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PPGD - SPGDT Pra RS - BSB Sumbar/RS M Djamil

Medical Priority Dispatch System

The Medical Priority Dispatch System (MPDS) is a way of categorizing and prioritizing
EMS incidents. The MPDS assigns a number-letter-number format code to each type of
incident. The first number (one of the numbers 1 through 32) indicates the category of the
incident (e.g., breathing problem). The letter (one of the letters A through E) indicates the
priority of the incident. Letter "A" indicates the lowest priority incident and "E" indicates the
highest priority incident, however not all letters are used within each category. The second
number indicates the subcategory of the incident. The MPDS codes are also commonly
referred to as "Clawson Codes" because the MPDS categorization system was originally
designed by Dr. Jeff J. Clawson.

MPDS Codes

1 - Abdominal Pain

2 - Allergic Reaction

3 - Animal Bites

4 - Assault

5 - Back Pain

6 - Breathing Difficulty

7 - Burn Subject

8 - Hazardous Exposure

9 - Cardiac Arrest

10 - Chest Pain

11 - Choking

12 - Seizures

13 - Diabetic Problems

14 - Drowning

15 - Electrocution

16 - Eye Problem

17 - Falls

18 - Headache

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19 - Heart Problem

20 - Environmental Exposure

21 - Hemmorrhage

22 - Industrial Accidents

23 - Overdose

24 - Pregnancy

25 - Psychiatric Problem

26 - Sick Call

27 - Stab/Gunshot/Penetrating Trauma (S, G, or P)

28 - Stroke

29 - Traffic Collision

30 - Traumatic Injuries (specific)

31 - Subject Unconscious

32 - Medical Nature Unknown

33 - Transfer

MPDS Codes

Priority System

Alpha Response=Code 1--Low Priority

Bravo Response=Code 2--Mid Priority (calls that may involve First Responders)

Charlie Response=Code 3--Possibly Life Threatening

Delta Response=Code 3--Life Threatening

Echo Response=Code 3--Full Arrest or Imminent Death

Omega Response=Code 1--Lowest Priority

1 - Abdominal Pain

Code! Sub Category

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1D1! ! Not alert

1C1! ! Fainting or near fainting >50 y/o

1C2! ! Females fainting or near fainting 12-50 y/o

1C3! ! Males w/ pain above navel >45 y/o

1C4! ! Females w/ pain above navel >45 y/o

1A1! ! Abdominal pain

2 - Allergic Reaction

Code! Sub Category

2E1! ! Ineffective breathing

2D1! ! Severe respiratory distress

2D2! ! Not alert

2D3! ! Condition worsening

2D4! ! Swarm attack (bees)

2D5! ! Snakebite

2C1! ! Difficulty breathing or swallowing

2C2! ! Special medications or injections used

2B1! ! Unknown status (3rd party caller)

2A1! ! No difficulty breathing or swallowing

2A2! ! Spider bite

3 - Animal Bites

Code! Sub Category

3D1! ! Unconscious or arrest

3D2! ! Not alert

3D3! ! Dangerous body area

3D4! ! Large animal

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3D5! ! Exotic animal

3D6! ! Attack or multiple attack

3B1! ! Possibly dangerous body part

3B2! ! Serious hemorrhage

3B3! ! Unknown status (3rd party caller)

3A1! ! Not dangerous body area

3A2! ! Non-recent injuries >6 hours

3A3! ! Superficial bites

4 - Assault (A=Assault / S=Sexual Assault)

Code! Sub Category

4D1! ! Unconscious or arrest

4D2! ! Not alert

4D3! ! Abnormal breathing

4D4! ! Dangerous body area

4D5! ! Multiple victims

4B1! ! Possibly dangerous body area

4B2! ! Serious hemorrhage

4B3! ! Unknown status (3rd party caller)

4A1! ! Not dangerous body area

4A2! ! Non-recent injuries >6 hours

5 - Back Pain

Code! Sub Category

5D1! ! Not alert

5C1! ! Fainting or near fainting >50 y/o

5A1! ! Non-traumatic

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5A2! ! Non-recent injuries >6 hours

6 - Breathing Difficulty (A=Asthma)

Code! Sub Category

6E1! ! Ineffective breathing

6D1! ! Severe respiratory distress

6D2! ! Not alert

6D3! ! Clammy

6C1! ! Abnormal breathing

6C2! ! Cardiac history

7 - Burn Subject

Code! Sub Category

7D1! ! Unconscious or arrest

7D2! ! Severe respiratory distress

7D3! ! Not alert

7D4! ! Explosion

7D5! ! Multiple victims

7C1! ! Building fire w/ persons inside

7C2! ! Difficulty breathing

7C3! ! Burns >18% BSA

7B1! ! Unknown status (3rd party caller)

