AMPDS Flashcards
What are the priority symptoms?
- Abnormal breathing
- Chest pain/discomfort
- Decreased level of consciousness
- Serious haemorrhage
What is the patient chain of survival?
- Early recognition and response activation
- Early CPR
- Rapid defibrillation
- Effective ACLS
- Post-cardiac arrest care
What is AMPDS and how should it be used?
- It is a protocol
- Questions should be used exactly as written unless the answer is obvious or the spontaneously provided by the caller.
What is De Lucas Law?
EMDs will follow all protocols per se, avoiding freelance questioning or information unless it enhances, not replaces, the written protocol questions and scripts.
What is Frenzas law?
A thing not looked for is seldom found.
Define ‘freelance questions’.
A question that is not in the protocol and does not provide an appropriate clarification or enhancement to a question in the protocol.
Define ‘freelance instruction’.
instructions that are beyond the call takers scope of practise or that are incorrect.
What is a ‘leading question?’
A question that provides a probable answer to a question that may lead callers to give the answer they think the caller wants to hear
When may the call-taker rephrase the question or instruction using language equivalent or nearly equivalent to the script?
Once the scripted protocol question or instruction has been read as written if the caller:
- The caller does not understand the scripted protocol question or instruction
- The caller answers ambiguously
- The caller doesn’t answer after a reasonable period
Can a call-taker refer to a statement previously made by the caller?
The call-taker may refer to previous statements made by the caller (including spontaneous information) to make an objective statement and gather information
How should the call-taker refer to a previous statement made by the caller?
- Best practise: refer to callers’ statement and then asks the question as written
- Acceptable: refers to callers’ statement then requires the caller to confirm by asking a complete question
- Incorrect: provides caller with an answer
If something is written in blue, what does that mean?
Blue is for you
Think it, don’t say it
Pre-question qualifiers are in blue too
Who decides how to respond to calls?
(Bonus point: what info if this based on?)
The local medical director.
(NICE guidelines & research)
What is wrong with saying this sentence: ‘is the patient awake and breathing?’
It can confuse the caller, for example, someone may be asleep and breathing
They should be asked separately.
If someone identifies as something other than their assigned gender at birth, what would you do?
Put ‘unknown’ and add a note.
What is a first party caller?
The caller is calling for themself
What is a second party caller?
The caller is with the patient now
What is a third party caller?
Passer-by, calling on behalf of someone not actually there
When can you convert the third party caller into a second party caller?
When there are no mentioned or perceived safety concerns and when instructions are possible and appropriate
Can you enhance the protocol for a third party caller?
Yes, as it may be necessary to enhance the protocol for proper interrogation, call management and customer service practises
What is a fourth party caller?
Person in the control room who are called (police etc), they then decide an ambulance is needed
What are the 4 commandments?
- Chief complaint
- Age
- Status of consciousness
- Status of breathing
What are Miranda cards and why are they important?
They are made up of the 4 commandments and ensure services are able to give the EMD the correct information required to respond effectively.
What does SEND stand for?
Secondary Emergency Notification of Dispatch
What order are questions written in?
In order of priority based on call processing objectives:
1. Safety
2. System response
3. Patient care
4. Information for responders
If the EMD asks a question and doesn’t get a response, what should they do?
Repeat the question
If the EMD feels like the caller did not understand the question, what should they do?
Rephrase the question
Can the EMD move on from a question that doesn’t get a response?
If they have asked it at least twice, yes
Who defines determinant levels?
The local medical director
What are the determinant levels and what do they mean?
ECHO: early indicator – someone needs to go there now (anyone) then backup with paramedic/ALS (blue lights, sirens)
DELTA: blue lights, sirens, paramedic/ALS
CHARLIE: no blue lights, no sirens, paramedic/ALS
BRAVO: blue lights, sirens, any skill level/BLS
ALPHA: no blue lights, no sirens, any skill level/BLS
Ω - OMEGA: same as alpha but assessment can be done over the phone.
When can you add a suffix at the end of a code? Give an example.
When required.
For example, add the ‘C’ suffix if someone becomes combative/aggressive.
Prior to help arriving, the patient will do 1 out of what 3 things?
- Get better
- Get worse
- Stay the same
(significant change may mean a change in response!)
What does PDIs stand for?
Post-dispatch instructions (case exit is an example)
What does DLS stand for? What does it mean?
Dispatch life support
directs you to case exit, pre-arrival instructions, or to instructions found in additional information
What do the DLS letters NABC- mean?
N: newborn (<30 days)
A: infant (<1 year)
B: child (1-7)
C: Adult (8+)
What do purple panels mean?
Operant panels, cannot move on before asking this.
What are the ECHO determinant factors?
- Not breathing situations
- Ineffective breathing
CPR survival rates decrease by how much when delayed?
10% for every minute delayed
What is the most common cause for delayed breathing?
Agonal breathing that confuses people into thinking the patient is breathing
What are yellow panel cards?
Shunt cards - they may direct you to another protocol
Define ‘agonal breathing’
Ineffective, deteriorating breathing pattern that lingers after the heart has stopped. Often described as ‘gasping breaths’
What does it mean when a word is capatalized?
A definition is available for it.
What are the primary components of AMPDS?
- Case Entry Protocol
- Chief Complaint Protocol
- Diagnostic and instructional tools
- Pre-Arrival Instructions
- Case Exit Protocols
What are the 6 roles and responsibilities of an EMD?
- Telephone interrogator
- Dispatch life support instruction provider
- Resource allocator (triage)
- Logistics coordinator
- Field coordinator
- Life impactor
What are the benefits of structured call-taking?
- Established standard of service
- Prioritized responses
- Quality improvement procedures
- Certification and accreditation
- Reduced exposure to liability
Describe the protocol flow of AMPDS
- Ask all case entry protocol questions.
- Then choose relevant CC protocol.
- Then ask all appropriate key questions.
- Select the determinant code.
- Send a response.
- Provide post-dispatch instructions.
- Read critical EMD information.
- Follow the appropriate dispatch life support links.
- Appropriate case exit instructions (x) – classed as post-dispatch instructions.
What is the purpose and function of the case entry protocol?
- To get the address of the emergency and call back number
- Get the chief complaint
- Caller party
- Number of patients
- Patient age
- Patient status of consciousness
- Patient status of breathing
How are chief complaint protocols formatted?
- Key questions (KQs)
- Determinant descriptors
- Post dispatch instructions (PDIs)
- Critical EMD information
- Dispatch life support (DLS) links
- Additional information
What is a determinant code?
protocol number – determinant level – determinant descriptor - suffix if applicable
(example: 13-C-2C)
