ems priority dispatch codes

This approach could similarly be used to predict the need or a L&S response. There are several explanations why some keywords in the Finnish national dispatch protocol are associated with categorization that over- or under-estimates the anticipated risk at dispatch in comparison to the NEWS. In the Kainuu region, the main author manually transferred the data from the paper EMS charts to the statistical program. Princ Emerg Med Dispatch. Commission E. Intelligent transport systems: The interoperable EU-wide eCall. Pasi Ohtonen for statistical assistance, and the EMS managers Jukka Angerman and Markku Alalahti for processing research data. 2011;19:19. Kuisma M, Holmstrm P, Repo J, Mtt T, Nousila-Wiik M, Boyd J. Prehospital mortality in an EMS system using medical priority dispatching: a community based cohort study. Emergency service response codes are predefined systems used by emergency services to describe the priority and response assigned to calls for service. Encounter level variables collected included dispatch code, priority level, EMS provider service level, PPE utilization, encounter disposition and transport facility type. Although there are no standards for evaluating dispatcher performance accuracy, studies have shown substantial discrepancies in priority assessment between dispatch centres and EMS personnel on the scene [3, 4]. Although we have used the ACS COT model, which was designed for trauma patients in a pre-hospital setting, the model was not specifically derived for decisions about EMS dispatching ambulances. Crash records without a corresponding ambulance record were excluded from the final dataset. See Table 3. 1. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. That it's taken so long after they sat through days of inquest testimony that determined the dispatch technology was "outdated" even back in 2004 has left Martin's familybitter and frustrated. The Medical Priority Dispatch System ( MPDS ), sometimes referred to as the Advanced Medical Priority Dispatch System ( AMPDS) is a unified system used to dispatch appropriate aid to medical emergencies including systematized caller interrogation and pre-arrival instructions. These AACNS have been found to predict injury severity with under triage rates of between 5 to 13% [23]. The ability of the National Early Warning Score (NEWS) to discriminate patients at risk of early cardiac arrest, unanticipated intensive care unit admission, and death. Our present results indicated that the current Finnish dispatch protocol is not optimal, even though it is an automated system that relies on protocol-based call taking. Provided by the Springer Nature SharedIt content-sharing initiative. It probed how rural areas were often underserved while ambulances were tied up in urban Ottawa. PubMed To try to fill this gap we wanted to assess the usability of the NEWS in this context. Studies investigating short- and long-term patient outcomes are also needed. Validation of the National Early Warning Score in the prehospital setting. We used Fine-Grained Records Integration and Linkage Tool (version 2, Emory University, US) and SAS (version 9.4. Conact of tour company of airport: (021 . Medical codes are 1-32. Ceklic, E., Tohira, H., Ball, S. et al. Unauthorized use of these marks is strictly prohibited. This fact further highlights the need for focused studies to re-evaluate the current protocol. The decision tree with a 2.7% under triage rate was closest to that specified by the ACS COT, had as predictorsMPDS codes, trapped, vulnerable road user, anyone aged 75+, day of the week, single versus multiple vehicles, airbag deployment, atmosphere, surface, lighting and accident type. Department of Agriculture. "When we have a number of calls held in the queue, we may be assigning and reassigning and reassigning paramedics to Code 4 calls that may not necessarily be Code 4.". Since dispatch protocols differ among countries, our results are not fully generalizable to countries using different criteria-based protocols. "I just don't understand why we invested so much time, effort and money into an inquest that's just not implemented," said Tammy Yenson, Martin's youngest daughter. Ottawa is finally moving to a medical priority dispatch system, which was recommended during a 2004 coroner's inquest. Some use codes assigned through a systemized dispatch system, such as the Medical Dispatch Priority System (MPDS); which uses criteria related to the number of resources needed (such as for multi-vehicle crashes), the potential for danger (such as for those involving hazardous chemicals) or those involving high mechanisms of injury (such as rollovers) [5]. Circulation. Google Scholar. Departure terminal office contact: (021) 51007414. Scand J Trauma Resusc Emerg Med. PubMedGoogle Scholar. Public Health Rep. 2021 Nov-Dec;136(1_suppl):54S-61S. Therefore, considering missing values to be normal is reasonable to some extent. We analysed data using the Chi-square Automatic Interaction Detector (CHAID) [14] technique for branching using SPSS (version 26. As discussed earlier, some types of medically high-risk patients do not receive a high NEWS. With respect to the NEWS, the highest rate of over-triage occurred in cases of traffic accidents and among patients with a decreased level of consciousness, chest pain, stroke, or undefined disturbance of vital signs. Patients assigned these 21 codes between July 2002 and June 2003 were included for further analysis. 