Rescue Codes

[redmonds]

I have been trying to figure out the new codes for my county and another local county that I work in. They both seem to be using the same code system, which is great, except I can't seem to get either one of them to let me in on the new code system. I was wondering if someone else might have an idea of what the codes are. Here is an example of some of the code that I am hearing...29 Bravo 9...we have 4 green...alpha, charlie, delta...etc? Usually, after the initial code call out, there seems to be what I would call a description of the EMD in regular language.

Thanks,

[n7lxi]

Medical Priority Codes
Abdominal Pain
1-D-1 Not alert
1-C-1 Fainting or near fainting >50 y/o
1-C-2 Females w/ fainting or near fainting 12-50 y/o
1-C-3 Males w/ pain above navel >45 y/o
1-C-4 Females w/ pain above navel >45 y/o
1-A-1 Abdominal pain

Allergic Reaction
2-E-1 Ineffective breathing
2-D-1 Severe respiratory distress
2-D-2 Not Alert
2-D-3 Conditioning worsening
2-D-4 Swarming attack (bees)
2-D-5 Snakebite
2-C-1 Difficulty breathing or swallowing
2-C-2 Special medications or injections used
2-B-1 Unknown status (3rd party caller)
2-A-1 No difficulty breathing or swallowing
2-A-2 Spider Bite

Animal Bites
3-D-1 Unconscious or arrest
3-D-2 Not alert
3-D-3 Dangerous body area
3-D-4 Large animal
3-D-5 Exotic animal
3-D-6 Attack or multiple animals
3-B-1 Possibly dangerous body area
3-B-2 Serious hemorrhage
3-B-3 Unknown status (3rd party caller)
3-A-1 Not dangerous body area
3-A-2 Non-recent injuries >6 hours
3-A-3 Superficial bites

Assault
(A= Assault/ S= Sexual Assault)
4-D-1 Unconscious or arrest
4-D-2 Not alert
4-D-3 Abnormal breathing
4-D-4 Dangerous body area
4-D-5 Multiple victims
4-B-1 Possibly dangerous body area
4-B-2 Serious hemorrhage
4-B-3 Unknown status (3rd party caller)
4-A-1 Not dangerous body area
4-A-2 Non-recent injuries >6 hours

Back Pain
5-D-1 Not alert
5-C-1 Fainting or near fainting >50 y/o
5-A-1 Non-traumatic
5-A-2 Non-recent injuries >6 hours

Breathing Difficulty
(A=Asthma)
6-E-1 Ineffective breathing
6-D-1 Severe respiratory distress
6-D-2 Not alert
6-D-3 Clammy
6-C-1 Abnormal breathing
6-C-2 Cardiac history

Burn Subject
7-D-1 Unconscious or arrest
7-D-2 Severe respiratory distress
7-D-3 Not alert
7-D-4 Explosion
7-D-5 Multiple victims
7-C-1 Building fire w/ persons inside
7-C-2 Difficulty breathing
7-C-3 Burns >18% BSA
7-B-1 Unknown status (3rd party caller)
7-A-1 Burns <18% BSA
7-A-2 Fire alarm unknown situation
7-A-3 Sunburn or minor burns

Hazardous Exposure
8-D-1 Unconscious or arrest
8-D-2 Severe respiratory distress
8-D-3 HAZ-MAT
8-D-4 Not alert
8-D-5 Multiple victims
8-D-6 Unknown status (3rd party caller)
8-C-1 Alert w/ difficulty breathing
8-B-1 Alert w/o difficulty breathing
8-A-1 CO alarm- EMS requested

Cardiac Arrest
9-E-1 Not breathing at all
9-E-2 Breathing uncertain
9-E-3 Hanging
9-E-4 Strangulation
9-E-5 Suffocation
9-E-6 Underwater
9-D-1 Ineffective breathing
9-B-1 Obvious death

Chest Pain
10-D-1 Severe respiratory distress
10-D-2 Not alert
10-D-3 Clammy
10-C-1 Abnormal breathing
10-C-2 Cardiac history
10-C-3 Cocaine
10-C-4 Breathing normally >35 y/o
10-A-1 Breathing normally <35 y/o

