BOSTON - Boston Emergency Medical Services (EMS) today announced several steps it is taking in conjunction with an independent review of its handling of a 911 call involving a 34-year-old Hyde Park man late last year.
Those actions include modifying the ``guidecards’’ that list the questions 911operators are required to ask to assist in determining a call’s priority, and requiring all call-takers to undergo a refresher course by April 1.
The independent review was ordered by Dr. Barbara Ferrer, executive director of the Boston Public Health Commission, the agency that oversees EMS, to resolve questions about the department’s handling of the medical emergency on the evening of Nov. 27, 2009, outside the Hyde Park man’s home. The first ambulance arrived at the scene 4 ½ minutes from the time the call was dispatched, and emergency medical technicians immediately began lifesaving care, including CPR and Automated External Defibrillator (AED.) The patient was resuscitated and transported to the hospital.
The independent review was conducted by Dr. Joseph Bergen, chair of the Department of Emergency Medicine at Emerson Hospital in Concord; it followed a similar internal review initiated by EMS immediately following the incident. Dr. Bergen’s review focused on whether Boston EMS personnel followed established call-entry and dispatch protocols, and whether the protocols at the time were appropriate.
``We appreciate the thoroughness of Dr. Bergen’s review and his recognition of Boston EMS’s preeminence in the field of emergency medical services, both locally and nationally,’’ said Dr. Barbara Ferrer, executive director of the Boston Public Health Commission. ``We are taking his review to heart and are confident that his analysis will guide our efforts as we move forward.’’
``Dr. Bergen performed a detailed and objective review of the facts and reached many of the same conclusions Boston EMS reached when it reviewed the matter internally and on its own initiative,’’ said EMS Chief James Hooley. ``Based on the internal and independent review, I am confident that appropriate steps have been taken, or will be taken, to address the concerns raised in this matter.’’
Dr. Bergen’s review found that while the 911 call-taker’s actions were reasonable based on the caller’s description of the patient as ``awake,’’ additional questions could have been asked to confirm the patient’s level of consciousness. A call reporting an unconscious person potentially would have received a higher priority response. Dr. Bergen also found that with the exception of some relatively minor ambiguities, the Emergency Medical Dispatch guidecard system used by Boston EMS call-takers to process 911 calls is ``appropriate for the standard of care and resources available’’ in the city.
The 911 call-taker involved in the Hyde Park incident has since completed an extensive refresher course and all other EMS operators have received retraining on the instructions they should relay to callers before an ambulance arrives.
Chief Hooley said that Boston EMS will modify its guidecards to include follow-up questions for operators, such as ``can the patient talk?’’ that would help verify the patient’s level of consciousness in cases where it is not readily apparent. All 911 operators will be trained with the modified guidecards as part of their ongoing training.
Boston EMS is recognized across the country as one of the premier EMS providers in the nation. In 2009, Boston EMS responded to more than 107,000 medical emergencies across the city, and transported more than 81,000 patients to area hospitals. Boston EMS is committed to ensuring high-quality and effective emergency medical services to the people of Boston, and is constantly reviewing its policies, procedures, and protocols to achieve these goals.