've ever been affiliated with have "had" to follow what the dispatcher said. We need to be able to use or training and experience to judge the fastest, yet safest, way to arrive on scene.

[The nots so new FNG]

Personally - I see this as a call to make by the Officer of the rig based on dispatch information and any relevant call history.

There are times when no-lights and sirens are appropriate (mentally unstable patients, some paitients with siezure disorders etc). There are times when its really not an emergency - an example would be a paraplegic indvidual who can't get his wheelchair back up his drive because of ice (just had that one). You may make those non-emergent or kill the lights/sirens once you get close.

Whatever you do - make sure to pre-arrange this with the dispatch center. It could be as simple as stating that we may choose to 'step up' the run based on the information we are given.

We don't really know what we have until we get there. We may have history with a set of individuals but the test would be what a reasonable response would be for that dispatch infomation we get. I would not want to defend a non-emergent run for a patient with chest pain and difficulty breathing just because the caller asked for it.

There are many who will argue for more non-emergent runs and cite examples of minimal differences in response times and increased accident rates etc. Personally - I see this is a place to improve our overall driving - hot or cold. Let the dispatch info dictate hot or cold but make sure our drivers are just as safe running hot as they are running cold.

[BoxAlarm187]

There are times when no-lights and sirens are appropriate (mentally unstable patients, some paitients with siezure disorders etc). There are times when its really not an emergency - an example would be a paraplegic indvidual who can't get his wheelchair back up his drive because of ice (just had that one).

Excellent point. At work, we're always dispatched "Code 3" for anyone threatening suicide (don't ask me why). I don't respond Code 3 just to go stage for 5 or 10 minutes for law enforcement to clear the scene, what good is running hot to staging just to sit there while all the cars you just passed pass YOU again?

[A SHIFT FF]

Thank You

Thank you for your responses! We have been in contact with our dept's attorney in that last few weeks and he is looking into the liability issues. I was just curious as to whether or not anyone on here has been in our shoes before and what else (besides getting attorneys involved) they may have done to resolve the issue.

Thanks again for your replies!

[DeputyChiefGonzo]

Civilians should not dictate fire department response policies... period.

[islandfire03]

Is your dispatch center using a medical priority screening program to make these decisions?
Are the dispatchers trained in Emergency medical dispatch?

If they are not , then they have no legal reason to be giving advice on how EMS should respond to any type of calls other than to advise if the scene is too dangerous , and to wait for law enforcement to secure the scene.

As far as them dictating how to respond it should be up the the officer in charge to decide if a downgraded response is appropriate.

[mrpita]

Good advice above. Especially "Get the lawyer involved", which you already have. He's the only one who can really give you your answer for liability and such, except maybe your insurance carrier. (We're self insured, so that's not an issue here.)

We respond emergency speed to everything, except a few specific incident types. One of the busiest EMS systems in the country, 90+% of our runs are BS. But each run is an emergency until we get there. We (in our professional trained capacity) then decide if it is an emergency requiring emergency speed to the ED.

We also have pre-determined responses for dozens of incidents. But it all depends on what the caller says. A truck gets one engine, but a tractor/trailer gets engine/ladder/chief. So the caller does dictate what they get in a sense, but its what keywords they use; not them telling you directly, saying "just send one engine". That's gonna bite you real quick. I would think you could setup for the dispatcher, if caller has A, B or C; send out X, Y, or Z. That should eliminate any play for the caller or the dispatcher to say "well, the house is on fire (or grandma's a code), but they don't want to be embarrassed, so just send one engine - quietly - and knock on the back door so the neighbors don't see."

[tree68]

Our dispatch is run by our office of Fire and Emergency Management and handles all fire, EMS, and law enforcement (9-1-1) dispatching for the county.

We get "no lights and sirens" requests all the time - and it is usually from an older person who doesn't want to make a fuss.

If our EMD determines that it's BLS or otherwise non-emergent/non-life-threatening, we may go all the way "quiet." Dispatch doesn't set the tone. We do. "Unstable ALS" gets the full treatment.

If it's the fifth call this week for old Mrs Wilson's lumbago acting up, we're probably gonna take our time.

Otherwise, you only have to worry about what the patient can see and/or hear. Just shut 'em down when you get close. If something happens, established policy will back up the crew chief's decision to run RLAS.

If it's a true emergency, they won't really care if you show up with a five piece band. They just want help.

If your dispatchers are using EMD, set up response levels based on what EMD returns. Odds are well thought out response SOPs based on known factors will stand up in court.

If you aren't using EMD, take all the help you can get. You can always send them back. Back in the day (pre-EMD) I ran more than a few "sick person" calls where the "sickness" was cardiac arrest...

For fire, etc, our dispatchers send whatever is called for by the dispatch criteria. A stove fire will be considered a structure fire and will be dispatched as such, regardless of the wishes of the caller. If/when we determine a reduced response is sufficient, we'll call off the cavalry.

[LFD2203]

Unless the company officer is subordinate in rank to the dispatcher, then the relationship between the dispatch center and the fire officer is only that of one person (dispatcher) gathering and passing along information to those who will deal with the issue (led by the fire officer).
The dispatcher's only real influence on the run is how they code it into the dispatching software. If they choose to enter a shooting as a sick case, that's on them.
The fire officer may ask the dispatcher for directions, but should never ask for direction.

[volff1170]

I can give an opinion from both sides of the spectrum. My fulltime job is as a 911 dispatcher that dispatches for the entire county for police, fire and EMS. I am also an Asst Chief at a volunteer fire department, one of which I dispatch for, as well.

