9-1-1 dispatch:
The glue that binds the county emergency services

by A. M Sheehan Advertiser Democrat Jan. 24, 2013

PARIS — On a warm and foggy Saturday night in January, three dispatchers begin their 12-hour shift in the OCRCC or RCC across from the county courthouse, next to the jail.

 

 Forty-three fire departments, 12 rescue squads and eight police agencies ... these are what the Oxford County Regional Communications Center dispatchers juggle on a daily basis.

Oh, and an ever ringing 9-1-1 line.

Except for Friday and Saturday night shift, there are three dispatchers on duty in 12-hour shifts. On Fridays and Saturdays, there are four on the night shift. 

One mans the call-taker desk. Their responsibility is to answer 9-1-1 calls.

Another is responsible for fire and rescue, a third for law and the fourth handles Rumford PD and backs up the call-taker desk.

All the desks have the capability to back up each other.

In front of each are five computer monitors, one keyboard and two mouses.

On a busy night, their job is akin to an air traffic control tower at a busy airport.

On their shoulders rests the safety of the county, its residents, its law enforcement, fire and rescue personnel.

And all they have on which to base snap decisions is their ears, the answers they get to the questions they ask the caller and well-trained judgement.

They must balance multiple calls, instantly triage those calls, make sure the necessary response is en route, information is given and everyone is accounted for.

Training

Like their colleagues in the field, dispatchers have to undergo weeks of initial training and continuing education as well as specialized training.

To begin with, each must take a two-day, state-mandated class to learn how to answer a 9-1-1 call.

Fairpoint Communications, which provides the 9-1-1 service, runs the course at the criminal justice academy.

Then there are three days learning the Emergency Medical Dispatch (EMD) protocol and software. This is taught by Fred Hurtado of Priority Dispatch Corp. which created the protocols and software. Priority Dispatch is approved by the National Academies of Emergency Dispatch® (NAED).

A week-long NCIC (National Criminal Information Center) class qualifies dispatchers to dispatch law enforcement.

A three-day Emergency Telecommunications course at the police academy and a CPR course taught by Med Care round out the initial training a dispatcher undergoes before being allowed anywhere near the dispatch consoles.

Dispatchers are licensed EMS and EMD operators and must seek continuing education credits on a regular basis.

Traffic controlOf the five computer screens the first two to the left of each dispatcher are the mapping and ANI/ALI screens. ANI is Address Number Info and ALI is Address Line Info. This screen also carries the TTY (Teletypewriter) capability as well. This enables those who cannot hear to place calls and communicate via the written word.

Back in the day of land lines being the primary mode of communication the arrival of E9-1-1 or Enhanced 9-1-1 enabled dispatchers to immediately know the exact address from which a 9-1-1 call was originating.

It changed the face of emergency dispatching allowing much faster response times and, in the case of a hang-up (which happens frequently in domestic assault situations), dispatchers knew exactly where to send police without having to call back and hope that the caller would, or could, answer.

Today, however, cell phones are the primary tool for communication and unless the cell phone is a newer model with GPS capability, dispatchers can only identify a 20-mile radius or the tower which is transmitting the call. Without specific information from the caller it is impossible to locate the specific address where the emergency is.

The next screen is the CAD (Computer Assisted Dispatch) and EMD, on which dispatchers can pull up information/records on an individual.

The fifth screen is the "radio" screen. This is accessed either by touch or by cursor. On this screen the correct tower is enabled, as well as the agency they are contacting. It automatically sends out the correct tone (in the case of fire or rescue) followed by the dispatcher's message. There is a foot pedal as well as a manual button or the touch screen that activates the microphone.

In addition, there is a newer notification system – PageGate. This is an automatic paging system. A dispatcher types a text message alerting fire or rescue personnel of an incident and the text is sent automatically to all the department member's cell phones. This backs up the radio tones to ensure that everyone knows they are being called to an incident be it a fire, medical emergency, crash, etcetera.

ProQA

ProQA is a software that gives dispatchers medically necessary sets of questions for the myriad types of medical emergency calls they will get. It then determines the severity of the emergency and the type of response needed.

For example, a 9-1-1 call comes in for an ambulance. A set series of questions must be asked by the dispatcher to determine if the rescue response should be Code 1 or Alpha (normal response – perhaps for someone who has fallen and needs help getting up) or a full Code 3 or Delta (lights, sirens, top speed such as for someone who has stopped breathing). (There is also an Echo designation which is reserved for calls of the disaster nature.)

At the call-taker's desk the information is typed into the ProQA form which instantly appears on the fire/rescue desk screen. Fire/rescue dispatcher then tones out appropriate first responder/ambulance response providing them with as much information as the 9-1-1 caller could provide. This enables the medical team to respond efficiently when they arrive, already knowing the nature and severity of the call.

