If your institution outsources an activity to another provider, that institution is a third-party provider. This includes everyone from your landscaper to your technology service provider. Whether you run a business or outsource it to a third-party provider, your institution is equally responsible for the outcome. This means it`s important to identify critical or high-risk suppliers. These are suppliers involved in critical activities that can have a huge impact on operations such as payments or IT. If callers receive instructions prior to arrival, it should be assumed and never asked that the Caller is willing and able to provide assistance when the situation is safe. Appellants are reluctant to need care for many reasons. Offering an “option” by asking for the will to help suggests an alternative that can convince someone not to act. Instead, the help readiness assumption is based on the caller contacting 911, and instructions must be provided prior to arrival. The good news is that the fourth part risk has become a little easier with the Statement of Standards for Attestation Commitments 18 (SSAE 18) released last year. SSAE 18 includes a vendor management element that requires a vendor to define the scope and responsibilities of each third-party vendor it uses, and that takes into account performance reviews, audits, and monitoring. Third-party vendors that can deploy SSAE 18 simplify third-party risk management.

This is where things can get particularly convoluted. If your supplier`s supplier outsources, this is a fifth party. (It doesn`t necessarily stop there, as that provider can outsource to another provider that creates a sixth, seventh, eighth part and beyond.) Again, your institution is responsible for the actions these providers take on your behalf. It`s important to know all the critical third-party providers your vendors use to understand potential risks and put strategies in place to mitigate them. SSAE 18 is your ally in understanding these relationships. The alternative is to follow the chain of critical suppliers, which makes managing suppliers difficult. Chapter 10EmS Dispatch Jeff J. Over the past 35 years, the 9-1-1 dispatcher has been shown to be able to quickly obtain reasonably accurate information about the signs and symptoms of frightened callers, allowing for more accurate medical categorization of patients [1,2]. In addition, the dispatcher can activate the emergency personnel configuration that is perfectly adapted to the specific emergency. It is not enough to send paramedics or first responders without thinking in all cases; It is necessary to accurately determine the need of these well-trained people [3].

If this does not happen for all calls, the number of available providers will be reduced due to their misuse.[4] An available paramedic team that is too far from the next patient may be ineffective simply due to excessive response distance. In the 1970s, this dilemma stimulated the development of emergency medical authorization and its essential training process [1,5]. The goals are to send the right resources to the right person at the right time and in the right way, and do the right things until help arrives. Since the dispatcher is often the least medically trained provider in the chain of survival, these objectives are achieved through specific training in the prudent use of a comprehensive protocol, including the points in Box 10.1. Box 10.1 Elements of a Medical Emergency Dispatch Log Systematized and Scripted Formal Caller Process Systematized, Scripted Instructions After Shipment and Pre-Shipment (Resuscitation) Descriptions of Clinical/Situational Problems and Related Codes Corresponding to the Dispatcher`s Assessment of the Type and Severity of injury or Illness with Vehicle Intervention Mode and Configuration Support and Definition Information Source Reference: Principles of EMD, 5th ed., ©2000-2014 International Academy of Emergency Medical Dispatch. Reproduced with kind permission. The key role of the dispatcher was defined in 1978 when salt lake city fire/EMS identified the medical dispatcher as a “weak link” in the chain of survival [6]. Until then, the average medical dispatcher had less than 1 hour of formal medical training. The advent of structured emergency medical dispatch protocols (EMD – this acronym is also used for the “emergency medical dispatcher”) and training as essential elements of the corresponding operation of EMS systems was a phenomenon of the 1980s.

A number of factors contributed to the delay in recognition. Medical directors have rarely observed the dispatch function, because for most emergency physicians, a preclinical case begins when the X-ray or phone announces an incoming patient. The function of the dispatcher in terms of expedition mechanics and decision-making process was unknown to the medical community. Whether the nearest appropriate unit was sent or a paramedic unit was not available due to an assignment prior to a “cat bite” call, or the originally affected vehicle never arrived because it was involved in an accident in which the light and siren were used unnecessarily, have remained hidden and are still not approached by many medical directors [7]. Myths of medical display There are nine widespread and virtually universal myths about medical display that delay the development of sound programs. These myths are malicious rather than innocent misunderstandings (Box 10.2) [8]. Box 10.2 The nine myths of medical dispatch The caller is too upset to answer accurately The caller does not know the required information The dispatcher`s medical expertise is not important The dispatcher is too busy to waste time asking questions, giving instructions or flipping through card files or using automated logs Dispatchers` telephone information cannot help victims and may even Be dangerous More staff and more units on site are always better It is dangerous not to respond to the maximum or not to respond with lights and sirens All you need to do EMD are protocols and trainingWe can do it ourselves (grow our newspapers at home) One of the most common myths is that most callers are hysterical. In 1986, Eisenberg et al. compared the emotional scores of 640 appellants who reported cardiac arrest with those of appellants who reported other complaints [9].

A standard emotional scale of 1 to 5 was used, with 1 representing “normal conversational language” and 5 representing a person who was “so emotionally desperate as information (e.g. B the address) could only be obtained with great difficulty.” Of the 146 non-cardiac arrest callers, the median emotional score was 1.4. Contrary to popular belief, the median emotional score of the 494 callers who reported cardiac arrest was only 2.1. In 1990, a study of 160 random callers in Los Angeles found an average emotional content/cooperation score (modified ECCS) of 1.2 [10]. No appellants were noted 5. Recent studies have found an average ECCS of 1.05 in 3,019 cases reviewed in British Columbia and 1.21 cases in 3,430 cases in Monroe County (Rochester, NY) [11]. A second myth is that callers don`t know the required information. In the expedition, the general classifications for default callers are first, second, third and fourth parts. A first caller is the patient himself. A second party caller is a person with the patient or familiar with the patient`s current condition.

A third-party caller is someone who is not with the patient and does not know him (for example.B. “I just saw a car accident out the window and it looks really bad!”). The appellants from four parties are related professionals who submit field requests for an EMS response (i.B police dispatchers, airports, security companies and other public safety agencies). Nearly 60% of callers can be classified as first or second callers, and about a quarter are third [12]. .