Choking
11-E-1 Choking verified/ ineffective breathing
11-D-1 Not alert
11-D-2 Abnormal breathing
11-A-1 Not choking now

Seizures
12-D-1 Not breathing
12-D-2 Continuous or multiple seizures
12-D-3 Irregular breathing
12-D-4 Breathing regularly not verified >35 y/o
12-C-1 Pregnancy
12-C-2 Diabetic
12-C-3 Cardiac history
12-B-1 Breathing regularly not verified <35 y/o
12-A-1 Not seizing now & breathing verified

Diabetic Problems
13-D-1 Unconscious
13-C-1 Not alert
13-C-2 Abnormal behavior
13-C-3 Abnormal breathing
13-A-1 Alert

Drowning
14-D-1 Unconscious
14-D-2 Not alert
14-D-3 Diving or neck injury
14-D-4 SCUBA accident
14-C-1 Alert w/ abnormal breathing
14-B-1 Alert & breathing normally w/ injuries
14-B-2 Unknown status (3rd party caller)
14-A-1 Alert & breathing normally w/o injuries

Electrocution
(E=Electrocution/ L= Lightning)
15-E-1 Not breathing / ineffective breathing
15-D-1 Unconscious
15-D-2 Not disconnected from power
15-D-3 Power not off
15-D-4 Long fall >6 ft.
15-D-5 Not alert
15-D-6 Abnormal breathing
15-D-7 Unknown status (3rd party caller)
15-C-1 Alert & breathing normally

Eye Problem
16-D-1 Not alert
16-B-1 Severe eye injuries
16-A-1 Moderate eye injuries
16-A-2 Minor eye injuries
16-A-3 Medical eye problems

Falls
17-D-1 Dangerous body area
17-D-2 Long fall >6 ft.
17-D-3 Not alert
17-D-4 Abnormal breathing
17-B-1 Possibly dangerous body area
17-B-2 Serious hemorrhage
17-B-3 Unknown status (3rd party caller)
17-A-1 Not dangerous body area
17-A-2 Non-recent injuries >6 hrs.

Headache
18-C-1 Not alert
18-C-2 Abnormal breathing
18-C-3 Speech problems
18-C-4 Sudden onset of severe pain
18-C-5 Numbness or paralysis
18-C-6 Change in behavior
18-B-1 Unknown status (3rd party caller)
18-A-1 Breathing normally

Heart Problem
19-D-1 Severe respiratory distress
19-D-2 Not alert
19-D-3 Clammy
19-C-1 Firing of AICD
19-C-2 Abnormal breathing
19-C-3 Chest pain >35 y/o
19-C-4 Cardiac history
19-C-5 Cocaine
19-C-6 Heart rate <50 or >130
19-B-1 Unknown status (3rd party caller)
19-A-1 Heart rate >50 or <130 w/o symptoms
19-A-2 Chest pain <35 y/o w/o symptoms

Environmental Exposure
20-D-1 Not alert
20-C-1 Cardiac history
20-B-1 Change in skin color
20-B-2 Unknown status (3rd party caller)
20-A-1 Alert

Hemorrhage
21-D-1 Dangerous hemorrhage
21-D-2 Not alert
21-D-3 Abnormal breathing
21-C-1 Hemorrhage through a tube
21-B-1 Possibly dangerous hemorrhage
21-B-2 Serious hemorrhage
21-B-3 Bleeding disorder or blood thinners
21-A-1 Non dangerous hemorrhage
21-A-2 Minor hemorrhage

Industrial Accidents
22-D-1 Life status questionable
22-D-2 Caught in machinery
22-D-3 Multiple victims
22-B-1 Unknown status (3rd party caller)

Overdose
(A=Accidental/I=Intentional/P=Poisoning)
23-D-1 Unconscious
23-D-2 Severe respiratory distress
23-C-1 Violent
23-C-2 Not alert
23-C-3 Abnormal breathing
23-C-4 Antidepressants
23-C-5 Cocaine
23-C-6 Narcotics
23-C-7 Acid or Alkali
23-C-8 Unknown status (3rd party caller)
23-C-9 Poison Control request for response
23-B-1 Overdose without symptoms
23-O-1 Poisoning w/o priority symptoms