7A1! ! Burns 35 y/o

7A2! ! Fire alarm unknown situation

7A3! ! Sunburn or minor burn

8 - Hazardous Exposure

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Code! Sub Category

8D1! ! Unconscious or arrest

8D2! ! Severe respiratory distress

8D3! ! HAZMAT

8D4! ! Not alert

8D5! ! Multiple victims

8D6! ! Unknown status (3rd party caller)

8C1! ! Alert w/ difficulty breathing

8B1! ! Alert w/o diffuclty breathing

8A1! ! CO alarm--EMS requested

9 - Cardiac Arrest

Code! Sub Category

9E1! ! Not breathing at all

9E2! ! Breathing uncertain

9E3! ! Hanging

9E4! ! Strangulation

9E5! ! Suffocation

9E6! ! Underwater

9D1! ! Ineffective breathing

9B1! ! Obvious Death

10 - Chest Pain

Code! Sub Category

10D1! Severe respiratory distress

10D2! Not alert

10D3! Clammy

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! PPGD - SPGDT Pra RS - BSB Sumbar/RS M Djamil

10C1! Abnormal breathing

10C2! Cardiac history

10C3! Cocaine

10C4! Breathing normally >35 y/o

10A1!! Breathing normally <35 y/o

11 - Choking

Code! Sub Category

11E1!! Choking verified/ineffective breathing

11D1!! Not alert

11D2!! Abnormal breathing

11A1!! Not choking now

12 - Seizures

Code! Sub Category

12D1! Not breathing

12D2! Continuous or multiple seizures

12D3! Irregular breathing

12D4! Breathing regularly not verified >35 y/o

12C1! Pregnancy

12C2! Diabetic

12C3! Cardiac history

12B1!! Breathing regularly not verified 6 feet

12A1!! Not seizing now & breathing verified

13 - Diabetic Problems

Code! Sub Category

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13D1! Unconscious

13C1! Not alert

13C2! Abnormal behavior

13C3! Abnormal breathing

13A1!! Alert

14 - Drowning

Code! Sub Category

14D1! Unconscious

14D2! Not alert

14D3! Diving or neck injury

14D4! SCUBA accident

14C1! Alert w/ abnormal breathing

14B1!! Alert & breathing normally w/ injuries

14B2!! Unknown status(3rd party caller)

14A1!! Alert & breathing normally w/o injuries

15 - Electrocution (E=Electrocution / L=Lightning)

Code! Sub Category

15E1!! Not breathing/ineffective breathing

15D1! Unconscious

15D2! Not disconnected from power

15D3! Power not off

15D4! Long fall >6 feet

15D5! Not alert

15D6! Abnormal breathing

15D7! Unknown status (3rd party caller)

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! PPGD - SPGDT Pra RS - BSB Sumbar/RS M Djamil

15C1! Alert & breathing normally

16 - Eye Problem

Code! Sub Category

16D1! Not alert

16B1!! Severe eye injuries

16A1!! Moderate eye injuries

16A2!! Minor eye injuries

16A3!! Medical eye problems

17 - Falls

Code! Sub Category

17D1! Dangerous body area

17D2! Long fall >6 feet

17D3! Not alert

17D4! Abnormal breathing

17B1!! Possibly dangerous body area

17B2!! Serious hemorrhage

17B3!! Unknown status (3rd party caller)

17A1!! Not dangerous body area

17A2!! Non-recent injuries >6 hours

18 - Headache

Code! Sub Category

18C1! Not alert

18C2! Abnormal breathing

18C3! Speech problems

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18C4! Sudden onset of severe pain

18C5! Numbness or paralysis

18C6! Change in behavior

18B1!! Unknown status (3rd party caller)

18A1!! Breathing normally

19 - Heart Problem

Code! Sub Category

19D1! Severe respiratory distress

19D2! Not alert

19D3! Clammy

19C1! Firing of AICD

19C2! Abnormal breathing

19C3! Chest pain >35 y/o

19C4! Cardiac history

19C5! Cocaine

19C6! Heart rate 130

19B1!! Unknown status (3rd party caller)

19A1!! Heart rate >50 or 5 months

19A2!! Chest pain <35 y/o w/o symptoms

20 - Environmental Exposure

Code! Sub Category

20D1! Not alert

20C1! Cardiac history

20B1!! Change in skin color

20B2!! Unknown status (3rd party caller)

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! PPGD - SPGDT Pra RS - BSB Sumbar/RS M Djamil

