Breathing Verification Diagnostic
October 12, 2018
The tool’s new title—“Breathing Verification Diagnostic Tool” (BVDxT) in the Medical Priority Dispatch System™ (MPDS®) version 13.1—says it all.
The diagnostic, available since MPDS v12.0, now has a name that more accurately describes when the tool should be used.
“The tool was always meant to verify effective breathing,” said Brett Patterson, IAED™ Academics & Standards Associate and Medical Council of Standards Chair. “But, somewhere along the line, it started being applied when the caller was uncertain about the patient’s breathing status, or even when the caller reported INEFFECTIVE or absent breathing.”
To clarify, the EMD should use the diagnostic in cases when the caller indicates that an unconscious (collapsed) patient IS breathing, but the EMD wants to VERIFY that the reported breathing is effective or the EMD suspects the reported breathing might be agonal. Note that the BVDxT symbol has been moved from the end of Case Entry Question 6, “Is s/he breathing?”, to the “Yes” answer option of the same question to strengthen this directive.
The EMD should not use the BVDxT when the patient is unconscious and the caller answers “No” to the Key Question “Is s/he breathing?", when the caller reports UNCERTAIN BREATHING (uncertain, unsure, indefinite, or even ambiguous about breathing), or when the caller offers any of the keywords associated with INEFFECTIVE or AGONAL BREATHING. In any of these cases, the EMD should begin CPR instructions immediately.
By Rule, also note that MPDS v13.1 now clarifies that it’s no longer necessary to use the BVDxT when it is obvious that the seizure patient is actively waking up.
The changes are incorporated into ProQA®.
It cannot be overstated that the BVDxT should be used to confirm that breathing is truly present rather than confirm the ineffectiveness of breathing, Patterson said.
“As Dr. Jeff Clawson [Inventor of the Emergency Dispatch Protocol Systems] sums it up,” Patterson said. “‘Use the BVDxT when you are unsure, not when the caller is unsure.’ Remember, if they don’t say yes, you must compress!”