Pregnancy
24-D-1 Breech or cord
24-D-2 Head visible
24-D-3 Imminent delivery > 5 months
24-D-4 3rd trimester bleeding
24-D-5 High risk complications
24-D-6 Baby born
24-C-1 2nd trimester hemorrhage or miscarriage
24-C-2 1st trimester serious hemorrhage
24-B-1 Labor > 5 months
24-B-2 Unknown status (3rd party caller)
24-A-1 1st trimester hemorrhage or miscarriage

Psychiatric Problem
25-D-1 Not alert
25-B-1 Violent
25-B-2 Threatening suicide
25-B-3 Near hanging
25-B-4 Unknown status (3rd party caller)
25-A-1 Non-violent & non-suicidal

Sick Call
26-D-1 Not alert
26-C-1 Cardiac history
26-B-1 Unknown status (3rd party caller)
26-A-1 No priority symptoms
26-A-2 Boils
26-A-3 Bumps
26-A-4 Cannot sleep
26-A-5 Cannot urinate
26-A-6 Catheter problems
26-A-7 Constipation
26-A-8 Cramps/spasms
26-A-9 Cut-off ring request
26-A-10 Deafness
26-A-11 Defecation/diarrhea
26-A-12 Earache
26-A-13 Enema
26-A-14 Gout
26-A-15 Hemorrhoids/piles
26-A-16 Hepatitis
26-A-17 Hiccups
26-A-18 Hungry
26-A-19 Nervous
26-A-20 Object stuck
26-A-21 Object swallowed
26-A-22 Penis problems
26-A-23 Rash/skin disorder
26-A-24 STD
26-A-25 Sore throat
26-A-26 Toothache
26-A-27 Transportation only
26-A-28 Wound infected

Stab/Gunshot/Penetrating Trauma (S, G, or P)
27-D-1 Unconscious or arrest
27-D-2 Not alert
27-D-3 Central wounds
27-D-4 Multiple wounds
27-D-5 Multiple victims
27-B-1 Non-recent injuries >6 hrs./ central wound
27-B-2 Known single peripheral wound
27-B-3 Serious hemorrhage
27-B-4 Unknown status (3rd party caller)
27-A-1 Non-recent >6 hrs. peripheral wounds

Stroke
28-C-1 Not alert
28-C-2 Abnormal breathing
28-C-3 Speech or movement problems
28-C-4 Numbness or tingling
28-C-5 Stroke history
28-C-6 Breathing normally > 35 y/o
28-B-1 Unknown status (3rd party caller)
28-A-1 Breathing normally < 35 y/o

Traffic Collision
29-D-1-A Major incident (aircraft)
29-D-1-B Major incident (bus)
29-D-1-D Major incident (train)
29-D-1-E Major incident (watercraft)
29-D-2-A High mechanism (all-terrain)
29-D-2-B High mechanism (motorcycle)
29-D-2-C High mechanism (auto-pedestrian)
29-D-2-D High mechanism (ejection)
29-D-2-E High mechanism (personal watercraft)
29-D-2-F High mechanism (rollovers)
29-D-2-G High mechanism (vehicle off bridge/height)
29-D-3 HAZMAT
29-D-4 Pinned
29-D-5 Not alert
29-B-1 Injuries
29-B-2 Multiple victims (one unit)
29-B-3 Multiple victims (additional units)
29-B-4 Serious hemorrhage
29-B-5 Unknown status (3rd party caller)
29-A-1 1st party caller w/ non-dangerous injury

Traumatic Injuries
30-D-1 Dangerous body area
30-D-2 Not alert
30-D-3 Abnormal breathing
30-B-1 Possibly dangerous body area
30-B-2 Serious hemorrhage
30-A-1 Not dangerous body area
30-A-2 Non-recent injuries>6 hrs.