"Sometimes people get really upset with us for asking all these questions," said Cammie Sprague, shift supervisor. "They just want us to send an ambulance."

"What they don't realize is that every question helps us help them," she explained.

CAD

Oxford County uses the Spillman Computer Assisted Dispatch (CAD) system for law enforcement dispatching. It is used by all but two agencies in the Oxford County dispatch area. (The two hold-outs are Paris and Fryeburg police departments which use a completely different system.)

CAD enables dispatchers to instantly communicate with law enforcement via computer with notes and details of the calls, wants, warrants, vehicle registration, orders of protection and bail conditions. This serves multiple purposes.

It keeps such information off the air, forms a complete record for future charges and court proceedings, keeps all the information in one database so all involved in an incident can have the same information, tracks 9-1-1 calls, maps emergency situations, traces dispatched units in real time and gives the responding officer a fuller picture of what he or she is dealing with enabling them to approach each situation in the safest manner.

In addition to dispatching, the dispatchers have paperwork, entering warrants, notarizing law enforcement documents, updating databases, etc. which are also their responsibility as well as dealing with walk-ins, often looking for the jail and law enforcement stopping by for paperwork or a quick chat.

On shifts where multiple calls are coming in one after another, juggling fires, crashes, rescue calls and police emergencies, the ability of the team to work as one, efficiently, calmly and professionally is what keeps the residents and emergency personnel in the county safe.

Cammie Sprague, Candace Jack and Katie Huggins sit at their stations. Huggins, a part-time dispatcher and mother of three, is at the call-taker desk. It is her responsibility to answer the 9-1-1 calls that come as well as the "business" line (non-emergency) calls.

Sprague and Jack are full-time dispatchers and moms. Sprague is the shift supervisor.

Sprague settles herself at the fire/rescue desk and Jack at the law desk.

911 team
TEAMWORK — The night shift at the Oxford County Regional Communication Center shares a moment of camaraderie after a tense half-hour of juggling multiple calls. From left, Melissa Adams, Cammie Sprague, Nicole Newton and Candace Jack. The team shares a mutual respect for each other as well as a friendship that carries off duty.

Although Friday and Saturday nights are slated to have four dispatchers on because traffic volume usually increases on these nights, the fourth dispatcher on this night team, Nicole Newton, is out sick, a victim of the norovirus raging through the county. Melissa Adams, a part-time dispatcher and full-time PACE EMT will be in at 10 p.m. to cover that slot.

Huggins is the newbie tonight with only a year on the job. Sprague has eight years and Jack, nine.

Huggins and Jack were CNAs prior to becoming dispatchers. Sprague had no emergency service background.

All three enthusiastically love their job. And they take pride in being a professional and competent team.

"We are the first responders," said Sprague.

"But all we have to work with," noted Jack, "is the voice on the other end of the call."

Jack said often that voice and what went down during the call gets stuck in their heads for a long time ... especially on a "bad" call.

"When you have a bad call, when it's over, you take a break, go outside, and have a good cry," she said.

"We're mothers, fathers, sisters, brothers, too," added Sprague, saying that they can all empathize with the caller or victim. "But we have to maintain focus."

In order to do their job, they have to remove their personal reactions and feelings from the equation and deal with each emergency from a professional, unemotional standpoint. This is not always easy. Fairly often, because the dispatchers live locally, they might know the caller. They usually always know the police officers, fire personnel and EMTs involved.

"Things happen a lot to people you know," said Sprague.

Sprague said she rarely tells a caller she knows who she is. "It works better that way," she explained, "although once in a while, I might." 

For example, she had a call from a friend who was extremely anxious. By identifying herself to the friend, she was able to calm the caller down until emergency responders arrived.

And then there's the call where they hear the last breath of the person on the other end. Those calls stick with them.

"I can still hear the screams of a mother whose child died," said Jack. "We have nightmares from those calls." For years.

There is a relaxed camaraderie amongst the dispatchers. It is a very quiet night which makes their job that much more difficult. A 12-hour shift is a long time to not get many calls and boredom can set in quickly.

Although there are other components to the job, such as paperwork, warrants to be entered into the system, faxes from other agencies, the jail, updates that need to be entered and sent to law enforcement, those are done quickly.

Jack's solution to boredom is to clean. She meticulously wipes down the desks, sweeps the floor, sanitizes the headpiece she wears, washes the floor and refills the humidifier. Then she heads to the kitchen and bathroom to do the same. Jack is a self-professed OCD who can't sit still and do nothing.

Huggins and Sprague chat quietly and Adams studies a three-inch thick textbook for the paramedic exam she has coming up.

Around midnight, a deputy and two area police officers stop in for paperwork and a quick chat.

There is a lot of good natured ribbing back and forth about whose job is more important.

Eventually the officers and deputy head back to their respective patrols and quiet settles in.