The call center I work in will not allow us to determine the level of response the fire dept or EMS agency. We are EMD trained but if you have ever seen the EMD system, you'll know that sometimes those criteria are pretty vague. When we dispatch a department, it is up to them to decide how to respond. I couldn't tell you how many calls that I have taken the seem like routine calls only to find out later that it was something very serious. When a caller asks for no lights/ sirens, we tell them that they are required to travel that way by law and will usually shut them down just before they get to the home. I'd hate to send a crew out for a "quiet response" only to find out its a serious problem... heck, I can't see through the phone to see what's actually going on.

From the fire department side, Like most other departments, we respond to nearly everything with lights and sirens, even alarm drops and the frequent flier that we have taken in 4 times that week.... We've had occasions where "Mr. Smith" has called a few times for a lift assist in a few days then we get a call for the same thing only to find out when we get there, its for a stroke... which is critical to get them to the ER quickly.

I think your dispatch is taking on a huge liability by determining the level of response... IMO

[hwoods]

And...........

Two things need to be addressed......... 1. Lawyers/Liability - Advise the Legal Folks of what you are going to do, and that it is their job to defend you from any action stemming from what you do. You run the Fire Department, The Lawyers don't.

2. The Dispatchers are there to serve the Fire Department, the Fire Department is not there to serve the Dispatchers.

After those Two Messages are delivered, there should be no problems.........

Beyond that, there are a few differences as you go from one part of the Country to another..... In Maryland, a person who is aware of the existance of an Emergency is required by Law to report it. Once an Emergency is reported to a 911 Center, the information about the Emergency is passed to the Appropriate Dispatcher who in turn alerts the proper agency to respond. Any comments like "No Lights and Siren" or "Just one Fire Truck" are totally ignored.

[mikeyboy411]

Code or No Code, That tis the Question.....

Our Dispatch tried that and we put an end to that... If the R.P. requests a "No Code" response I will do as others have said and will roll code until I get in the area, then I shut down the lights/siren.

When I respond to an Assault or we are advised to "Stage" I roll no code. I don't see the common sense behind rolling code and then shutting down while you stage. It makes more sense to me to roll no code, stage and then light them up when the scene is clear. Less stress and nobody aiming at us while we are driving.

We let the C.O. make the decision since they are responsible for the response of the Rig anyways.

Another way to do this is to have each type of call have it's own response mode/code. Example: Investigation (no code), Fire Alarm with no additional (no code), Ringing Alarm (code 3), so on and so on... Have the C.O.s get together and decide. Just my .02 though.

[MemphisE34a]

Two things need to be addressed......... 1. Lawyers/Liability - Advise the Legal Folks of what you are going to do, and that it is their job to defend you from any action stemming from what you do. You run the Fire Department, The Lawyers don't.

2. The Dispatchers are there to serve the Fire Department, the Fire Department is not there to serve the Dispatchers.

After those Two Messages are delivered, there should be no problems.........

Beyond that, there are a few differences as you go from one part of the Country to another..... In Maryland, a person who is aware of the existance of an Emergency is required by Law to report it. Once an Emergency is reported to a 911 Center, the information about the Emergency is passed to the Appropriate Dispatcher who in turn alerts the proper agency to respond. Any comments like "No Lights and Siren" or "Just one Fire Truck" are totally ignored.

The voice of reason, common sense, and EXPERIENCE.

[DaFAO]

2. The Dispatchers are there to serve the Fire Department, the Fire Department is not there to serve the Dispatchers.

Chief, no one is anywhere to serve anyone in this discussion. Due respect, that's a pile of crap. In a perfect world, fire dispatchers and operations companies WORK TOGETHER to fix the problem. I don't know of any jurisdiction where this Utopian scenario perfectly exists, but I know of lots of places where there is always beef between operations and communications because of attitudes like that. And while we're taking jabs at each other, the citizens suffer, and we all wind up looking like jobbers.

Civilians should not dictate fire department response policies... period.

Chief, this fellow not once said anything about 'civilians'. For all we know, they could be sworn deputies working radio.

JB, the ideal would be to have pre-determined responses to run types, established by your chain of command, to runs. Supplements to the call, like non-emergent response requests and/or reduced assignments, are not up to the caller. That's between you, your department, and the dispatcher(s). Like the other folks said, even with EMD, EFD, EPD, OPP, GED, Dee-Dee-Dee, or any other 'protocol', it's still up to your jurisdiction to sort out what the response should be. What I might recommend before getting all buck-wild with the lawyers and suits is to have your chain of command seek out the sheriff's radio chain of command and see what can be hammered out. If the lawyers are involved, it's already too late...Maybe it's just a matter of education for the dispatchers...

In reading your post again, what I might also suggest is that your county chief's association consider seeing if they can come to a general consensus on response protocols. Even with protocols like EFD, they still don't provide you with information on what type of response (that is, how many of what type apparatus type) should go. That's up to you and your department.

In your specific example of one engine company on a stove fire; unless the stove is outside in a field, I don't think any organization or department would suggest anything less than a structural response, or at least 1+1, assuming it's on fire in a dwelling. If any dispatcher or caller 'requested' one unit only, it's a loser from the start. In our metro area, anything on fire inside a structure is 9 times out of 10 a structural response. Anything on fire outside a structure (within about 5-10 feet) is still a structural response, until proven otherwise.

Regarding whether or not your fire department should respond with the EMS provider, perhaps instead of seeking a legal opinion first, you may wish to consider a study (formal or informal, doesn't matter for now) to see how many times on past runs a fire company was needed, either for manpower, closer response time, or some other circumstance where a fire response was needed. That might give some initial information to provide your legal counsel with, rather than relying strictly on what the law says.

Hope this helps...