Early Defibrillation

Dispatch Protocols

These are the rules that guide our public safety dispatchers. In police jargon these are often referred to as "SOP" or "standard operating procedures." These are provided as a model but every police department is unique to the community it serves and will need to modify its practices to meet its specific needs.

7-130 Medical Dispatch Protocol

The goal of this policy is to ensure that anyone in need of emergency medical assistance receives proper and timely care. Patient care is the ultimate priority. The Rochester Police Department, Rochester Fire Department, Olmsted County Sheriff’s Office and other first responder units within Olmsted County shall collaborate as a team in order to provide the best patient care available under the circumstances.

Some preliminary decisions made by communications personnel will be based upon incomplete or inaccurate information. RPD personnel should err on the side of patient and public safety.

7-130.10 When to Respond

The Communications Unit will screen incoming medical calls to determine the urgency of the medical problem according to guidelines provided by the Police Medical Director and/or Mayo Clinic Emergency Communications. Those guidelines will generally define what does or does not constitute a medical emergency and whether or not our Communications Unit will dispatch any first responder.

The primary concern is with medical emergencies, i.e. those conditions that may pose a substantial threat to the life of the patient. First responders should be assigned to these calls within the timelines established in 7-103.01. Responding units are generally expected to respond code three.

Calls for non-emergency medical assistance will not generally be assigned to any first responder unless specifically requested by the ambulance service or there is a law enforcement or public safety interest in responding to the call as defined in 7-130.15. When the ambulance service requests a first responder be assigned to a non-emergency medical call within the City of Rochester, the primary responder will be the Rochester Fire Department. The Rochester Police Department should respond to non-life threatening medical calls only if the Rochester Fire Department cannot respond or the Police Department is specifically requested by Gold Cross.

If there is reasonable doubt about the nature of the medical threat posed, dispatchers shall err on the side of patient safety and handle the call as an emergency.

7-130.15 Law Enforcement or Public Safety Interest in Medical Calls

Some medical calls will present a need for officers/deputies to respond for investigative or safety reasons rather than patient care exclusively. These include but are not limited to calls regarding:

psychiatric problems, suicide threats or attempts
criminal activity – assaults, child abuse, narcotics overdose, etc.
falls or injuries on public property
seizures or other conditions involving altered mental status

Dispatchers shall assign at least two officers or deputies to any of these calls that pose a threat to the personal safety of any person, including the first responders and/or the officers/deputies themselves. Dispatchers should send one officer/deputy to calls of a non-threatening nature that might require investigation.

The officers/deputies will determine the appropriate response code depending upon the circumstances of the call.

7-130.20 Call Assignments for Medical Emergencies - Within Rochester

Dispatchers shall make every effort to assign two officers and a single engine from the Rochester Fire Department to every medical emergency call

Dispatching of police and fire units shall be done virtually simultaneously, however, police units will be considered the primary concern when dispatch assignments are made. There will be times when all police units are busy on other calls. This does not relieve a dispatcher of the responsibility to assign two police officers to the call. The mere fact that a fire company has been assigned to and is responding to the call does not mean that the dispatcher is relieved of the need to assign a primary or secondary police unit. A dispatcher is relieved of the responsibility of assigning one or both police units only when:

the assignments have been made
instructed to cancel first responders by Gold Cross
a police, fire or Gold Cross Unit has arrived on the scene and indicates that no additional assistance is needed
additional information is received that allows the call to be downgraded to a non-emergency call

Nothing in this section shall be construed to authorize any delay in assigning and/or dispatching any fire or police unit to the call.

7-130.40 Specific Actions Required

When dispatching emergency medical calls within the City of Rochester, police dispatchers shall:

use alert tone #2 prior to broadcasting the call
assign the closest available squads
assign the appropriate fire station
use voice radio dispatching as the primary means of communicating with
responders – do not rely upon MDT transmission alone

If CAD shows all squads are busy, the call should be assigned to the closest car(s) already assigned to (a) lower priority call(s).

