6.3 The Public Service Access Point (911 Dispatch) in Prehospital Medicine

The first point of contact for the public with emergency services is the public service access point, commonly known as 911 dispatch. When a 911 call is made, the initial dispatcher will ask what type of emergency it is: police, fire or EMS. They will then transfer the call to the appropriate dispatcher for the specific emergency. In EMS, this dispatcher is known as the emergency medical dispatcher (EMD).

EMDs are responsible for gathering the needed information, including the location, type of illness or injury, the patient’s age, and the severity of the situation. Based on this information, an EMD dispatches the closest appropriate unit(s). In critical emergencies, while units are being dispatched, a second dispatcher may provide pre-arrival medical instruction to the caller. These instructions can include guidance on how to open an airway of an unconscious person, stop the bleeding from a traumatic injury, perform CPR, or other life-saving instructions. These instructions are tailored based on the information gathered during the initial call. The goal is to begin to begin life-saving care before first responders arrive.

In critical situations, the closest fire engine or police vehicle may also be dispatched, bringing medical supplies such as narcan, AEDs, and bleeding control kits to the scene.

Training and Certification for EMDs

To work as an EMD, a background in healthcare is not required. Many EMDs have prior experience in fields such as law enforcement. While certifications vary by state, a degree or certification is typically not required to work as an EMD.