Tonight was the second session (of ten overall) of the Boulder Fire Department Citizen Academy. The police department has run a similar program for some time; this is the fire department’s inaugural. About three dozen vetted citizens are receiving a pumper fleet’s worth of information from a range of folks including the department’s highest echelons. Tonight we learned about dispatch and toured the dispatch center.
For the past several years I’ve quietly held an interest in conducting a feasibility study in my state to try to identify and assess the factors at play were we to try to create a palliative first responder system—let’s call it MyPAL. MyPAL’s purpose would be to provide substantial, pain and symptom relieving medical treatment to the dying at their homes in order to facilitate dying “in place,” at home, without unwanted transport to hospital and the ICU (this happens for a variety of reasons).
Tonight I learned about and was exposed to a profound dispatch tool. Its a software program that—I believe—displaces an “analog” (that is, clipboard-based flipchart) version of a symptomatic diagnostic tool. The 911 operator poses question after question and, essentially, runs down a decision tree based on how a caller answers, in order to arrive at a problem code which is then relayed to the crew(s) dispatched to respond, so that they know what they’re responding to. The software seems robust and it’s called ProQA.
Each medical condition requires a set of medical protocols for an appropriate response. Makes sense. Here’s the salient aspect: the tool’s medical protocols are vetted annually by 80 doctors, we were told.
At this moment all I can do is to try, abstractly, to map this to palliation. For all I know some medical protocol could be exactly the same for rescue or for palliation, at least to a point. Maybe the only difference would be a “do not transport (to the hospital)” clause for palliation. I’d wager that some number of protocols would differ or require additional steps for palliation compared to lifesaving. In any case all of them would require review.
I was told that ProQA—either the entire product or perhaps just the protocols, but I don’t know for sure at this writing—is nationally-available tool. In other words, the state of Colorado has not contracted for this.
What this might bode for any state implementing a palliative responder system, I can’t say. For me, this is all new information to throw into the mix.