2012;61:135. Determinant suffixes give additional flexibility to differentiate responses based on specific criteria. CAS To develop an algorithm to identify cases for which a L&S ambulance response is required, using MVC characteristics. doi: 10.1371/journal.pone.0226518. 1. The strengths of this study include its prospective design and the inclusion of EMS patients from all priority categories. While it is not a novel idea that crash characteristics be used to predict injury severity [8, 9], there is a scarcity of research exploring whether crash characteristics could improve the dispatch accuracy in identifying those MVCs that do/do not require an ambulance L&S response to the scene. We conclude that we were able to derive a model with a reasonable under triage rate, however, this model had an associated high over triage rate. We conducted a retrospective cohort study using ambulance and police data from 2014 to 2016. Medical Priority Dispatch System (MPDS) is a type of Emergency Medical Dispatch (EMD) system used to prioritize 9-1-1 calls and optimize resource allocation. A total of 12,729 emergency medical services missions were evaluated, of which 616 (4.8%) were prioritized as A, 3193 (25.1%) as B, 5637 (44.3%) as C, and 3283 (25.8%) as D. Overall, 67.5% of the dispatch missions were correctly estimated according to NEWS. Lift assists and minor spills come to mind, as do the ever popular "I've fallen and I can't get up" call where there is no injury, but may require forced entry. Ceklic E, Tohira H, Ball S, Brown E, Brink D, Bailey P, et al. Cite this article. HT, SB, EB, DB, BP, RB and JF helped write and review the manuscript. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. In the 1970s, priority emergency medical services (EMS) dispatch systems were introduced to help triage 911 calls and resources. The corresponding rates of missing measurements among the urgent AB missions were 3.1, 4.0, 5.1, 9.5, 22.7, and 41.6%, respectively. Western Australian Police Force. A systematic review of the evidence supporting the use of priority dispatch of emergency ambulances. What you may have missed at NAVIGATOR 2023, IAED 2023 | Privacy Policy | Terms and Conditions. First, our results falsely indicate an underestimation of cardiac arrest patients. Morbidity and Mortality Weekly Report. 1). An "Alpha Response" is a response without lights and sirens. Article Due to differences related to ambulance availability, demand and road conditions, each EMS must define their acceptable level of risk when deciding the prioritization of ambulances [19] and may deem the under/over triage rates presented here as operationally acceptable. Over/under triage rates of various decision trees. If they're using such a system, it would be an extremely dramatic departure from standard operating procedure for fire departments in Central Ohio (there is no separate municipal EMS around here, it's all run by the FD). However, it is difficult to define a reasonable level of over- or under-triage. Secondary (inter-facility) transports and missions where patients were not encountered (aborted mission or patient not found) were excluded. Among the priority B calls, 9.8% were classified as high risk, 18.9% as medium risk, and 71.3% as low risk based on the NEWS. doi: 10.1177/00333549211012400. The rst number (one of the numbers 1 through 32) indicates the category of the incident (e.g., breathing problem). Unclear markings (eg, poor handwriting) were excluded from the data. Am J Emerg Med. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine For example, there has been some success in predicting anatomical injury (the Injury Severity Score) using crash characteristics and a machine learning methods [24]. IBM Corp., Armonk, NY. In this context, over triage is defined as dispatching an ambulance with lights and sirens (L&S) to a low acuity MVC and under triage is not dispatching an ambulance with L&S to those who require urgent medical care. Your privacy choices/Manage cookies we use in the preference centre. An ideal system would match patient need with ambulance dispatch priority. A total of 16,177 missions were carried out by the EMS during the study period, corresponding to an annual rate of 229.5 ambulance calls per 1000 inhabitants. Cookies policy. An expert panel reviewed andmodified a previously derived set of low-priority EMS dispatch codes. The authors thank MSc. Silcock DJ, Corfield AR, Gowens