Communications

Ottawa Paramedic Communications Officers are the first link in the chain of survival. They provide a re-assuring voice for those in need of urgent medical assistance, and ensure that the appropriate paramedic care is sent to emergencies in the City of Ottawa, Cornwall, Stormont, Dundas & Glengarry and the United Counties of Prescott & Russell.

Have you ever wondered what happens when you dial 9-1-1?

Your one emergency phone call sets off a chain of events that may pass through several different emergency call centers and many different operators. Your phone call may change hands 5 times before the paramedics are alerted to respond and all of this usually happens in less than 120 seconds. When your call is first dialed in Ottawa, it is answered at the Ottawa Police 9-1-1 Communications Centre in downtown Ottawa and is then relayed to the Ottawa Central Ambulance Communications Center in the south end of Ottawa, where staff specialize in answering and dispatching medical emergency calls.

The 9-1-1 Operator

In Ottawa, when you dial 9-1-1, your call first goes to a Public Safety Answering Point (PSAP) located at the Ottawa Police 9-1-1 Communications Centre where it is received by a group of specially trained 9-1-1 operators.

These 9-1-1 operators are the ones who answer your call for help and say, “9-1-1 emergency, do you need Police, Fire, or Paramedics?" Depending on your answer to this question, the 9-1-1 Operator can forward your call to specialized Call Takers at:

• Ottawa Police Service
• Ottawa Paramedic Service
• Ottawa Fire Service

If your call is redirected to either the Ottawa Fire Service or Ottawa Paramedic Service, it travels across the city to two separate and completely different locations. The 9-1-1 Operator may also remain on the line to gather more information while you are speaking to any one of these services.

Central Ambulance Communications Centre

The Ottawa Paramedic Service - Central Ambulance Communications Centre is responsible for receiving and dispatching all calls that deal with medical or traumatic life threatening emergencies in Eastern Ontario. It is staffed by Communications Officers who must be fluently bilingual in English and French. This specialized centre controls ambulance resources in the urban and rural areas of Eastern Ontario such as:

• City of Ottawa
• United Counties of Prescott and Russell
• United Counties of Stormont, Dundas and Glengarry
• City of Cornwall

Once your call is redirected to the Ottawa Paramedic Service - Central Ambulance Communications Centre it is answered by the Communications Call Taker using a computerized (Windows-based) phone system. As soon as the call taker obtains your information and enters it into another Windows-based Computer Aided Dispatch (CAD), your emergency is prioritized and it is sent across the room to Assignment Officer dispatcher. That dispatcher is responsible for selecting the most appropriate paramedic unit to respond to the call. This entire process must happen in less than 120 seconds, at the 90th percentile, for Code 4 (life threatening) calls.

How it all goes down

Call Taker

When the Call Taker first answers your emergency call, they will confirm the address where the paramedics are needed with a system called the Automatic Number Identifier / Automatic Location Identifier (ANI/ALI). The person calling is then asked some very important protocol questions:

• “Is the person awake?"
• “Is the person breathing normally?"
• "How old is the person?"
• “Tell me what happened"

If no potential life threatening conditions are assessed during this primary questioning, further, more specific questioning will be asked. If the situation is life threatening, the Call Taker will provide immediate life saving instructions by phone.

Based on your answers to all of these questions, the call is prioritized and sent to the Assignment Officer dispatcher who will immediately dispatch the paramedics to the address where they are needed with a very minimal amount of information (in order to rapidly get the response started). From the time the call is first answered, it must be prioritized and sent to the Assignment Officer's computer in less than 45 seconds, at the 90th percentile, for Code 4 (life threatening) calls.

While the paramedics are being sent, the Call Taker will continue to gather more information by following a computerized flow chart called the Dispatch Priority Card Index (DPCI). Depending on the nature of the emergency, the DPCI directs the Call Taker to ask precise questions that pertain to specific emergencies. The DPCI can also help the Call Taker provide clear and concise pre-arrival first aid instructions to the caller.

In the middle of all this, the Call Taker may also place the caller on hold to notify Police or Fire if they are needed. As you can probably imagine, people who call for paramedics might be very distraught depending on the circumstances that they are dealing with. Considering that the Ottawa Paramedic Service - Central Ambulance Communications Centre answers over 170,000 calls each year for the City of Ottawa alone, it should be obvious that this job requires someone who can stay calm under pressure.