Trial by fire

In most jobs there is a training period. Usually those periods are anywhere from 30 to 90 days. For a dispatcher the training period is more like eight to 12 months. Even then, because of the focus of the four desks, a dispatcher may have had more time on some than others.

"I remember my first time on fire," said Sprague. "I had just been hired full-time [having worked for months part-time] and my supervisor at the time had the approach that if 'they' thought I was qualified for the full-time spot then 'have at it.'"

A structure fire came in and, according to Sprague, she didn't handle it well. "I was terrified and got little support from the other desks." For a long time after that, she was nervous at the fire desk. Now, it's her favorite desk and, she says, her strength.

As a supervisor, she believes in assigning her team to their strengths. For example, Jack is outstanding on the law desk so that is her assignment on Sprague's team.

Sprague takes the fire desk which is arguably, the most complicated when  there is a big emergency such as a multi-response structure fire.

Anyone who has listened to a scanner can hear multiple fire personnel calling in to dispatch with their status, often stepping on each other's calls (talking at the same time) which makes the dispatcher's job very difficult.

The dispatcher has to be able to separate those responses, answer by repeating whatever was said to them and giving the fire or rescue personnel the time of the transmission. When transmissions are coming in on top of each other it can be very stressful.

Dispatcher shifts are currently arranged to the benefit of the bottom line. In the past, dispatchers worked eight-hour shifts but this set-up over seven days resulted in weekly overtime being paid.

Now, they are on 12-hour shifts – three a week – and one four-hour shift. While this eliminates overtime, it wreaks havoc with the dispatchers' sleep cycles – especially those on the night shift teams.

Most have families and, in the case of Sprague's team, are moms. Jack has six children and they need her attention. After getting off work at 6 a.m. she plans to go home, clean, take her kids skating and, maybe, fit some sleep in her day.

Sprague has trouble sleeping. All of them, often, need some sort of aid in order to sleep. Most don't get enough sleep.

The other sacrifice they regularly make are missed holidays with their families.

"I haven't had one Christmas with my kids," said Jack. "But this year, for the first time, I got to have Thanksgiving with them!"

There are not a plethora of extra dispatchers available so when a shift needs coverage, dispatchers are called in regardless of whether they had a holiday off. This happens a lot, according to the dispatchers.

And vacations away? "Forget it," said Jack. "We take our vacations in 45-minute increments," she laughed.

Good calls, bad calls

For Jack, on her first day of training she had a 16-year-old deliver a 17-year-old's baby in a car on the side of the road.

"I earned my 'Stork Wings' that day," she laughed.

Newton has had the misfortune of being on each desk as bad calls have come in.

Sometimes 9-1-1 calls are from elderly who may not have a big emergency but they are simply lonely. The dispatcher will try and take some time to talk with these callers if there are no other emergencies coming in.

"You take five minutes," said Huggins, "and it means the world to them."

"If we can't talk to them right then, sometimes we'll call back," said Jack.

Sometimes we have to practice what is called 'Verbal Judo,'" said Huggins. There is a training course in this as well. It is the process a dispatcher needs to go through to get the caller to calm down and answer the necessary questions in order for the dispatcher to send the appropriate response and to notify the responders exactly what they can expect when they arrive.

This is often necessary in medical calls where the caller is understandably upset, panicked or, sometimes, hysterical.

For example, the call-taker may have to walk someone through doing CPR. The Verbal Judo comes in when the caller shies away from doing so.

It is a judgement call on the part of the call-taker who has only the information given to them by the caller to work with, as they cannot see the victim. They have to ascertain how long a person has not been breathing or has had no pulse in order to make the determination to have someone start CPR.

So the dispatcher talks with the caller and, often, convinces the caller to start CPR. This has saved lives, said Huggins.

Dispatchers have "delivered" babies over the phone as well, earning their "Stork Wings."

The ProQA aides them in the procedure for every medical emergency.

But when a call goes "bad" there is no one as hard on the dispatchers as themselves. Regardless of the fact they did everything right and there was nothing more they could have done to change the outcome, the dispatchers shoulder the guilt.

When there's a "bad" call, dispatchers are given a debriefing opportunity the same as fire, rescue and law enforcement personnel. This is a state team that comes in to talk through the incident with those who took part. Newton says she needed that debriefing after a recent "bad" call.

"It helped," she said, but it doesn't take away the memory.

Non-emergency calls

And then there are the daily (and nightly) non-emergency calls to 9-1-1.

"My neighbor is blowing their snow onto my property," is an example they chuckle about.

Or the press calls, in the middle of an emergency, to "confirm" there is an emergency because it was heard on the scanner.

"What you heard is what we know," said Jack, "so go see for yourself!"

Dispatchers are not allowed to give any information to the press. They only information they can give is which agency the press need to contact.

