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emergency services and coordinating census this video belongs to didactic

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unit 1 the emergency coordination census and it works on learning outcome from 1

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use center dispatch management systems emergency coordinators and identifying

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the functions and elements of the dispatch call system in 1986 the general

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health law established that health care in our country be organized into health

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services one for each autonomous community. Later in 2003 the cohesion and

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quality law of the national health system establishes benefits common to

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all the national health system to ensure continued and comprehensive health care

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at the appropriate level of care among these common benefits are the emergency

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units care which are the situations that force a quick or immediate attention

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this service is provided 24 hours a day whether in health centers at the

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patient's home or on-site it is provided by either primary care or specialist

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care or services dedicated to urgent care among these urgent care services are the emergency

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medical services which are the set of devices means and professionals who attend the emergency

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they move to the place where it happens monitor diagnose and treat the patient and also carrying

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out the transfer when necessary transferring the patient to the appropriate health center

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Spanish emergency services are different from each other because in each autonomous community

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we have a different health service, but also due to its origin. In the community of Madrid,

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same resources include Coordinating Centers for Urgencies and Emergencies, the Health Urgent

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Transport Network and Emergency Teams, Urgent Care Centers currently called Continuous Service Points,

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or PAC, and the emergency rooms of hospitals.

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The Urgencies Coordination Centre and Emergencies is the physical space and the functional organisation that manages and controls the provision of healthcare,

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being in addition the gateway for the citizen to our emergency service.

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As we will see in the next video, all HR services must have Type 112 integrated coordination centres,

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but this coexists with specialised coordinating centres of the 061 type that manage in various ways both emergency resources and non-urgent medical transport units.

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The essential phases of the activity of a coordinating centre can be summarised in two parts.

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First of all, receiving the call and processing the information.

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In this phase we locate the incident, we classify the victim if possible and we recognise the type of problem.

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It can be done in two phases, by a professional collecting the essential data of the call

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call and another professional who analyzes it and proposes the type of assistance.

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Also, if the situation has just begun, in this step we can start the assistance

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by instructing the caller over the telephone. Let's see a video now where such assistance is

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carried about. Samuel, good morning. Yeah, you call me from Jammol,

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death of street number one calla metro station tell me tell me what can we yeah a patient is

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unconscious you say we're going to try to do some painful stimulus let's see doesn't he answer

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nothing lying on the ground doesn't he move moving his arms legs nothing no have to check if he's

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breathing if he breathes normally like you and me no breathing we have to start doing cpr is there

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anyone else who can help you yeah we tell tell the person to look for subway security personal please

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get your phone on speaker mode please let's start do cardiac compressions okay

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clear the chest you will have to do them at this rate one two three four five six seven

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follow the rhythm of a tone you have to get the defibrillator it will be in the sub area in the

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entrance area at the main lobby come on keep the rhythm the patient doesn't move right so

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go on you go on don't worry the ambulance is on the way has our security arrived yeah

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okay are they going to start doing the cbr yeah come on thank you very much

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the second phase is the resource management assigning a specific unit of medical transport

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to each call during the answering time or immediately after it. Let's see how this

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assignment is made. Sabor592 from headquarters, we're going to sign you a 3.1 code, a witness,

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cardiac arrest. They are doing a massage and they have used a defibrillator. Please inform us upon

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your arrival. When the situation requires it, different emergency services collaborate in

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healthcare. In our case, to facilitate intervention, the summer team requests a

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national police unit that will facilitate healthcare and expedite the

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transfer to the hospital. National police? Yeah. Are you already there? Right? Come on,

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we're on our way. Finally, the patient recovers his vitals thanks to the alert

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and the intervention of a citizen in addition to the efficient management of

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the coordination center and the health assistance from the mobile intensive

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care unit arriving to the scene which transfers a patient to the hospital. In

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this occasion the critical condition of the patient requires that resource

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management operator establishes communication by radio or by phone call

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with the hospital

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without adequate resources

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to receive our patient

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in this way we confirm

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that they can receive him

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and besides informing

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the hospital doctor

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of the assistance given

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in the out of hospital setting

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summary is the clinical hospital

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is the ER doctor

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is it the ER doctor

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yeah look a six-year-old man

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will be arriving

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recovered heart arrest

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he's a man who has fainted in public

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and gone into cardiac arrest.

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Witnesses have started doing CPR

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until the arrival of the basic ambulance

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that has given Edesa two charges,

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after which they have kept on with the CPR

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for about 10 minutes.

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The mobile ICU has arrived on medication

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and after two more shots, he has gotten a pulse.

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He is now in a sinus rhythm

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with a right branch block intubated

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and with an external pacemaker.

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right now he's got two big caliber clients and waiting for you to give us a bed

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no no he had no history no history the only thing he was medicated for the prostate

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well he's going there in about 15 minutes as soon as they exit towards there

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it'll take about 15 minutes to get to the hospital when they are about five minutes away i'll tell you

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okay okay okay perfect well that's it well there are no way what's the name of the doctor in charge

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dr herrera right uh the door of the er okay dr herrera er door okay perfect we'll let's go there

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thank you very much see you later to end we must know that the regulation management or dispatch

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of calls is not the same in all emergency services. Some use a simple dispatch in which

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a resource is always assigned to every call. An ICU or a basic ambulance will be assigned

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at the discretion of the operator or following instructions of his company. This is the case

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of some more civil protection. In other cases, an algorithm dispatch can be used that allows

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to conclude different types of response as programmed.

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In this case, using a decision tree created in the classroom, as we will learn in the

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video Classification and Dispatch of Calls, we can get the resolution of the call that

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may end in the transfer to a health centre, providing telephone information or assigning

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a mobile ICU, or a basic ambulance as indicated by the algorithm.

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Finally, some services perform a medical regulation of the demand with the aim of

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adapting the resources assigned, resolve claims over the phone or refer to other services.

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This is the case of the SUMA 112. After knowing the general operation of the coordinating

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centres of emergencies, we can propose calls for different incidents as a classroom exercise.

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for example a traffic accident with a hurt motorist or severe headache of 7

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hours, a crushing chest pain for minutes or a possible sprain. In each case we

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will analyze how it would be its regulation for each type of dispatch and

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we will represent the management in the classroom. For example before a cold with

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a calf and mucus of two days without other serious signs or symptoms, a coordinating

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centre that applies simple algorithm would assign this call a basic ambulance.

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If there were any indicator of severity, the operator of the company's instructions could

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consider it as a reason to assign a mobile ICU in a dispatch using simulating algorithm.

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determine that the call is referring to a respiratory sickness showing signs of

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infection and does not present any danger. The applied algorithm tells us

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that we must recommend the patient to go to a health center urgently. We would

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provide him with information on the nearest emergency sensors and in case he

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rejects this resolution or could not come on his own we would assign him a

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basic ambulance. Finally, in a dispatch with medical regulation, this professional, according

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to his training and capacity to diagnose and prescribe, may, for example, diagnose that

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it is a common cold, recommending some rest, antibiotics and nasal decongestants and to ask

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further help if alarming signs or symptoms would appear later on. In the

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next video we will know more about the coordinating centres of urgencies and

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emergencies of the 112 type which integrate their activity with the rest

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of the intervening services. Likewise in later videos we would propose resources

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that facilitate and encourage the realization of simulation activities in

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class.