PA, Rooney KD. United States [ edit] Descriptive statistics, 95% confidence intervals (CIs), and logistic regression were calculated for the 107 codes and code groupings (9E vs. 9E1, 9E2, etc.) The aim of this study was to evaluate the accuracy of the protocol by comparing risk assessment guided by the national criteria-based dispatch protocol at the time of the emergency call with the NEWS at the EMS scene to quantify the rate of over- and under-triage. Before Of the highest dispatch priority missions A and B, 76.9 and 78.3%, respectively, were overestimated. Three (3) factors in combination form a determinant code that drives the response configuration. The dispatch protocol must be made more sensitive to decrease under-triage to the acceptable rate of less than 5% and more specific to reduce over-triage of the highest priority A and B calls. In Finland, calls for emergency medical services are prioritized by educated non-medical personnel into four categoriesfrom A (highest risk) to D (lowest risk)following a criteria-based national dispatch protocol. Categories C and D were combined since a kappa coefficient can only be calculated if both variables have the same number of categories. [cited 2021 Apr 7]. Similar priority distributions have been reported in previous studies of the Finnish EMS system, including 32.7% A and B calls in the Helsinki metropolitan area, [12] and 34.5% in Southern-Finland urban area [13]. Background: Traffic Inj Prev. Emerg Med J. 2013;84:46570. 2023 May 16;21(1):184. doi: 10.1186/s12916-023-02879-7. Both the levels and misclassification costs were varied to identify the best decision tree model. v13 Robeson County Communications, revised May 2016 1 - Abdominal Pain / Problems 1D1 Not alert 1D2 Ashen or gray color reported 50 1C1 Suspected aortic aneurysm (tearing/ripping pain) 50 1C2 Diagnosed aortic aneurysm Of the patients who were assigned a high-risk NEWS, 24.8 and 43.2% had initially been classified as A and B priorities, respectively, and 32.0% as low urgency priority C or D. Comparing the dispatch assessment with the NEWS revealed that the risk assessment made by the dispatcher was correct in 67.5% of cases (Table4). When search suggestions are available use up and down arrows to review and enter to select. PubMed Misclassification costs allowed us to preference those MVCs that required a L&S response over those that did not. The authors also thank all EMS providers. Calls for emergency ambulance assistance for motor vehicle crash (MVCs) patients substantially contribute to the demand on emergency medical services [1]. Newspaper articles of 20 years ago sound remarkably like the news stories of today. Bookshelf The NEWS of <5 (low risk) warrants assessment by personnel to determine whether intensified medical care is required; this risk group was considered similar to the low urgency priorities C and D. Permission to perform this study was obtained from both Hospital Districts and the Office of Data Protection Ombudsman. Fusion of dispatching centres into one entity: effects on performance. Serious injury prediction algorithm based on large-scale data and under-triage control. Marko Hoikka. Our study used a composite index based on whether anyone died on scene or in transit, the priority from the scene and any medication/interventions/observations considered as requiring a L&S response. Citizens'Right and Performance Management: (021) 55678392, (021) 51008965. Kate Porter covers municipal affairs for CBC Ottawa. For the purposes of this study, a Glasgow coma score of 1415 was considered equivalent to A (alert) in the NEWS, and a score of <14 was considered equivalent to VPU (voice, pain, unresponsive). The president of the Ontario Association of ParamedicChiefs, however, explained successive Ontario governments did not make ambulance dispatch a priority. A kappa value of <0.20 indicates slight reliability, 0.210.40 fair reliability, 0.410.60 moderate reliability, 0.610.80 substantial reliability, and >0.80 indicates almost perfect reliability [10]. 2011;37:738. In Protocol 29, some Determinant Descriptors and suffixes are associated with a high frequency of air medical flights. - Emergency Fire Dispatch 2. patient absconded); Patient transfer between hospitals; Not emergency: Use of the ambulance for other than delivering patient care, such as transport of equipment; Stood down: Ambulance dispatched but then received a higher priority job or another crew was closer to the scene; Cancelled: Individual calls from the scene and states they no longer require the ambulance; Unable to locate scene: Ambulance is sent but cannot locate the MVC. Regarding priority, the assessment of NSC was more common when the EMS was dispatched with a low priority by the EMCC. Calls are prioritized into four categories, from A (highest priority) to D (lowest priority), and the code given to the EMS units consists of two parts: keyword and priority. In some CADs, the problem/nature displayed will also be based on the CAD code.