20A1!! Alert

21 - Hemmorrhage

Code! Sub Category

21D1! Dangerous hemorrhage

21D2! Not alert

21D3! Abnormal breathing

21C1! Hemorrhage through a tube

21B1!! Possibly dangerous hemorrhage

21B2!! Serious hemorrhage

21B3!! Bleeding disorder or blood thinners

21A1!! Non-dangerous hemorrhage

21A2!! Minor hemorrhage

22 - Industrial Accidents

Code! Sub Category

22D1! Life status questionable

22D2! Caught in machinery

22D3! Multiple victims

22B1!! Unknown status (3rd party caller)

23 - Overdose (A=Accidental / I=Intentional / P=Poisoning)

Code! Sub Category

23D1! Unconscious

23D2! Severe respiratory distress

23C1! Violent

23C2! Not alert

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23C3! Abnormal breathing

23C4! Antidepressants

23C5! Cocaine

23C6! Narcotics

23C7! Acid or alkali

23C8! Unknown status (3rd party caller)

23C9! Poison Control request for response

23B1!! Overdose w/o symptoms

23O1! Poisoning w/o priority symptoms

24 - Pregnancy

Code! Sub Category

24D1! Breech or cord

24D2! Head visible

24D3! Imminent delivery >5 months

24D4! 3rd trimester bleeding

24D5! High risk complications

24D6! Baby born

24C1! 2nd trimester hemorrhage or miscarriage

24C2! 1st trimester serious hemorrhage

24B1!! Labor >5 months

24B2!! Unknown status (3rd party caller)

24A1!! 1st trimester hemorrhage or miscarriage

25 - Psychiatric Problem

Code! Sub Category

25D1! Not alert

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25B1!! Violent

25B2!! Threatening suicide

25B3!! Near hanging

25B4!! Unknown status (3rd party caller)

25A1!! Non-violent & non-suicidal

26 - Sick Call

Code! Sub Category

26D1! Not alert

26C1! Cardiac History

26B1!! Unknown status (3rd party caller)

26A1!! Non priority symptoms

26A2!! Boils

26A3!! Bumps

26A4!! Cannot sleep

26A5!! Cannot urinate

26A6!! Catheter problems

26A7!! Constipation

26A8!! Cramps/spasms

26A9!! Cut-off ring request

26A10! Deafness

26A11! Defecation/diarrhea

26A12! Earache

26A13! Enema

26A14! Gout

26A15! Hemorrhoids/piles

26A16! Hepatitis

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! PPGD - SPGDT Pra RS - BSB Sumbar/RS M Djamil

26A17! Hiccups

26A18! Hungry

26A19! Nervous

26A20! Object stuck

26A21! Object swallowed

26A22! Penis problems

26A23! Rash/skin disorder

26A24! STD

26A25! Sore throat

26A26! Toothache

26A27! Transport only

26A28! Wound infected

27 - Stab/Gunshot/Penetrating Trauma (S, G, or P)

Code! Sub Category

27D1! Unconscious or arrest

27D2! Not alert

27D3! Central wounds

27D4! Multiple wounds

27D5! Multiple victims

27B1!! Non-recent injuries >6 hours / central wounds

27B2!! Known single peripheral wound

27B3!! Serious hemorrhage

27B4!! Unknown status (3rd party caller)

27A1!! Non-recent >6 hours / peripheral wounds

28 - Stroke

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! PPGD - SPGDT Pra RS - BSB Sumbar/RS M Djamil

Code! Sub Category

28C1! Not alert

28C2! Abnormal breathing

28C3! Speech or movement problems

28C4! Numbness or tingling

28C5! Stoke history

28C6! Breathing normally >35 y/o

28B1!! Unknown status (3rd party caller)

28A1!! Breathing normally 6 hours

29 - Traffic Collision

Code! Sub Category

29D1A ! Major incident (aircraft)

29D1B ! Major incident (bus)

29D1D! Major incident (train)

29D1E! Major incident (watercraft)

29D2A ! High mechanism (all-terrain)

29D2B ! High mechanism (motorcycle)

29D2C ! High mechanism (auto-pedestrian)

29D2D! High mechanism (ejection)

29D2E! High mechanism (personal watercraft)

29D2F! High mechanism (rollover)

29D2G! High mechanism (vehicle off bridge/height)

29D3! HAZMAT

29D4! Pinned

29D5! Not alert

29B1!! Injuries

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! PPGD - SPGDT Pra RS - BSB Sumbar/RS M Djamil

29B2!! Multiple victims (one unit)

29B3!! Multiple victims (addtional units)

29B4!! Serious hemorrhage

29B5!! Unknown status (3rd party caller)

29A1!! 1st party caller w/ non-dangerous injury

30 - Traumatic Injuries (specific)