Subject Unconscious
31-E-1 Ineffective breathing
31-D-1 Unconscious
31-D-2 Severe respiratory distress
31-D-3 Not alert
31-C-1 Alert w/ abnormal breathing
31-C-2 Cardiac history
31-C-3 Multiple fainting episodes
31-C-4 Single or near fainting episode & alert
31-C-5 Female 12-50 w/ abdominal pain
31-A-1

Medical Nature Unknown
32-D-1 Life status questionable
32-B-1 Standing, moving, sitting, or talking
32-B-2 Medical alert notification
32-B-3 Unknown status (3rd party caller)

Transfers
(T=Transfer/ I=Interfacility)
33-D-1 Suspected cardiac or respiratory arrest
33-C-1 Not alert (acute change)
33-C-2 Abnormal breathing
33-C-3 Significant hemorrhage or shock
33-C-4 Possible acute heart problems or MI
33-C-5 Acute severe pain
33-C-6 Emergency response requested
33-A-1 No priority symptoms

[redmonds]

Thanks n7lxi.

This is starting to make some sense now. Is this the new code that everyone may be going to one day? I know there were some issues with 9/11 and also New Orleans and Katrina.

Rodney

[daleduke17]

Yes, those are the EMD codes. Omega,Alpha, Bravo, Charlie, Delta, and Echo are codes for the seriousness of the call.

The first number is the page on the EMD book that the primary symptom is on. Page 9 is cardiac arrest for instance. Page 26 is a catch all (or is it 29?)

Omega - refer to another jurisdiction (Poison Control, Suicide Prevention, DCFS)
Alpha - BLS no lights/sirens. No ALS
Bravo - BLS lights/sirens. No ALS
Charlie - BLS lights/Sirens. ALS no lights/sirens
Delta - BLS and ALS lights/sirens
Echo - this is reserved for immediate death situations. This will get BLS and ALS lights and sirens, plus a close unit with a defibrilator or other life saving needs.

The last number is another part of the primary symptom. It gives a more exact description of the problem.

http://www.memphisfire.net/divisions/ems/EMD-Cards.pdf

Here is a good copy of actual EMD cards.

So, lets use page 1, Abdomial Pains for an example. Call Taker answers the phone and they go through the script on the first page of "Abdominal Pains"

Call Taker: 911, what is the telephone number you are calling from?
Caller: 555-1212
Call Taker: What is your address?
Caller: 127 Mount Evans Point. Carlock.
Call Taker: What is the emergency?
Caller: My son is complaining of stomach pains
Call Taker: Is he completely awake?
Caller: No. He was, but he isn't now.
Call Taker: I'm sending the paramedics, stay calm and I'll tell you what to do next.

Then, the call taker sends the information to the fire/rescue dispatcher as the call taker goes to another page to give instructions on determining if the patient is breathing, or if CPR is needed to be done.

On the dispatcher side, you would hear this (I'll use random units for the ambulance numbers)

"*Tone* Carlock Rescue, Carlock Ambulane. You're needed at 127 Mount Evans Point in Carlock for a 1-D-1. "

The reason for "1-D-1" is that it was the first primary symptom. The Delta response was due to the boy not being alert. The second 1 was that he wasn't alert. Some pages have multiple ones (like 9-E).

Hope that helps you out on figuring out the EMD codes.

-Dale

[bpckty1]

Does anyone have a list of Fire Determinant Codes? A local VFD is using codes such as 51-D-1, 55-A-3, etc.

[SAR2401]

Great list Rob but you'd better have a good memory or a lot of wallet cards on you to use this system. What happened to plain English? I thought the fire service was leading the charge for this. A complicated code system seems like a giant step backwards.

[daleduke17]

Originally Posted by SAR2401

Great list Rob but you'd better have a good memory or a lot of wallet cards on you to use this system. What happened to plain English? I thought the fire service was leading the charge for this. A complicated code system seems like a giant step backwards.

One of the better parts of the EMD code system is that you don't have every Tom, Dick and Harry (no offense to anyone with those names) knowing what their neighbors have for medical problems. Personally I wouldn't want my neighbors knowing if I had certain medical problems. (26-A-2-22 is definately one of them) Plus, if it were something serious such as a suicidal person, drowning, or something else serious like that, the media doesn't need to know right as the call is being toned. They can wait to hear it on the SO's channel, or they can wait to read the media copy of the report later.

Then there is the issue of looky-loo's. I don't even want to start on that one.

