EMD Protocols


Emergency Medical Dispatch Protocols

Updated 3-13-08

CALL TYPE/PRIORITY DETERMINANT LEVEL COUNTY FD CITY FD POLICE
Abdominal Pain-3awake & breathing normallyAmbulanceNoNoNo
Abdominal Pain-2Pt > 50 yo, pregnant females or fainting personsTraumaYesNoNo
Allergic Reaction-3awake & breathing normallyAmbulanceNoNoNo
Allergic Reaction-2If pt not talking normally, or difficulty breathing, or has history of allergic reaction or has hives or rashTraumaYesYesNo
Animal Bite-3bleeding controlledAmbulanceNoNoYes
Animal Bite-2bleeding not controlled and/or if bite on head or neckTraumaYesNoYes
Assualt/Rape-3pt is awake and bleeding controlledAmbulanceNoNoYes
Assualt/Rape-2bleeding not controlled of if pt is not awakeTraumaYesNoYes
Back Pain-3non-traumaticAmbulanceNoNoNo
Breathing Problems-3no history of asthma, awake and talking, < 35 yoAmbulanceNoNoNo
Breathing Problems-2asthma history, awake and talkingTraumaYesNoNo
Breathing Problems-1not awake or altered LOC or any pt >35 yo w/o history of asthmaMedicYesYesNo
Burns-3uncomplicatedAmbulanceNoNoNo
Burns-1involving face, difficulty breathing or chemical burnMedicYesYesNo
Carbon Monoxide/HazMat-3awakeAmbulanceYesYesYes
Carbon Monixide/HazMat-1not awakeMedicYesYesYes
Cardiac Arrest-3obvious death from a relable sourceAmbulanceNoNoYes
Cardiac Arrest-1cardiac arrestMedicYesYesYes
Chest Pain-3w/o difficulty breathing or pt <35 yoAmbulanceNoNoNo
Chest Pain-2w/ difficulty breathing but no history of heart problems & pt < 35 yoTraumaYesNoNo
Chest Pain-1w/ difficulty breathing and prior history of heart problems or any pt > 35 yo or on an automatic internal defibrillatorMedicYesYesNo
Choking-3not choking now, alert and talkingAmbulanceNoNoNo
Choking-1chokingTraumaYesYesNo
Convulsions/Seizure-3seizure has stopped & pt is breathing normallyAmbulanceNoNoNo
Convulsions/Seizure-1still seizing or multiple seizures of difficulty breathing or pregnant or head injuryMedicYesYesNo
Diabetic Problem-3awake & talkingAmbulanceNoNoNo
Diabetic Problems-2not awake or not talking normallyTraumaYesYesNo
Drowning-3out of water and breathing normallyAmbulanceNoNoYes
Drowning-1if out of water and trouble breathingMedicYesYesYes
Drowning-1still in water-swimming poolMedic, WRT, DOYesYesYes
Drowning-1still in water-swift water, river, dams, drain pipes, creeksMedic, WRT, TRT, DOYesYesYes
Electrical Injury-3pt awake, talking normally and no LOCAmbulanceYesYesYes
Electrical Injury-1LOC or pt not talking normallyMedicYesYesYes
Eye Problems-3minor eye problemAmbulanceNoNoNo
Eye Problems-3chemical burnAmbulanceYesYesNo
Fall-3fall < 10 feet, awake and talkingAmbulanceNoNoNo
Fall-2fall > 10 feet or not awake or not talking normallyTraumaYesYesNo
Heat/Cold Exposure-3pt is awakeAmbulanceNoNoNo
Heat/Cold Exposure-1not awake or not talking normallyMedicYesNoNo
Hemorrhage-3minor or easily controlled, cathetersAmbulanceNoNoNo
Hemorrhage-2bleeding not controlled or not awake and talking normally or rectal bleed or vomiting bloodTraumaYesYesNo
Industrial/Farm/Machinery Accident-3awake, talking, not entrapped, bleeding controlled, no HazMatAmbulanceNoNoYes
Industrial/Farm/Machinery Accident-1not awake or bleeding uncontrolled or HazMat present, or unknown injuries, major trauma or entrapementMedic, Squad, DOYesYesYes
Overdose/Poisoning/Alcohol-3awake and talking normally, or alcohol onlyAmbulanceNoNoYes
Overdose/Poisoning/Alcohol-1not awake or not talking normally, or hallucinations, severe agitationMedicYesNoYes
Pregnancy/Childbirth-3labor or 1st & 2nd trimester vaginal bleedingAmbulanceNoNoNo
Pregnancy/Childbirth-2vaiginal bleeding in the 3rd trimester, delivery of infantTraumaYesNoNo
Psychiatric/Behavioral Problems-3awake w/ injuriesAmbulanceNoNoYes
Psychiatric/Behavioral Problems-2bleeding not controlledTraumaYesYesYes
Psychiatric/Behavioral Problems-1unconsciousMedicYesYesYes
Sick Person-3sick w/o specific complaintAmbulanceNoNoNo
Sick Person-2not talking normallyTraumaYesNoNo
Stabbing/Gunshot Wound-2all GSW's or stabbingsTrauma, DOYesYesYes
Stabbing/Gunshot Wound-1multiple victims1 Trauma Unit per Pt, DOYesYesYes
Stroke/CVA-3awake & talking normallyAmbulanceNoNoNo
Stroke/CVA-2not talking normally or not breathing normallyTraumaYesNoNo
Motor Vehicle Accident-3injury from past MVA, pt not at sceneAmbulanceNoNoNo
Motor Vehicle Accident-3minor injuries, unknown injuriesAmbulanceYesYesYes
Motor Vehicle Accident-2car vs. pedestrian or car vs. motorcycle, or if significant impactTraumaYesYesYes
Motor Vehicle Accident-1vehicle overturned or patient trapped or in or under vehicle or significant impact or multiple patientsTrauma, Squad, DOYesYesYes
Injured Person-3broken bones or minor bleedingAmbulanceNoNoNo
Injured Person-2bleeding not controlledTraumaYesYesYes
Unconsciousness/Fainting-3now awake & talkingAmbulanceNoNoNo
Unconsciousness/Fainting-1not awake or unknown respiratory status or w/ possible respiratory or cardiac arrest or a history of cardiac problemsMedicYesYesYes
Unknown Problem/Person Down-3all casesAmbulanceNoNoNo
Standby/Public Safety Request-3stable PD events, or athletic events w/ no current injuriesAmbulanceN/AN/ANo
Standby/Public Safety Request-1unstable PD ops w/o persons trappedMedicYesYesYes
Mutual Aid Assistper protocolper protocolNoNoNo
Aircraft Emergencies-1all aircraft emergenciesTrauma, Squad, DOYesYesYes
Lifeline Alarms-3all lifeline alarmsAmbulanceNoNoNo
Public Service Call-3stable situation w/o current injuriesAmbulance (Routine)NoNoNo
Public Service Call-3unstable or unknown situationsAmbulanceNoNoNo
Fire Standby-3FD ops w/ no one trappedAmbulanceN/AN/AYes
Fire Standby-12nd alarm assignments or persons trappedMedic, Squad, DON/AN/AYes
Special Rescue Situation-1all special rescue situationsPrimary Protocol, Squad, TRT, DOYesYesYes