[i]. Triage by emergency medical systems (EMSs) is therefore important to ensure the right care is provided to the right patient, in the right amount of time [2]. Emergency medical dispatching plays an important role in the chain of medical care and patient survival [1]. No patient found: Paramedics arrived on-scene but there was no patient present (e.g. But it never came.". Second, our findings may falsely indicate an overestimation of chest pain and stroke patients. The new dispatch system could help,according to Poirier, if the triage for ambulance responses is more sophisticated. Suffixes can also identify when more specialized resources are needed. This retrospective observational cohort study analyzed requests for EMS through a single public safety answering point (PSAP) serving a mixed urban, suburban, and rural community over one year. Wilson S, Cooke M, Morrell R, Bridge P, Allan T. Emergency Medicine Research Group (EMeRG). MeSH : 1. https://www.cdc.gov/mmwr/preview/mmwrhtml/rr6101a1.htm. Yenson was with her. OConnor RE, Cone DC. Sasser S, Hunt R, Faul M, Sugerman D, Pearson W, Dulski T, et al. For crash characteristics the categories of no one ejected (99.0%), everyone ambulant (97.9%) and no vehicle rolled (96.3%) had the highest proportion of MVCs attended. Google Scholar. Scand J Trauma Resusc Emerg Med. The Advanced Medical Priority Dispatch System (AMPDS) codes 1-32 actually originated in the United Kingdom and were adopted in the US many years ago. EMS providers prospectively recorded data for the present study on EMS charts between 1.1.2014 and 30.6.2014. Google Scholar. A validation of machine learning-based risk scores in the prehospital setting. Clipboard, Search History, and several other advanced features are temporarily unavailable. Privacy The "Alpha" designation is for non-priority calls and many have started using the "Alpha response" terminology over the radio. It is a priority for CBC to create products that are accessible to all in Canada including people with visual, hearing, motor and cognitive challenges. Both areas are covered by the same emergency medical communication centre (EMCC). Science of emergency medical dispatch. The calculations of the NEWS for each patient were made automatically based on the clinical variables entered into the statistical program, and the calculated NEWS was used to re-evaluate the patients risk assessment. The indicators included specific clinical interventions, administered medications and patient clinical observations recorded by paramedics (see Supplementary material). That actually is it. By not triaging patients as well as it could, Ontario has probably had longer ambulance response times, he said. - Anyone had one or more L&S dispatch indicators (described below). - Emergency Medical Dispatch Based on the information received, the Kent County Office of Emergency Service personnel shall assign an emergency fire dispatch or emergency medical dispatch response code and dispatch appropriate unit (s). The inquest jury concluded paramedics were short-staffedand underfunded. 2015;89:315. 2015;81:2117. Acad Emerg Med. Springer Nature. E.M.D. Provided by the Springer Nature SharedIt content-sharing initiative. The first level of this tree was the MPDS dispatch code, followed by a combination of whether anyone was trapped, a vulnerable road user was involved, anyone was aged 75 or over, the day of the week, whether the crash involved a single or multiple vehicles, airbag deployment, the atmosphere, road surface, lighting and type of accident. Consider the possibilities. Passport police contact: (021) 51007331. SAS Institute Inc., Cary, NC, USA) for this purpose. JavaScript is disabled. EC, HT, SB, and JF developed the study. 2009;119:20235. MPDS dispatch codes are those that best describe the incident, such as the code for rollover (D2p), HAZMAT (D3) or sinking vehicle (D2s) [5]. J Am Coll Surg. The MRWA crash data is a composite dataset of information collated from Western Australian Police (who attended all fatal and critical injury crashes); and drivers involved in the crash. Sandersonis also chief of Hamilton's paramedic service and saw firsthand the difference MPDSmade when Vancouver paramedics implemented it more than a decade ago. In SJ-WA a L&S response is the highest priority ambulance response, where L&S are used on the way to the scene. IBM Corp. Armonk, NY,). Of concern is that one-third of the patients with a high medical risk according to the NEWS on the scene were initially classified as low urgency C or D priorities at dispatch. Feldman MJ, Verbeek PR, Lyons DG, Chad SJ, Craig AM, Schwartz B. sharing sensitive information, make sure youre on a federal Even an agency without a CAD system can use a simple computer application or flip cards to indicate to the emergency dispatcher what response corresponds to each Determinant Code, orfor single-tier systems running HOT to every callwhen additional resources are needed. See Table 4 and Fig. McLay LA, Mayorga ME. The hospital districts organize the emergency medical services, which respond to a total of 35,000 emergency missions annually. BMC Emergency Medicine Flow chart of study cohort, and mission distribution according to priorities and National Early Warning Score (NEWS). 