Code! Sub Category

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 (≥ 6hrs)

31 - Subject Unconscious

Code! Sub Category

31E1!! Ineffective breathing

31D1! Unconscious

31D2! Severe respriatory distress

31D3! Not alert

31C1! Alert w/ abnormal breathing

31C2! Cardiac history

31C3! Multiple fainting episodes

31C4! Single or near fainting episodes & alert

31C5! Female 12-50 y/o w/ abdominal pain

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! PPGD - SPGDT Pra RS - BSB Sumbar/RS M Djamil

32 - Medical Nature Unknown

Code! Sub Category

32D1! Life status questionable

32B1!! Standing, moving, sitting, or talking

32B2!! Medical alert notification

32B3!! Unknown status (3rd party caller)

33 - Transfer (T=Transfer / I=Interfacility)

Code! Sub Category

33D1! Suspected cardiac or respiratory arrest

33C1! Not alert (acute change)

33C2! Abnormal breathing

33C3! Significant hemorrhage or shock

33C4! Possible acute heart problems or MI

33C5! Acute severe pain

33C6! Emergency response requested

33A1!! No priority symptoms

EMS Priority Dispatch Standard - Version 3 (March 2011)

Dispatch standards

Calls received for emergency medical assistance shall be prioritised using ProQA from
AMPDS

The dispatch cross referecne (DCR) table six level priority classification as approved by
PHECC shall be ulilised

The EMS response to each of the six priority levels shall be as outlined in the table below

The principles for dispatchers shall be applied when dispatching resources to an emer-
gency medical incident

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! PPGD - SPGDT Pra RS - BSB Sumbar/RS M Djamil

Clinical Status Code Description

1 Echo Life threatening – Cardiac or respiratory ar-

rest
Life threatening
Delta Life threatening other than cardiac or respi-
ratory arrest

2 Charlie Serious not life threatening - immediate

Serious not life threatening Bravo Serious not life threatening – urgent

3 Alpha Non serious or life threatening

Non serious or life threat- Omega Minor illness or injury

ening

Essential Response

Ambulance with minimum Paramedic (Omega : Ambulance with minimum EMT)

Response to scene

Lights and siren (Alpha and Omega : Normal traffic, no lights or siren)

Vehicle type

CEN B ambulance (Alpha and Omega : CEN A or B ambulance)

Recommended Response

Echo

a) Advanced Paramedic.

b) Responders (minimum CFR)

c) Minimum 3 to 4 practitioners or responders on scene

Delta

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a) Advanced Paramedic.

b) Responders (minimum EFR) if able to get to scene prior to ambulance.

Charlie

Advanced Paramedic for appropriate conditions

Additional extra response

Ambulance Officer according to operational requirements

Non EMS resources

Fire Service, Garda, Coast Guard, Utility services as required

Principles for dispatchers

1 The nearest available ambulance shall be tasked to the highest priority incident

2 The 'recommended response' other than an ambulance shall be dispatched if resources

are available

3 Dispatchers shall have discretion to override ProQA to assign a higher priority to an inci-
dent

4 An ambulance tasked to lower priority incident may be diverted to higher priority incident
when resources are limited

5 The Dispatcher may preserve the availability of ambulances by queing Alpha and
Omega priority incidents until sufficient resources are available

6 When response is delayed Dispatchers shall inform the caller of estimated time of arrival

7 The Dispatcher shall make contact with caller if ambulance response is delayed (> 20
minutes) to verify patient's condition and review priority of incident

8 Any recommended resource should only be deployed if it has a reasonable expectation

of making patient contact.

Dispatch Codes

1 AMPDS identifies an appropriate Chief Complaint code following caller interrogation by

the call taker

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2 The dispatch cross reference (DCR) codes are fixed by AMPDS and cannot be changed
as they are linked to software and field guides etc.

3 AMPDS has designated six response levels (Echo, Delta, Charlie, Bravo, Alpha &
Omega) which are linked to the DCR codes.

4 The response level to each DCR code is agreed by MAG (MAG has agreed not to down
grade the AMPDS responses to any DCR code but reserves the right to upgrade the re-
sponse to specific DCR codes to meet Irish clinical standards, 463 {26%} such upgrades
have been made to date)

5 The Command, Control & Communications Centre, when activating a response to an in-
cident, shall give the DCR code for the information about the incident to the
Practitioners(de-emphasing the letter in the code) and a MAG agreed response level of
Echo, Delta, Charlie, Bravo, Alpha or Omega

6 Dispatchers and Practitioners must be made aware that DCR codes and dispatch re-
sponse levels may differ due to MAG decisions

Document Owner: Brian Power

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