Emergency Medical Dispatcher - History

History

A dispatch function of sorts has always been a feature of both emergency medical service and its predecessor, ambulance service. The information processing, if only to identify the problem and the location of the patient, has always been a logical part of the process of call completion. Prior to the professionalization of emergency medical services, this step in the process was often informal; the caller would simply call the local ambulance service, the telephone call would be answered (in many cases by the ambulance attendant who would be responding to the call), the location and problem information would be gathered, and an ambulance assigned to complete the detail. The ambulance would then complete the call, return to the station, and wait for the next telephone call. Although earlier experiments with the use of radio communication in ambulances did occur, it was not until the 1950s that the use of radio dispatch became widespread in the U.S. and Canada. Indeed, during the 1950s the presence of radio dispatch was often treated as a marketing inducement, and was prominently displayed on the sides of ambulances, along with other technological advances, such as carrying oxygen. Dispatch methodology was often determined by the business arrangements of the ambulance company. If the ambulance were under contract to the town, it might be dispatched as an 'add-on' to the fire department or police department resources. In some cases, it might be under contract to the local hospital, and dispatched from there. In many cases, small independent ambulance companies were simply dispatched by a family member or employee, employed part-time in many cases. Ambulance dispatchers required little in the way of qualifications, apart from good telephone manners and a knowledge of the local geography.

In a parallel evolution, the development of 9-1-1 as a national emergency number began, not in the United States, but in Winnipeg, Manitoba, Canada, in 1959. The concept of a single answering point for emergency calls to public safety agencies caught on quickly. In the United States, the decision was made to utilize the Canadian number, for reasons of ease of memory (4-1-1 and 6-1-1 were already in use), and ease of dialing. In 1967, the number was established as the national emergency number for the United States, although by 2008, coverage of the service was still not complete, and about 4 percent of the United States did not have 9-1-1 service. Calling this single number provided caller access to police, fire and ambulance services, through what would become known as a common Public-safety answering point (PSAP). The technology would also continue to evolve, resulting in Enhanced 9-1-1 including the ability to 'lock' telephone lines on emergency calls, preventing accidental disconnection, and Automatic Number Identification/Automatic Location Identification (ANI/ALI), which permits the dispatcher to verify the number originating the call (screening out potential false alarms), and identifying the location of the call, against the possibility of the caller becoming disconnected or unconscious.

As the skill set of those in the ambulance increased, so did the importance of information. Ambulance service moved from 'first come...first served' or giving priority to whoever sounded the most panicked, to trying to figure out what was actually happening, and the assignment of resources by priority of need. This occurred slowly at first, with local initiatives and full-time ambulance dispatchers making best guesses. Priority codes developed for ambulance dispatch, and became commonplace, although they have never been fully standardized. As it became possible for those in the ambulance to actually save lives, the process of sending the closest appropriate resource to the person in the greatest need became very important. Dispatchers needed tools to help them make the correct decisions, and a number of products initially competed to provide that decision-support.