Dispatchers will exercise judgment regarding the relative positions of squads and their ability to respond in a timely manner. Dispatchers may assign the call to a squad that is busy on a lower priority call but closer to the medical emergency than an available squad that is farther away.

Dispatchers will consider factors other than call priority when pulling officers from other calls to handle medical emergencies. Officers should not be reassigned from calls that could imperil public safety. Such calls might include active domestic disputes, incidents involving a custodial arrest, an accident with traffic congestion, etc. Conversely it should be relatively easy to pull officers from parking complaints, criminal damage to property calls, etc.

7-130.50 Specific Actions Prohibited

Alert tones will be used for life-threatening emergencies only.
First responders (including the Rochester Fire Department) cannot be canceled until an assessment of the patient has been made.
First responders (including the Rochester Fire Department) cannot be canceled from a medical call unless the ambulance service is also canceled.
Do not dispatch the call by incident type only. Provide a concise description of the problem.

7-130.60 Taking the Initial Call

When a call for medical service is received within the Gold Cross service area, the call taker will transfer the call to St. Mary’s Emergency Communications as soon as possible. It may be reasonable to inquire about the nature of the problem before transferring in order to expedite the dispatch process. Do not go through the full process of confirming the address, call back number, etc. prior to transferring the call to Emergency Communications.

Call takers will monitor the call after it is transferred to Emergency Communications in order to gather additional information concerning the incident. Responding units will be updated as the circumstances require. The call taker may disconnect from the three-way call after the information needed to properly dispatch the call is acquired.

For medical calls outside the Gold Cross service zone, dispatchers will verify the incident location, the nature medical problem and verify the call back number. The call will be dispatched in accordance with the preceding rules, excluding 7-130.20.

7-130.70 Medical Calls Involving Possible Cardiac Problems - City of Rochester Only

Any call for medical assistance that could reasonably be related to a cardiac problem is a medical emergency and shall be handled as such.

Dispatchers answering calls for medical assistance shall be alert for factors that may indicate/involve a cardiac problem. These factors include but are not limited to:

cardiac history
chest pain or tightness in the chest
radiating pain, especially in the left arm
strokes reported by bystanders
unconsciousness
unexplained falls with altered mental state or loss of consciousness
collapse after exertion
dizziness in patient over age 35
difficulty breathing
erratic pulse
drowning
electrocution
asphyxiation
severe blow to the chest with loss of consciousness

Cardiac arrests may exhibit symptoms that vary widely from patient to patient. The setting and circumstances of the incident itself can also provide cues. A dispatcher should make a reasonable attempt to discover the basic nature of the medical problem and dispatch the call accordingly. The dispatcher should err on the side of patient safety and assume that the problem is cardiac related if there is reasonable doubt.

The call assignment process for cardiac related medical emergencies is the same as described in 7-130.20 except that the dispatch shall see that a squad equipped with a defibrillator is assigned to the call as quickly as possible regardless of the relative positions of responding squads and/or fire units.

A supervisor may recommend changes in assignments to enhance the response to cardiac-related medical calls but no supervisor has the authority to cancel RPD response.

7-130.75 Officer's/Deputy's Actions When Arriving On Scene

Officers/deputies arriving on scene of a medical call shall:

notify the Communications Unit that they are on-scene
conduct an assessment of the patient and begin administering care as needed
notify the Communications Unit if a cardiac arrest (Code 45) is involved
request additional assistance as needed or downgrade the response of other units if there is no emergency

7-130.80 Defibrillators - Squad Status

RPD Officers will notify the Communications Unit as to whether or not they are equipped with a defibrillator immediately after going into service. Any changes in this status during the shift must be reported to the Communications Unit immediately.

Dispatchers will make note of which squads have defibrillators and will keep this information immediately available in order to expedite the assignment process when needed.

Dispatchers will assume that all fire stations are equipped with defibrillators unless otherwise specifically notified.

7-130.90 Confirming Location of the Call

Dispatchers will make a reasonable effort to confirm the location of the call and to assign the appropriate responding units. It is understood this confirmation process is not perfect. Dispatchers will err on the side of the best interest of the patient if exact location of the call cannot be confirmed.