Dispatchers

There are 5 dispatcher roles that are used to disseminate information to Ottawa Paramedics. Dispatchers may have to monitor anywhere from 0 to 65 paramedic units at a time on anywhere from 1 to 3 radio channels; not to mention being responsible for answering multiple phone lines at the same time.

1 - Assignment Officer (Alpha dispatcher)

The first dispatcher is referred to as " Alpha" because they monitor the Alpha radio channel. This Alpha dispatcher first receives the emergency call information on their main computer screen. They are notified by both visual and audible prompts that a call needs to be dispatched.

The next step is to locate the address in a computerized mapping system. Once the Alpha dispatcher knows where the address is, they identify the closest and most appropriate paramedic unit to respond to the call in less than 75 seconds. The paramedics are then notified by restricted radio or secure phone line and directed to switch to a different restricted radio channel (Bravo or Charlie) for the rest of their call details.

2 - Incident Officers

Once the paramedics change their radio frequency, the Incident Officers give the paramedics all the relevant information they require to help the patient including the call location, hazards (if applicable), the patient's age and gender, the type of medical emergency and what additional resources are responding.

These dispatchers are also responsible for updating the paramedics of any health and safety issues as well as pertinent patient information as it becomes available. They will also liaise with police, fire and other agencies as required.

The Incident Officers will monitor the paramedics from the time they are en route to the scene of the emergency until the time the paramedics clear the hospital and become available again. Incident Officers essentially share the same roles but there are often two of them to share the workload over two different channels.

3 - Deployment Officer dispatcher

The Deployment Officer shares the same radio frequency as the Alpha dispatcher. The Deployment Officer is charged with logging on vehicles at the beginning of their shifts and directing all available paramedic units to strategic positions within the city as dictated by the deployment plan. They monitor eating periods, as well as work to ensure paramedic units are sent home on time at the end of their shifts.

4 - Regional dispatcher

The Regional dispatcher monitors - you guessed it - the regional channel.

They are responsible for dispatching all units in Prescott-Russell and Cornwall, Stormont, Dundas & Glengarry Counties.

5 - MCI dispatcher

The MCI dispatcher is called to action in the event of a Multiple Casualty Incident. Examples would consist of a major incident involving multiple patients and multiple resources such as large motor vehicle collisions, airport events, structure fires with multiple patients and chemical, biological, radiological, nuclear or explosive incidents to name a few.

Special tactical channels remain available for use when the MCI dispatcher gets called to action.

Dispatcher Work Stations

The dispatcher's work station is ergonomically designed and equipped with a main restricted radio system, 2 backup radios, a secure phone system, a backup telephone, six computer monitors, 2 keyboards, 4 computer mice and a numerical keypad.

These computers run 24/7 and give the dispatcher the ability to monitor and direct absolutely everything from one desk. It is without a doubt that this job requires an extraordinary ability to multitask and stay calm under pressure.

Other Important Staff

The Ottawa Central Ambulance Communications Centre is also staffed with other important personnel.

These include but are not limited to Communications Trainers, Superintendents of Communications, Training and Quality Assurance Superintendents, Special Projects, Systems Technicians, Administrative Assistants, Commanders, a Deputy Chief and sometimes even the Chief.

All work together as a team in order to provide the highest level of care to the people they serve.

THE 9-1-1 TECHNOLOGY

Have you ever wondered what kind of technology is used from the time your call is placed until the Paramedics arrive and start treating life-threatening emergencies?

The Priority System

When a Paramedic crew responds to a call, the dispatcher first prioritizes it based on the information obtained by the call taker at the Ottawa Paramedic Service - Central Ambulance Communications Centre. These priorities are also called “codes":

• CODE 1 - non life threatening or deferrable
• CODE 2 - scheduled transfer or appointment
• CODE 3 - emergent (may use lights or sirens)
• CODE 4 - life threatening (must use lights or sirens)

Computers

The Dispatcher work station is ergonomically designed and equipped with six computer screens.

• SCREEN 1 - Administrative PC for monitoring patient distribution to hospitals, paramedic duty breaks, policies & procedures
• SCREEN 2 - Used for radio, secure phone
• SCREENS 3, 4 & 5 - Computer Aided Dispatch with information about unit status & availability, active calls and maps
• SCREEN 6 - Telephone system, backup radio channels and base paging

Secure Phone System

All phone communications to and from the CACC occur over a secure phone system called the Pantel Windows Intertalk Console (WIC).

