Art Braunschweiger

Art Braunschweiger


By Art Braunschweiger

ProQA medical users will instantly recognize “Pets, Pills, and Porch Lights” as an irreverent reference to three of the Post-Dispatch Instructions (PDIs) from the Case Exit Protocol in the Medical Priority Dispatch System (MPDS). We give the instructions to callers all the time, but how often do we really think about them? For many emergency dispatchers, the Case Exit PDIs are merely something to get through before the call is ended.

PDIs are actually much more important than that.

At NAVIGATOR 2014 in Orlando, Fla., Thomas Margetta presented the session “Your PSAP is a 747,” an in-depth look at aviation disasters, including the causes behind them and how lessons learned apply to a 9-1-1 Public Safety Answering Point (PSAP) environment. We can use a similar analogy if we think about the Case Exit process like preparing for landing.

The majority of commercial airline arrivals are non-events. Flight attendants make one last pass through the cabin to pick up trash. Passengers are told in that polite but don’t-make-me-have-to-remind-you-again voice to power down and stow electronic devices. Every instruction falls under the reason of “preparing the cabin for arrival,” as the litany goes, and to keep you from becoming injured or possibly killed before the aircraft is parked safely at the gate.

An airplane is a blissfully serene place to catch up on work. It annoys me to have to shut down my laptop 20 minutes out from our destination. But in the event of something bad happening on the way down, my laptop could become a projectile that might seriously injure a fellow passenger or me. Similarly, my seatback has to be returned to its fully uncomfortable position because if I’m thrown forward against my lap belt in a crash, my upper body has less distance to travel, and I’m not likely to slide forward under the belt.

A similar rationale is behind the Case Exit PDIs we give so routinely. “Family pets” evokes images of Fluffy the cat and Mr. Jingles the gerbil. But the family menagerie might well include a breed of canine known to act aggressively when protecting its human family, and just because you can’t hear a dog doesn’t mean there isn’t one. Lots of dogs don’t bark incessantly (mine don’t).

Every Case Exit PDI matters or it wouldn’t be there. Badly frightened dogs can hurt responders or cause chaos on scene. Patients can become worse after eating or drinking. Each PDI should be given with the appropriate emphasis and sufficient pause before moving on to the next instruction. Relating the instruction to the situation at hand, providing the instruction is given in a materially identical manner, can enhance a PDI. For example, “I hear a dog barking. Please put the dog away along with any other family pets.” (While we’re at it, the porch light instruction is intended to be given in the middle of the day. It’s a proven attention-getter when responders are looking for the home.)

In delivering PDIs, don’t turn them into questions (“Do you have any pets?” “Okay, then, put them away.”). There are a lot of things our 9-1-1 callers need to remember and do, and for that reason protocol instructions should be given concisely and efficiently. Let’s remember that word choice matters, and PDIs are part of the protocol script. It’s not acceptable to say, “If anything changes, give me a call back.” That particular PDI reads, “If s/he gets worse in any way, call us back immediately for further instructions.” That tells the caller why they need to call back.

The Case Exit PDIs are a part of customer service. People do appreciate the help we give, and PDIs do make a difference in preparing the scene for responder arrival.