PSC - May/June 2017 Issue - 41

early on stages your caller to (1) be able to
visualize the victim to check for proper
breathing and (2) set up the environment
for compressions. The victim could be on
their stomach and need to be rolled over to
check for chest rise and fall as well as for
ease in performing chest compressions.
* Occasionally, a brief seizure prior to full
arrest (10-20 seconds) can throw off the
EMD because the caller may report this
to be a seizure, but typically it will not last
long. Nevertheless, the breathing is not
normal or continuous.
* Agonal breathing/respirations are ineffective movements of air or spasms along the
airway that are often mistaken for breathing. With agonal respirations you will not

* Is the person BREATHING? Chest rising
or falling continuously? "NO"
* "GO" to CPR PAIs
Seconds count. If there is absence of
breathing, agonal breathing, gurgling, snoring, doubt or confusion about the breathing
status of the victim, the best course is to "GO"
to your CPR instructions. What will be the
worst case if you are beginning compressions on someone not needing compressions?
Most likely the victim will complain, which
is a good sign! Also, even with properly performed compressions, there typically is a
low risk for life-threatening injury due to
chest compressions.
This "NO-NO-GO" approach gives you
decision benchmarks to keep you focused

caller. If you have to repeat an instruction,
reading it off the card is easier than trying
to remember what words you used the first
time and ensures PAI delivery is consistent
every time. The scripted instructions are the
approved instructions you are authorized to
provide, and compliance will help to protect
you and your agency from a negligence claim.
PAIS - HIGH-PERFORMANCE
COACHING

Providing PAIs effectively not only involves
the EMD "sticking to the script" but also using
the proper voice volume, pitch, inflection and
rate of speaking to keep the caller focused on
the task at hand and encouraged.
We are working in a visually blind environ-

have proper chest rise or frequency of
breathing. They will be ineffective breaths
occurring "once in a while" and could be
accompanied with sounds caused by air
trapped in the airway passing over the
vocal chords (snoring or moaning) but
not providing any oxygen to the body.
Identifying agonal respirations is a key
assessment skill for the EMD to acquire.
You can learn how to audibly assess by
listening to examples, possibly from your
agency's recording archives or by searching "agonal respirations" online. Check
the reference links in this article for a few
examples to add to your research on this
vital assessment skill.
Adherence to the interrogation script will
minimize delays.
* Verifying the address is paramount. If we
don't know where, we cannot send any
help there.
* Obtaining a name helps us with caller rapport, and obtaining a phone number provides us a way to call back if disconnected.
* Getting the caller next to the victim properly stages us for interrogation and PAIs
instead of wasting time later to get them
near the victim.
KEEPING IT SIMPLE - "NO-NO-GO"

This mnemonic device is easy to remember:
* Is the person AWAKE? "NO" (move onto
next question)

to immediately move to the next question or
action without delay. You must follow your
approved sequence. Doing so keeps you on target and minimizes a freelanced interrogation.
PAIs - adherence to protocols for High
Performance CPR
The APCO EMD Guidecards comply with
the 2015 AHA guidelines. The AHA revisions
place emphasis on the benefits of properly
performed chest compressions, especially
since most callers are not trained in CPR.
PAIs for those trained in CPR are there to
support the trained person if needed.
Don't skip past AED verifications.
Additionally, at the onset of PAI delivery,
every caller should be polled regarding the
availability of an automatic external defibrillator (AED). If one is available, it is a must
to have this device brought to the victim
and connected. An AED will analyze and
deliver shocks if deemed acceptable by the
AED software. Thus, this is one instruction
you do not want to bypass. Verify quickly,
and if not available, move on.
Follow the scripted instructions.
Research and testing ensure the wording used
is as effective as possible. Read the PAIs right
from the guidecard - it's easy and takes less
time than "reinterpreting" it. If you take the
time to reinterpret the guidecard language,
you are taking up time that the victim does
not have. Freestyling or summarizing the
instructions may cause confusion for the

ment, and we must leverage every benefit we
have using our guidecards and voice. Be prepared for the caller to be emotionally charged,
and make adjustments to your verbal presentation towards the caller. Learn quickly to sense
emotional triggers and how to de-escalate the
caller. Here are some high-performance coaching techniques to consider:
* Keeping them focused on the task can
minimize re-escalation of anxiety and
emotions.
* Use "persistent repetition," which is easily
accomplished by reading the instruction
again using your non-verbal techniques
(voice tone, volume, pitch, inflection, etc.)
* Maintain an appropriate rate of speech
- do not "rapid-fire" your pre-arrival
instructions. Each caller has a different
level of communication skills and may
miss an instruction. Remember they are
experiencing a heightened level of anxiety
and emotions.
* Proper voice articulation goes along with
rate of speech; clearly speak each word. We
are talking through various mediums (hardlines, wireless and data), and signals can
change, drop out or otherwise be disrupted.
Careful articulation maximizes your probability of clearly communicating the PAIs.
* Be patient! Think of how you might
respond in their situation. Remember you
must sound patient because they can hear
how you feel.