2006;13:95460. Part of If additional information is gathered after the initial dispatch, the run can be upgraded to include lights and sirens as necessary. We limited records in the crash data to those defined as a reportable road crash [13], with crashes that result in damage costing<$5,000 AUD or not resulting in injury, not being required to be legally reported. And then I could hear sirens," remembers Yenson. Your US state privacy rights, Article 2014;113:22633. Reporting a traffic crash. Royal College of Physicians. When the emergency dispatcher accepts the Determinant Code presented at the Send screen, a corresponding value called a CAD code passes to CAD. Patients with the NEWS of 5 or 6 (medium risk) should trigger an urgent assessment by personnel with core competencies to assess acutely ill patients, which was considered equivalent to priority B. CHAID decision tree model with 84.8% over triage and 2.7% under triage rate. (DOCX 137 kb), Distribution of mission codes, priorities, National Early Warning Scores (NEWS), and accuracy of the risk assessment derived from the NEWS. Model E variables were: MPDS dispatch codes, anyone trapped, vulnerable road user, anyone aged75years, day of the week, single v. multi-vehicle, airbag deployed, atmosphere, road surface, lighting, accident type. From The RadioReference Wiki Contents 1 Medical Priority Codes 1.1 Abdominal Pain 1.2 Allergic Reaction 1.3 Animal Bites 1.4 Assault 1.5 Back Pain 1.6 Breathing Difficulty 1.7 Burn Subject 1.8 Hazardous Exposure 1.9 Cardiac Arrest 1.10 Chest Pain 1.11 Choking 1.12 Seizures 1.13 Diabetic Problems 1.14 Drowning 1.15 Electrocution 1.16 Eye Problem Patients assigned these 21 codes between July 2002 andJune 2003 were included for further analysis. All authors designed the study, analysed and interpreted the data, drafted and critically revised the manuscript. The transferred data included only objective values, so the subjective bias was minimal during the data collection. By using this website, you agree to our Available from: https://www.agriculture.gov.au/abares/research-topics/aboutmyregion/wa-perth#regional-overview. Acta Anaesthesiol Scand. 2013;21:73. While not specifically for a prehospital setting, the ACS COT suggests a 5% under triage and a 25% to 35% over triage rate, as acceptable for trauma team activation at any emergency department [13]. JF receives research funding from SJ-WA. Alice Martin's children have been waiting for the province and the city to move to the "medical priority dispatch system" (MPDS) since the 2004 inquest into their mother's death. It is anticipated that the implementation of future technologies such as AACNS will improve the accuracy of identification of those MVCs that require a L&S response. Initial Dispatch Codes (IDC): Immediately to the left of each criteria is an Initial Dispatch Code (IDC). About my region: Regional profiles. The ECNS is the nurse-triage system implemented directly in Emergency Medical Services (EMS) communication centers throughout the world to provide alternative referral options to patients with non-life-threatening, non-emergency, and low-acuity determinant codes as assessed by ProQA and the MPDS Protocols. Box 500 Station A Toronto, ON Canada, M5W 1E6. These centres organize the responses to medical calls and calls for fire and rescue services and police, all of which are accessed through the common European emergency phone number 112. b. Probabilistic matching was used to link subjects. The predictor variables were crash characteristics (e.g. Columns Art Braunschweiger In my travels for Priority Dispatch , "We don't use Determinant Codes" is something I've heard more than once. This model had seven levels, with 58 nodes and 32 terminal nodes (Fig. Over triage, in the context of limited EMS resources, could result in ambulances not being available for other, more time-critical patients as well as the additional risk of an ambulance crashing [4]. Ethics approval has been granted as an amendment to the Western Australian Pre-hospital Record Linkage Project by the Curtin University Human Research Ethics Committee (HR 128/2013) under which there is waiver of patient consent consistent with The Australian National Statement on Ethical Conduct in Human Research. Priority code D is assigned if the patient is stable but needs to be assessed by an EMS unit. Summary measurements are expressed as the mean, standard deviation, and range, unless otherwise stated. Several decision trees predicted the need for a L&S response. These systems use indicators such as intrusion depth, change in velocity at impact and restraint use, to automatically relay information to EMSs regarding the predicted injury severity of the involved in the crash. My IP Address Lat/Long Of My Location Postal Code vs Zipcode My Postal Code Postal Code Map Postal Code Format World Postal Code World Currency List National Postal Services. In some CADs, the problem/nature displayed will also be based on the CAD code. Both A and B priority codes are urgent, indicating that the call should immediately be transmitted to the closest EMS unit(s). Similarly, a Swedish study found a 27% correspondence when comparing the first dispatch priority made by EMCC with a second priority assessment made by the ambulance crew on the scene using the Swedish criteria-based triage protocol [4]. 