Brett Patterson

Brett Patterson

Irena Weight


By Brett Patterson and Irena Weight

Do Academy experts have all the answers? Generally, yes, but sometimes even the people constantly immersed in the development of the Medical, Police, and Fire Protocol find questions requiring clarification from experts closer to the subject. When that happens, we assume that the same question or, at least, a derivative of the question must be circulating among our membership. In a nutshell, that’s why The Journal will periodically feature the column “Experts Ask The Experts.”

In way of introduction, we have expert Brett Patterson, Academics & Standards associate and Medical Council of Standards chair for the International Academies of Emergency Dispatch (IAED), asking a question answered by expert Irena Weight, PDC, director of Translations, Standards, and Logic Design.

Brett’s Question:

Is there some purpose for the light red lines around certain PAI panels in the MPDS cardset, i.e., Panels C17/15a, B12/18/18a?

Irena’s Answer:

I wouldn’t say they are completely unexplained. They were first added in v11.3, and the reason would require some digging in our old protocols drafts, which likely are already archived off-site, to pinpoint the exact time when this happened, although the archives may still not contain the exact explanation of why the lines were added.

I recall that they were added to graphically group all of the panels pertaining to breathing evaluation. The idea was that EMDs using a cardset only, without ProQA, could go to this block of PAI panels at any time they questioned the patient’s breathing. This would be similar to how ProQA users can open the Agonal Breathing Diagnostic in ProQA in the same circumstances.



Brent’s reply:

I had a chance to speak with Dr. Clawson today and he basically confirmed your recollection, at least with regard to the “grouping” of very important information or instruction. The original idea was to group areas of PDIs that we wanted EMDs to, in Doc’s words, “be absolutely sure to get it right.” This makes complete sense with regard to breathing evaluation, breathing status, and use of the AGONAL BREATHING Diagnostic in the PAI sequence. If a patient is reported to have started breathing during CPR, we better make absolutely sure the patient is actually breathing before we stop compressions and move to the Maintain and Monitor panel.

As you know, information concerning this graphic is not currently included in the EMD curriculum. Instead, in v.12.2 we created a new symbol [see red question mark above] for the mandatory use of the AGONAL BREATHING Diagnostic that is situated in the ABC protocols next to the “Started Breathing” links. This symbol was added to create a concrete link between the report of a patient in arrest starting to breath and the definitive use of the AGONAL BREATHING Diagnostic. The red lines remain as a remnant and a subtle reminder to “be absolutely sure to get it right” in these very important sections of the protocol.

I have been associated with the MPDS for more years than I care to recall and yet I still seem to learn something new about it on a regular basis. You, and other dedicated people like you, continue to make this complex and yet elegantly simple tool the best it can be!