The Scope Of Care

Lizzy Grenus, Communication Training Supervisor, and Nadine Zilke, Support Service Manager, have been with St. Cloud Communications (St. Cloud, Florida, USA) for a few decades now (28 for Grenus and 25 for Zilke), and they both remember the complexity of working in emergency dispatch before the International Academies of Emergency Dispatch^® (IAED^™) protocols were implemented.

“We used to have to sit with people and make sure they have a plethora of different calls under their belt before signing them off on training,” Zilke said. “Now we just have to train new employees to navigate the protocols properly and effectively—the rest comes with time.”

Take Communications Operator Carly Staal for example. Staal was hired at St. Cloud in 2020 and had never taken a cardiac arrest call until fairly recently. A woman called to report that her 45-year-old daughter had stopped responding in the middle of a conversation. The caller was understandably upset, becoming distracted and not answering Staal’s questions.

Staal was able to calm her down to the point that she could give the address and other pertinent information, but when it came to getting hands on the chest of the patient, there was yet another barrier—the patient was positioned on a recliner, which isn’t conducive to effective chest compressions. All the while, a dog was constantly barking in the background, adding to the overall feeling of chaos. Even though Staal had never taken a call exactly like that before, she knew what to do thanks to the protocols and her accompanying training.

A Facebook post from the Positively Osceola page summed up Staal’s achievement: “She used the Medical Priority Dispatch System™ (MPDS®) and was able to provide Pre-Arrival Instructions. Between Staal and the police officers who quickly arrived on scene, the patient walked out of the hospital about a week later on her own.”¹

The call was celebrated locally at a ceremony held by the Orlando Health St. Cloud Hospital, where they honored the work of the St. Cloud Fire Rescue Department, the St. Cloud Police Department, and, of course, the first link in the chain of survival, Staal herself.

Another notable call was one where supervisor Susan Krokosz helped a pair of parents deliver a baby in the back of their Tesla. Krokosz has been with St. Cloud for 15 years and her unflappability comes through during a recording of the call where she was able to coax the father into giving more information than simply the address, such as how far apart the contractions were. She let him know that an ambulance was on the way, but in the meantime, they would help his wife give birth together. Using the protocol instructions, Krokosz helped guide a squalling newborn into the world despite the less-than-ideal setting.

Grenus likes highlighting both calls as an indication of the scope of the job. “The calls can be anywhere from saving lives to bringing them into this world. We really are the first on scene and set the mood for the rest of the call.”

Part of the secret to their success? Grenus and Zilke cite the fact that St. Cloud is a triple Accredited Center of Excellence, which means they consistently meet compliance standards set by the IAED for medical, police, and fire emergency dispatch.

“Before the protocols, we had to try to pull questions out of thin air,” Zilke said. “And in those cases, you’re always going to be critiqued after the fact.”

The protocols assist Emergency Dispatchers in delivering help to callers of all ages.

“We’ve had people in training be able to walk children through lifesaving instructions,” Grenus added. “With the protocols, it doesn’t matter if you’ve been here six months or 10 years, you can deliver the same service, no matter what.”

Source
1. “Life-saving Teamwork in St. Cloud.” Positively Osceola. Facebook. 2025; Aug. 2025. https://www.facebook.com/PositivelyOsceola/posts/pfbid02NEKgvUZ922EKjnNZiZaKGUB9noop8e4JozefF58xHMzjcD8P34JvEFoqZh8GQxRol (accessed Sept. 1, 2025).