Medical Priority Dispatch System

Each dispatch determinant is made up of three pieces of information, which builds the determinant in a number-letter-number format. The first component, a number from 1 to 36, indicates a complaint or specific protocol from the MPDS: the selection of this card is based on the initial questions asked by the emergency dispatcher. The second component, a letter A through E (including the Greek character Ω), is the response determinant indicating the potential severity of injury or illness based on information provided by the caller and the recommended type of response. The third component, a number, is the sub-determinant and provides more specific information about the patient's specific condition. For instance, a suspected cardiac or respiratory arrest where the patient is not breathing is given the MPDS code 9-E-1, whereas a superficial animal bite has the code 3-A-3. The MPDS codes allow emergency medical service providers to determine the appropriate response mode (e.g. "routine" or "lights and sirens") and resources to be assigned to the event. Some protocols also utilise a single-letter suffix which may be added to the end of the code to provide additional information, e.g. the code 6-D-1 is a patient with breathing difficulties who is not alert, 6-D-1A is a patient with breathing difficulties who is not alert and also has asthma, and 6-D-1E is a patient with breathing difficulties who is not alert and has emphysema/COAD/COPD. Protocols • Abdominal Pain/Problems • Allergies (Reactions) / Envenomations (Stings, Bites) • Animal Bites / Attacks • Assault / Sexual Assault / Stun Gun • Back Pain (Non-Traumatic / Non-Recent) • Breathing Problems • Burns (Scalds) / Explosions • Carbon Monoxide / Inhalation / HAZMAT / CBRN • Cardiac or Respiratory Arrest / Death • Chest Pain • Choking • Convulsions / Seizures • Diabetic Problems • Drowning / Diving / SCUBA Accident • Electrocution / Lightning • Eye Problems / Injuries • Falls • Headache • Heart Problems / A.I.C.D. • Heat / Cold Exposure • Hemorrhage / Lacerations • Inaccessible Incident / Entrapments • Overdose / Poisoning (Ingestion) • Pregnancy / Childbirth / Miscarriage • Psychiatric / Suicide Attempt • Sick Person • Stab / Gunshot / Penetrating Trauma • Stroke (CVA) / Transient Ischemic Attack (TIA) • Traffic / Transportation Incidents • Traumatic Injuries • Unconscious / Fainting (Near) • Unknown Problem (Collapse 3rd Party) • Inter-Facility Transfer / Palliative Care • Automatic Crash Notification (A.C.N.) • HCP (Health-Care Practitioner) Referral (United Kingdom only) • Pandemic / Epidemic / Outbreak (Surveillance or Triage) • Inter-Facility Transfer specific to medically trained callers Protocol 36 This Protocol was created to handle the influx of emergency calls during the H1N1 pandemic: it directed that Standard EMS Resources be delayed until patients could be assessed by a Flu Response Unit (FRU), a single provider that could attend a patient and determine what additional resources were required for patient care to reduce the risk of pandemic exposure to EMS Personnel. In March 2020 the protocol was revised to assist with mitigating the COVID-19 pandemic. Response Determinant ==Instructions to the caller==

As well as triaging emergency calls, MPDS also provides instructions for the dispatcher to give to the caller whilst assistance is en route. These post-dispatch and pre-arrival instructions are intended both to keep the caller and the patient safe, but also, where necessary, to turn the caller into the "first first responder" by giving them potentially life-saving instructions. They include: • cardiopulmonary resuscitation for adults, children, babies, and newborns • the use of a defibrillator • the use of the Heimlich manoeuvre to clear the airway of a choking patient • delivery of a baby • extinguishing the flames for a person on fire • escaping from a sinking vehicle • bleeding control • flushing of chemical contamination • cooling of burns • administration of epinephrine/adrenaline autoinjectors • administration of Narcan/naloxone ==Responses in the United Kingdom==

Whilst MPDS uses the determinants to provide a recommendation as to the type of response that may be appropriate, some countries use a different response approach. For example, in the United Kingdom, most, but not all front-line emergency ambulances have advanced life support trained crews, meaning that the ALS/BLS distinction becomes impossible to implement. Instead, each individual response code is assigned to one of several categories, as determined by the Government, with associated response targets for each. Response Determinant NHS England Clinical Response Model • This may include an emergency ambulance, a rapid response car, ambulance officers, or specialist crews e.g. HART. Other basic life support responses may also be sent, e.g. Community First Responder. • If an emergency ambulance is unlikely to reach the patient within the average response time, a rapid response car and/or Community First Responder may also be dispatched. The exact nature of the response sent may vary slightly between Ambulance Trusts. Following a Category 2, 3, or 5 telephone triage, the patient may receive an ambulance response (which could be Category 1-4 depending on the outcome of the triage), may be referred to another service or provider, or treatment may be completed over the phone. In an independent report into the emergency response to the Manchester Arena bombing, an Advanced Paramedic for the North West Ambulance Service stated it was "very much understood" that MPDS "vastly underemphasises the priority of traumatic calls." Response Determinant NHS Wales Pilot Clinical Response Model ==See also==