[Jay911]

Originally Posted by bpckty1

Does anyone have a list of Fire Determinant Codes? A local VFD is using codes such as 51-D-1, 55-A-3, etc.

That's an extension of the Medical Priority Dispatch System, called (drumroll) the Fire Priority Dispatch System. Here is a link I pulled from one of the threads elsewhere in this forum from the last time this came up.

Originally Posted by daleduke

One of the better parts of the EMD code system is that you don't have every Tom, Dick and Harry (no offense to anyone with those names) knowing what their neighbors have for medical problems. Personally I wouldn't want my neighbors knowing if I had certain medical problems. (26-A-2-22 is definately one of them) Plus, if it were something serious such as a suicidal person, drowning, or something else serious like that, the media doesn't need to know right as the call is being toned. They can wait to hear it on the SO's channel, or they can wait to read the media copy of the report later.

Actually, daleduke, the intent was never to obfuscate; SAR2401 has a valid point. The intent of EMD is to provide a quick reference to the dispatcher so that calls can be entered and dispatched swiftly and efficiently. Any center that is dispatching (voicing) a "29B/06" instead of a "Traffic Accident with unknown injuries" is not following the guidelines set out by the MPDS's authors/manufacturers. When I dispatch I am always using plain English. That's the reason that there's a plain English component to the card's name, right beside the number (which should be used as a quick-reference, to locate the right card and flip to it quickly).

[w0fg]

NIMS, the National Incident Management System, mandates the use of plain language for reasons of interoperability. EMD codes, or even 10-Codes, are in contravention of the national standard.

[bpckty1]

Jay wrote:
"That's an extension of the Medical Priority Dispatch System"

Thanx

[bluelightspecial2800]

Originally Posted by w0fg

NIMS, the National Incident Management System, mandates the use of plain language for reasons of interoperability. EMD codes, or even 10-Codes, are in contravention of the national standard.

+ 1 on that. Our services are all now required by the county to use plain english.

[UFEMTFF]

Originally Posted by w0fg

NIMS, the National Incident Management System, mandates the use of plain language for reasons of interoperability. EMD codes, or even 10-Codes, are in contravention of the national standard.

Wrong.

It is not required on internal communications, only multi-agency incidents. See here: http://www.nimsonline.com/

Important parts highlighted:

It is required that plain English be used for multi-agency, multi-jurisdiction and multi-discipline events, such as major disasters and exercises. Beginning in the fiscal year that starts on Oct. 1, 2006, federal preparedness grant funding is contingent on the use of plain English in incidents requiring assistance from responders from other agencies, jurisdictions and functional disciplines.

While the NIMS Integration Center doesn’t require plain English for internal operations, we strongly encourage it. We believe it is important to practice everyday terminology and procedures that will need to be used in emergency incidents and disasters. NIMS implementation is a long-term effort and it's probably not possible to persuade everyone to change ingrained habits overnight. But we do hope that over time, everyone will understand the important of using common terminology, that is, plain English, every day

[bpckty1]

A couple of comments about the codes:

HIPPA Inspired?

Makes dispatching (and billing) easier. The call taker enters the Codes on CAD, but it reads out both the codes and complaints in plain English on the MDTs.

Dispatcher will state "Fall Victim, 17-B-2," when dispatching a unit. Everyone knows from the plain English that it is a fall victim, and then the Medic (and those few scannists with the list posted earlier in this discussion) refers to the code list to determine what may be needed at the scene.

[SAR2401]

Hmmm...the agencies that I've heard using these codes always have the same thing happen after dispatch. The fire unit or medic will come on and ask dispatch for more details on the call, after which the dispatcher will give more details in plain English since the codes only very generally describe the problem - see code 26-A-22 for one that will almost certainly elicit a response for more details. I can see on the CAD end how these codes would make billing and retrieving calls from a databse easier but I fail to see how they save any time on-air and only serve as a source of confusion. 26-A-2 and 26-A-22 will sound sufficiently similar on the radio that there will almost always be a request for clarification since both codes are for very different conditions.

[bpckty1]

"26-A-2 and 26-A-22 will sound sufficiently similar on the radio that there will almost always be a request for clarification since both codes are for very different conditions."

Unless.....

;^>