Definition of Response Level:

  • Ambulance Level - ambulance with EMT-B driver and EMT-B attendant. This is the basic level of unit that is sent to relatively simple medical problems.
  • Trauma Level - ambulance with EMT-B driver and EMT-E attendant. This type of unit can handle more life-threatening emergencies.
  • Medic Level - ambulance with EMT-B driver and either EMT-I or EMT-P attendant. This is the most well equipped unit, and is able to handle life-taking emergencies.
  • Squad Level - heavy rescue truck with highly trained rescue personnel. This unit is dispatched anytime there is a problem accessing a patient.
  • Engine Company - fire truck with EMT's; only sent in city limits on motor vehicle accidents and certain life-taking calls where manpower is required, in Albemarle County an engine is sent on all ALS calls.
  • DO (Duty Officer) - command officer who is in charge of that duty period's operations

    Click here for an explanation of medications and procedures allowed by each EMT level.
    Click here for an full explanation of each EMT level.

    The Emergency Communications Center (ECC) receives 911 emergency request for assistance and dispatches the appropriate level of response based on a pre-defined set of protocols. All advanced life support calls in the County receive an automatic dispatch of the nearest fire station as a "first-responder" until the arrival of the ambulance. Some calls also receive automatic dispatch of law enforcement. A first responder unit is not dispatched in the city, (unless life taking call or MVA) because of quicker response of CARS ambulances.

    ECC also has the ability to pre-arrival instructions to the calling party so they may the victim before the arrival of the ambulance. These pre-arrival instructions have been instrumental in saving lives. To aid in locating calling parties and reduce the number of false calls, ECC has an Enhanced 911 system that displays the callers address as soon as the phone is answered by communications personnel.

    On violence & unknown rescue calls, Police are sent automatically. They do not provide patient care, only protection for rescue personnel.


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    For Help using this system, email me at:

    jburruss@hotmail.com