Posts by TrueNorth

    Name/Type of Mission: Dead on arrival/obvious signs of death (new mission or upgrade from cardiac arrest)

    Units Required: 1 ambulance, 1-2 patrol cars

    POI Required (Use “none” if not needed): none

    Patients: 1 (no transport)

    Prisoners: 0

    Credit Reward: 600-800

    May expand to:

    Name/Type of Mission: Suspicious death/Homicide

    Units Required: 1 ambulance, 4 patrol cars

    POI Required (Use “none” if not needed): none

    Patients: 1 (no transport)

    Prisoners: 0

    Credit Reward: 800-1200

    For the majority of these calls, the fire department would be needing to complete a rescue to determine the total amount of patients. If it were truly realistic, you’d have patients coming in waves (for some of the calls), meaning you’d need to constantly recheck the mission and update the units attached. The police ones in particular are actually quite realistic in that EMS won’t go on-scene until police have finished dealing with the incident.

    You can always anticipate the number of patients and attach the ambulances with the initial dispatch. I, for one, don’t mind the current setup.

    Airway closing would be respiratory arrest, and like all respiratory arrests, if it not dealt with promptly, will further develop to a cardiac arrest due to lack of oxygenation.

    As for other points, both allergic reactions and cardiac arrests should go to general internal, as any ER has the capability of dealing with both and time requires the nearest open ER be the patient destination. Also, if the cardiac arrest is due to trauma, it is called a traumatic arrest. General internal would still be appropriate for this patient, however, some jurisdictions may have a bypass policy in place depending on the proximity to a trauma centre.

    I have brought this up before, but the mods have stated that they are assigned those specialties to fill the need for the specialty, and as medical recently got a lot of attention, it was not likely anything would change anytime soon. Not sure if that is still the case though.

    Issues arise with the mission generation while the app/game is closed. The buildup of missions would then have a lot of dead patients when the player reopens the game. If this would be added, it would need the ability to be turned on and off by the player, depending on their playing style. I would not put this high on the priority list for that reason.

    Also to be noted, even with serious medical emergencies,a lengthened response time does not always mean death in real life, sometimes it just results in permanent disability or decrease in quality of life. Even an MI can pass without intervention, but still need an angiogram/angioplasty in the future (sometimes scheduled several weeks or even months after the initial incident).…_Priority_Dispatch_System

    Here is the most accurate page I’ve found so far. Unfortunately, it just gives the protocol descriptions, but they are, for the most part, accurate. 36 is still listed as ‘Flu like symptoms’ instead of ‘Pandemic’ and Protocol 35 only exists in the UK. The company keeps their codes quite private.

    In relation to the sepsis call, would 26 (as a delta or Charlie) be a better protocol than 6? Sick person as opposed to breathing problems?

    That would be a decent addition. Make it so that after the helicopter leaves, the zone disappears. If that were to be implemented, they should add a helicopter landing pad expansion for hospitals as well, so that HEMS can only bring patients to hospitals that are equipped with heli-pads.

    Nosebleed could perhaps have a lower transport rate, however, a fever can be indicative of numerous other issues beyond just a high temperature, such as appendicitis, infection, UTI, sepsis and much more. In a young child, it can even lead to a febrile seizure (possible mission upgrade?). So while the complaint of the patient may just be a fever, it could be a way bigger issue than that, therefore requiring transport for further care.

    Building on the unused expansion aspect, I feel that the urology one doesn’t need to exist, as there are no emergency calls that would require the transport destination to specialize in urology. However, it would be really cool to get a paediatric expansion, possibly at the base level like internal medicine and general surgery are. The lost child could then have it as it’s destination requirement. And there are paediatric specific diseases that could be added as well.

    Ah ok that makes sense. It is quite difficult adding missions for the cardiac surgery and neurosurgery specialisations as in my mind these are things that come after visiting a neurology and cardiology department but I may be wrong.

    In Manitoba we have a protocol for strokes where if they score high enough on the LAMS scale or have surpassed the time limit for TPA treatment, we take them straight to the neurosurgery department at a capable hospital.

    As for cardiac surgery, unless you consider angiogram/angioplasty cardiac surgery, I can’t think of anything EMS would need to bring to a cardiac surgery centre. I’ve considered any hospital that can do cardiac monitoring to have cardiology capabilities. It’s a bit of a stretch, but considering the variety of MIs possible, unless you have a STEMI, we aren’t going to divert to a cath lab.

    Good to know about the developer verses mods. The issue is more so if you’re trying to maintain a realistic playing style. While TIAs can sometimes require surgery, that would be in an ongoing care regiment, while in the emergent situation the game is simulating, TIAs don’t require emergency surgery as they usually resolve within minutes and are treated more as a warning sign for future strokes (or monitored for development into a full stroke).

    Edit: And the patient codes are correct. I was quite thrilled when they got added and I saw they were the same ones we use in Manitoba.