2. https://doi.org/10.1111/1742-6723.13181. SJ-WA is the sole, contracted provider of single-tier advanced life support EMS in Perth. A feature called Cursor Priority also allows an agency to designate which Determinant Code takes priority when more than one applies within the same level. Your US state privacy rights, In A priority responses, a prehospital physician unit is included, if available. My Location. Your CAD vendor can provide you with more information. Medical priority dispatch codescomparison with National Early Warning Score. National Library of Medicine In complete case analysis we found that every vital parameter for the NEWS calculations was measured in 4122 cases (total 32.3%; priority A 43.8%, priority B 44.2%, priority C 31.7%, priority D 19.9%). Br J Anaesth. This study also has some evident limitations. The study was funded by Oulu University Hospital EVO grant. So we hung up. Due to their poor prognosis, patients found in unwitnessed cardiac arrest are categorized as priority B and not priority A by the Finnish dispatch protocol, while the NEWS considers these to be high-risk patients. J R Stat Soc Ser C. 1980;29:11927. With MVCs people on the scene are usually not medically trained and cannot provide reliable information about medical need. Tehran, Tehran, Iran. MMWR Recomm Reports. . Likewise, there exists no standard metric for EMS accuracy. Finland has a national dispatch authority with six regional EMCCs. Clawson J, Dernocoeur KB, Murray C. Protocol 29: Traffic/Transportation Incident. Perth had a population of approximately 2 million people and covers an area of 6,400 square kilometres [10]. Increasing emergency number utilisation is not driven by low-acuity calls: an observational study of 1.5 million emergency calls (2018-2021) from Berlin. national health and medical research council,1116453, Prehospital, Resuscitation and Emergency Care Research Unit (PRECRU), School of Nursing, Curtin University, GPO Box U1987, Perth, WA, 6845, Australia, Ellen Ceklic,Hideo Tohira,Stephen Ball,Deon Brink,Paul Bailey&Judith Finn, Emergency Medicine, Medical School, The University of Western Australia, Perth, Australia, St John Western Australia, Belmont, WA, Australia, Stephen Ball,Elizabeth Brown,Deon Brink,Paul Bailey,Rudolph Brits&Judith Finn, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia, You can also search for this author in This group was considered equal to priority A in the Finnish EMS. On the ProQA side, the user-defined response for each Determinant Code is entered into the ProQA Paramount Admin Utility and appears on the Send screen in the rightmost column titled Responses (user-defined). But that text doesnt actually tell CAD what to doits the alphanumeric CAD code that does that. Under triage rate was defined as the proportion of MVCs where a L&S response was determined to have been required, among crashes where the decision tree predicted that L&S was not required (i.e. They are responsible for evaluating all incoming emergency phone calls and making risk assessment following a criteria-based national standardized dispatch protocol. Sanderson saidthe dispatch centres in Ottawa, Thunder Bay, and Dryden are among the next wave, but he intends to keep pressure on the PC government to speed up the extensive training and rollout to the rest of Ontario. 1). The importance of this variation between each EMS is aptly captured in the notion that if you have seen one EMS, you have seen one EMS [20]. Closed Captioning and Described Video is available for many CBC shows offered on CBC Gem. Model D variables were: MPDS dispatch codes, anyone trapped, vulnerable road user, anyone aged75years, day of the week, single v. multi-vehicle, airbag deployed, atmosphere, road surface, lighting, accident type. A psychiatric emergency coding as a 25-B-3 (THREATENING SUICIDE) could be designated to get a response of BLS PD HOT. Data includes information pertaining to the crash (such as location, weather and road environment details), as well as information to do with the vehicle (such as make, model, year of manufacturing and safety features) and persons involved (age, sex, role in the crash and injury severity).

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