April 13, 2005
De Luca’s Law
“EMD’s will follow all protocols per se, avoiding freelance questioning or information
unless it enhances, not replaces, the written protocol questions and scripts.”
This is a very important thing to remember while using the MPDS protocols. Deviating
from the protocol can and will cause a delay in the call process. It can and does cause
inaccurate coding of the calls and causes both the call taker and the caller to lose
confidence in the system.
However, there is an important thing to remember. You can clarify or enhance any
portion of the scripted protocol if the information is obvious or has already been
volunteered by the caller.
I have heard time and again that you have been told, “all questions must be asked.” That
is true. It is the only way to obtain a clear and true picture of the patient’s condition. It is
really important to really listen to our callers and hear what they are telling us. For
example, lets use the following scenario and process a call using the protocol card set or
ProQA. Try to actually use the protocol while running this scenario.
you “-------------911 Where is your Emergency?”
caller “We are at 199 East Main Street, Apt 402, Colonial Hills Apartments”
you “What is the phone number you are calling from?”
caller “It’s 867-5309”
you “What’s the problem?, Tell me exactly what happened?”
caller “Well, you see, my husband is having a terrible time of it, he has asthma and can’t
hardly catch his breath. He is really pale”
you “Are you with him now?”
you “How old is he?”
caller “He is 74”
you “Is he conscious?”
you “Is he breathing?”
You have by now determined this needs processed on protocol #6 “Breathing Problems” for the
you “Is he able to talk to you?”
you “Is that how he usually talks?”
you “Is he completely awake?”
The next key question is where it is not necessary to ask. The caller has already answered it in her
answer to “exactly what happened.” But remember, since this has already been answered by
information volunteered by the caller, you can reword this if you choose or simply answer it yourself
and move forward. An example of rewording this question is as follows:
you “You said he was turning pale, is that correct?”
caller “Yes, he is terribly pale”
By acknowledging what the caller has said, they have confidence that you have heard them and they
are being listened to. Asking this question as it is written, “Is he changing color?” Could cause this
caller to get agitated with you and lose confidence in the entire process.
you “Is he clammy?”
caller “No he does not appear to be”
you “Does he have a history of heart problems”
caller “No, he is generally in good health”
Now this last question is like the changing color question. It has already been answered by the caller.
An example of rewording it is as follows:
you “And you said he had asthma was that correct?”
In either of these questions where the answer was already provided, you can simply
answer these yourself and it is not necessary to reword them. However I realize that
many of you feel more comfortable at least acknowledging them and it assists you in the
manipulation through the interrogation process.
It’s quiz time!!
All answers can be found in this article, or in the protocol.
True or False
#1. Ad-libbed questions are O.K.?
#2. It is Frenza’s Law that states, “EMD’s will follow all protocols per se, avoiding
freelance questioning or information unless it enhances, not replaces, the written
protocol questions and scripts?”
#3. I can reword a question if I don’t think it makes sense.
#4. I can enhance any portion of the protocol if the information is obvious or the answer
has already been provided.
#5. Asking the patient’s age is one of the 4 “commandments”
#6. A recent sudden onset of severe pain in a patient with a headache will make the
complaint a priority symptom?
#7. Simple chest pain is not a priority symptom.
#8. Conscious and breathing can be asked as one question.
#9. Trauma is a priority symptom
#10. There are 4 priority symptoms
BONUS~~ Name the priority symptoms and give the associated protocol # for each.
DON’T SCROLL DOWN
UNTIL YOU WANT THE ANWERS!
BONUS----Breathing Problems #6
Chest Pain #10
Unconscious/Fainting (near) #3