    So as happy as I am that there is a new medical mission, why is the required transport destination for a TIA neurosurgery? It’s a mini stroke that in the real world would get transported to any hospital ER, or at most, one that has basic neurology capabilities. The only time neurosurgery is used in an emergent situation is for a full blown stroke that is suspected to be a large vein occlusion (LVO).

    I know it has been brought up a number of times about medical mission transport requirements being inaccurate, but is there any way for actual medical professionals to give advice to the developer about medical calls and transport destinations?

    I've never heard of this before. Of course I live in New Jersey as we have EMS differently. But this is interesting. I was gonna say EMS courses were already mentioned but you beat me to it lol.

    I've been having blonde moments all day so if you could further explain this I'd really appreciate it

    Sounds interesting so far

    In Manitoba, EMS was originally ran by Rural Municipalities (basically Canada's version of a County). Then the province gave that responsibility to Rural Health authorities, who took over all EMS stations, with the exception of a couple of private services. Since Manitoba is such a large area, and some of the EMS stations are spaced far apart, some Rural Municipalities got their fire departments to train their volunteer members as Emergency Medical Responders (EMRs) and to recruit paramedics as volunteer firefighters, so that they could attend EMS calls as a first response, therefore decreasing the time from when the 911 call is made to when first care is provided to the patient. The majority of these departments have mini-pumpers or utility units designated as their MFR units.

    So basically, MFR is just a means to improve patient care on behalf of the RMs. They are dispatched by the medical dispatch centre, like an ambulance. I'm not totally sure how widely this model is used, and even how it will look in the coming years in Manitoba, as our EMS delivery system is getting another overhaul. But it would definitely be of use in the game, so it's nice to hear from TACRfan that something similarly could be on the way.

    Something that I thought of while planning future rural fire stations is that some of them have a medical first response model that isn't currently featured in the game. It could be implemented as an extension, but it would have to be available to small fire stations as well. Basically, you would have the option to buy a utility unit or a mini pumper (type 2 Engine) that was designated medical first response, that would treat the patient to the same extent as a fly car would, but not transport. You could then also use it for your fire calls as a normal fire unit. You would also need it to show up in your ambulance drop down when dispatching.

    You could also create a new fire course to go along with this to train staff in medical first response, or, as has been suggested in a few different threads, make it an EMS course so you can implement EMS training facilities (although you would then need it to accept fire staff, but I don't see that being much of an issue).

    I can see this making the most difference for North America, where our rural EMS stations are far apart and the MFR Fire Departments fill a gap in service.

    I don't understand why they would add clinics. If they are referencing an Urgent care facility where minor injuries (nosebleed, fever, other variations on existing missions), then that would make more sense. But like JebbyJnr said, having ambulances staffed out of them would be frivolous. What I would like to see is when you do a hospital expansion, you then get to select which of the associated calls that hospital can handle. For example, most ERs can manage trauma calls. So falls, hemorrhages, cardiac and respiratory arrests (of which those last two need to be removed from the trauma requirement) could go to any hospital. But then you could mark that hospital as unavailable to the more major trauma calls. If they want to add transfers, then if a major call gets brought to a hospital that can't handle it, 10 minutes later have it pop up as a transfer to a different centre.

    They also need to get more specific with the medical calls if they're going to do that. Stroke could have a variation of a Large Vein Occlusion Stroke (LVO) that needs a comprehensive stroke centre (Neurosugery), while all others can go to primary centres that have the capability (Neurology where Stroke is checked off). Add a ROSC call that cardiac arrests can turn into that needs to go to a cardiac centre verses the nearest hospital for the call that stays an arrest. COPD and CHF exacerbation could be created and so on. It would be neat to see more diverse medical calls and the same effort to create different levels of medical calls that they have shown with the fire calls.

    Our alliance just had a promotion to a co-admin position, however, the player named to that position does not have the ability to build alliance buildings or start expansions to current ones. They also cannot start lessons in the education facilities. We've tried logging out and back in, removing previous roles, all to no avail. Does anyone have any experience with this? We haven't had this issue before.

    To add to this thread, with the code the developers put on the cardiac arrests (9-E-1, or any other 9 code) the destination should be closest ER, no trauma requirement, as the code indicates a medical related arrest. If they want to add a trauma requirement for an arrest, they need to be coding them as one of the following: 3-D-1, 4-D-1, 13-E-1, 13-E-2, 17-D-2, 21-D-1, 27-D-1, 29-D-6, 30-D-1. All of these codes are associated with traumatic injuries, with the priority letter and info number indicating arrest. If they only want to pick one, I would go with 30-D-1 as its code translates to Traumatic Injuries: ARREST.

    As for the accuracy of which hospital the rest should go to, the trauma centre requirement needs to be removed for accuracy. All ERs are equipped to deal with these emergencies, to stabilize the patient before sending them to a more appropriate centre. A cardiac centre would be a destination if ROSC is achieved, but for that, they need to create a new call that an arrest can convert to.