All conversations over the secure phone lines are recorded by a computer system and can be used to quickly review information or even as evidence in court.

When CACC receives a land line call from the 9-1-1 dispatch centre, the Call Taker will see the caller's address information pop-up on a screen called the Automatic Number Identifier / Automatic Location Identifier (ANI/ALI). The information is always confirmed to ensure that it is accurate and then the Paramedics are sent to the call.

Restricted Radios

The restricted radios are the primary tool used to notify the paramedics when they have a call. The paramedics can communicate with the dispatchers or with each other.

When the Paramedics are out of their trucks, the transmissions are relayed from their portable radios to the repeater system in their truck, to the communications centre towers at the Ottawa Paramedic Service - Central Ambulance Communications Centre and vice-a-versa.

Red Phones

All paramedic posts, hospital emergency departments and headquarters are also equipped with a red phone that connects paramedics directly to the CACC and vice-a-versa.

If for any reason paramedic crews cannot be reached via radio, the red phone can be used for communicating.

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Becoming a Communications Officer

Communication Officers are a crucial link for all medical emergencies. The smooth and efficient operation of the Central Ambulance Communications Centre (CACC) is highly dependent on the dedication, expertise and professionalism of the dispatch staff.

Ottawa Paramedic Communications Officers are the first link in the chain of survival. They provide a re-assuring voice for those in need of urgent medical assistance, and ensure that the appropriate Paramedic care is sent to emergencies in the City of Ottawa, Cornwall, Stormont, Dundas & Glengarry and the United Counties of Prescott & Russell.

The Ottawa Central Ambulance Communications Centre (CACC) treat over 170,000 calls for service annually. They work closely with Allied Agency partners to deliver excellence in pre-hospital care.

Communications Officers are fluently bilingual, they use computer aided dispatch (CAD) technology and ensure that emergency calls are appropriately prioritized to ensure patients receive best definitive care in a timely manner.

Response Time Performance Plan

The Ottawa Paramedic Service is devoted to successfully achieving the targets laid out in its current response time performance plan, as approved by Ottawa's City Council. Response time performance is regularly monitored, analyzed and reported to the Ministry Of Health and Long-Term Care.

Category	Target Time	Percent Rank Target
^ SCA	2 min	80 %
* CTAS 1	2 min	80 %
* CTAS 2	2 min	75 %

^ SCA - Sudden Cardiac Arrest

* CTAS - Canadian Triage and Acuity Scale

Communication Officers Recruitment Process

Communications Officers are initially hired as Communications Officer Trainees. They will be trained to multi-task in a fast-paced dynamic call centre, using critical thinking, sound judgment and strong decision making skills.

Communications Officers work in a highly stressful but rewarding environment. They work 12-hour shifts and rotate from days to nights every two weeks. Main roles and responsibilities include processing urgent and non-urgent 9-1-1 call requests, dispatching the calls as well as deploying and actively monitoring paramedic resources.

Required qualifications and skills:

• Grade 12 plus one year of post secondary education;
• Valid CPR and Standard First Aid Certification;
• Criminal Reference Check;
• A minimum of four years experience in a customer service field (face-to-face or telephone);
• Advanced level of English in oral expression, oral comprehension, reading comprehension and writing expression;
• Advanced level French in Oral expression and oral comprehension;
• Able to type at a minimum of 40 wpm with 90% accuracy;
• Ability to multi-task;
• Strong recall memory.

Screening Process

1. Telephone interview
2. Multi-tasking test administered on a computer (Criticall™)
3. Interview.
4. Language proficiency assessment
5. The candidate will be invited for a 12 hour observation shift
6. Suitability test (written test with a follow-up interview)
7. Reference checks

Successful candidates will be placed on the Job Inventory or be offered a Trainee position.

Communication Officers Training Program

The Communications Officers Training Program is an 18-month stepped approach. The first few days at the Communications Centre are focused on orientation, information about the training program and familiarization with the Ottawa Paramedic Service.

New recruits are attending a seven-week ACOCP (Ambulance Communications Officers Certification Program) administered by the Ontario Ministry of Health and Long-Term Care. Trainees must successfully complete this certification in order to carry on to the local training program.

Trainees are then introduced to the Communications Centre live environment where they are matched with a Communication Trainer and Officer who will mentor them for the duration of the local training program. After eighteen months of training and successful periodic evaluations, Communications Officer Trainees are promoted to the Communications Officer Status.