Jack said that nightly they get a press call asking if anything has happened that night. "No murders, no rapes, no kidnappings," is her pro forma answer ... every time. Now, when she starts saying that, the reporter hangs up on her.

Not so quiet

Another night a week later – a Friday – and a bitter cold one, it is not so quiet at dispatch. On this shift, Newton has recovered from her bout with the flu and is back on the call-taker desk. Sprague is on fire, Jack on law and Adams on Rumford.

As the team arrives for their shift, they exchange notes with the outgoing team. This team includes Joe Cormier, Keith Tilsley and Supervisor Steve Cordwell.

Each member of the team logs into the desk she will be manning, plugs in her respective head set and settles in.

Not long into the shift there is a medical call. Sprague dispatches PACE.

Soon after there is a call for flames shooting from a chimney in Denmark. The caller is a bit vague about the exact location simply describing it as a canoe rental place.

Sprague, Adams and Newton work to direct the fire personnel to the address. This is done based on what the caller described and their personal knowledge of the area. The fire department arrives at the correct address.

A few more calls come in. Law enforcement calls for a registration check. Jack's fingers fly over the keyboard as she runs the registration, as well as the background on the registered owner or the driver, if a different individual.

In seconds she has brought up whatever information there is on the subject, copied and pasted into the CAD form and sent it to the officer's computer so he or she knows exactly what they are dealing with.

This can be life-saving information if the subject is known to be combative, have weapons or dislike law enforcement.

There are a number of 9-1-1 calls that ring and then disconnect. Dispatchers immediately call back. If no one answers, law enforcement is dispatched to follow up if the dispatcher can ascertain the address from which the call originated.

This is important especially in the case of domestic violence. Sometimes when they call back they are told "everything is fine, it was a 'pocket call,'" but when an officer arrives they will find it was actually an assault in progress.

This happens approximately half the time, Jack guessed.

Jack's job on the law desk also includes keeping track of the many officers out on patrol. When she sends an officer into an unknown situation especially a domestic, she is mandated to check on the officer's status every three to five minutes.

While this can be problematic or irritating for the officer, Jack has no choice. And should the call go "bad," Jack knows immediately and can send more reinforcements.

She always runs a history of the address the officer is responding to whether asked for or not.

"I want to know what my guys are getting into," said Jack.

She will then notify the responding officer if there are weapons, and ask if she should send back up.

"If I'm going home, they're going home."

Jack has been recognized for her work. In 2010 she was honored for talking a domestic assault victim out of the situation and into a safe place until help could arrive. That same year she convinced the parents of an injured child to let her talk with the child to calm him down until the ambulance arrived.

Jack shrugs it off with the comment that all dispatchers do the same thing, and all should be recognized.

Dispatchers have a rule of thumb – "when in doubt, send them out" – meaning that even if it is unclear if there is an emergency, they send a response.

20:35 – the 9-1-1 line rings. The caller can be heard across the room. It is an hysterical caller in Paris and Newton's voice instantly goes into a soothing, level mode as she attempts to calm the caller down and get the necessary information. She manages to get an address from the caller although exactly what is wrong, other than the caller being in a snowbank and very cold, is not clear.

Sprague immediately dispatches rescue and Jack dispatches law enforcement. The dispatchers take no chances and cover all probabilities. Has the caller been assaulted? Is it a domestic violence situation? Was there a crash?

Newton can't immediately get answers to those questions just the repeated snowbank and cold. Newton asks the requisite question in many different ways, jumping from one question to another then returning to the unanswered ones. Eventually she gets a bit more information. Her voice and tone never change.

20:44 – an alarm comes in in Paris and Jack dispatches an officer to check into it. The Paris chief calls in that he will respond as well.

20:46 – a 9-1-1 call comes in regarding a threat in Paris. Jack diverts the chief from the first call to investigate.

20:48 – a 9-1-1 call comes in reporting a chimney fire. Sprague dispatches the automatic mutual aid for this call.

20:54 – a 9-1-1 call comes in about horses loose on a road in Norway.

Although there were nine minutes between the first call and the second, there were only two, two and six minutes between the next three calls. Consequently, all four dispatchers were answering the 9-1-1 line, dispatching response and following up, keeping track of where various personnel were and what was happening.

Newton is still on the line with the first call. Adams is answering the next 9-1-1 call. Jack is dispatching law to that call and answering the third 9-1-1 call. Newton is off the first call and answering the fourth. Sprague is dispatching fire departments and keeping up with their responses. Jack is dispatching law enforcement. Adams dispatches other law enforcement.

The phone rings again to cancel the horses call – they have been rounded up.

The dispatch center never reflected the tension or stress involved in juggling these multiple calls, minutes apart. To the untrained, however, it was incredibly stressful, but very impressive.

When things quieted down, Newton and Sprague sat back and picked up the relaxed chat where it had been left when the phone started ringing.

Adams went back to her textbook.

Jack started cleaning.