PSC | May/June 2017

The properly trained EMD has become the vanguard in the
chain-of-survival by being the first emergency responder to have
access to the medical emergency through the phone and one
that can have an immediate positive effect on the call.

41



Table of Contents for the Digital Edition of PSC - May/June 2017 Issue

President’s Channel
On Scene
Public Safety Communications Systems: The Future Is Smart
Evolution of the PSAP
E-Comm: A Model for Consolidated Emergency Communications and Public Safety Support
The Dos and Don’ts of Designing Your Communications Center on a Budget
When Germs Attack – Help Your PSAP Fight Back
How a Scheduling System Can Save Your Sanity
Advances in Quality Assurance and Improvement Software
9-1-1, Show Us Your Emergency
High Performance CPR & CDE Exam
Managing Peers in the PSAP & CDE Exam
Direct Channel With APCO
PSC - May/June 2017 Issue - Intro
PSC - May/June 2017 Issue - cover1
PSC - May/June 2017 Issue - cover2
PSC - May/June 2017 Issue - 3
PSC - May/June 2017 Issue - 4
PSC - May/June 2017 Issue - 5
PSC - May/June 2017 Issue - 6
PSC - May/June 2017 Issue - 7
PSC - May/June 2017 Issue - 8
PSC - May/June 2017 Issue - 9
PSC - May/June 2017 Issue - President’s Channel
PSC - May/June 2017 Issue - On Scene
PSC - May/June 2017 Issue - 12
PSC - May/June 2017 Issue - 13
PSC - May/June 2017 Issue - Public Safety Communications Systems: The Future Is Smart
PSC - May/June 2017 Issue - 15
PSC - May/June 2017 Issue - Evolution of the PSAP
PSC - May/June 2017 Issue - 17
PSC - May/June 2017 Issue - 18
PSC - May/June 2017 Issue - 19
PSC - May/June 2017 Issue - E-Comm: A Model for Consolidated Emergency Communications and Public Safety Support
PSC - May/June 2017 Issue - 21
PSC - May/June 2017 Issue - The Dos and Don’ts of Designing Your Communications Center on a Budget
PSC - May/June 2017 Issue - 23
PSC - May/June 2017 Issue - When Germs Attack – Help Your PSAP Fight Back
PSC - May/June 2017 Issue - 25
PSC - May/June 2017 Issue - 26
PSC - May/June 2017 Issue - 27
PSC - May/June 2017 Issue - 28
PSC - May/June 2017 Issue - 29
PSC - May/June 2017 Issue - How a Scheduling System Can Save Your Sanity
PSC - May/June 2017 Issue - 31
PSC - May/June 2017 Issue - Advances in Quality Assurance and Improvement Software
PSC - May/June 2017 Issue - 33
PSC - May/June 2017 Issue - 34
PSC - May/June 2017 Issue - 35
PSC - May/June 2017 Issue - 9-1-1, Show Us Your Emergency
PSC - May/June 2017 Issue - 37
PSC - May/June 2017 Issue - 38
PSC - May/June 2017 Issue - 39
PSC - May/June 2017 Issue - High Performance CPR & CDE Exam
PSC - May/June 2017 Issue - 41
PSC - May/June 2017 Issue - 42
PSC - May/June 2017 Issue - 43
PSC - May/June 2017 Issue - Managing Peers in the PSAP & CDE Exam
PSC - May/June 2017 Issue - 45
PSC - May/June 2017 Issue - 46
PSC - May/June 2017 Issue - 47
PSC - May/June 2017 Issue - 48
PSC - May/June 2017 Issue - 49
PSC - May/June 2017 Issue - Direct Channel With APCO
PSC - May/June 2017 Issue - cover3
PSC - May/June 2017 Issue - cover4
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