An professional in emergency drugs testified on the Sidney McIntyre-Starko coroner’s inquest that software program utilized by British Columbia 911 operators takes too lengthy to suggest doubtlessly life-saving cardiopulmonary resuscitation (CPR).
Dr. Michael Kurz mentioned the medical precedence dispatch system (MPDS) that guides 911 call-takers of their over-the-phone response doesn’t meet the “agreed-upon commonplace of care.”
“I’m certain that if you happen to make it down the protocols in MPDS, there are directions for CPR,” mentioned Kurz, an emergency doctor and professor of drugs on the College of Chicago.
“The priority I’ve — and why I am testifying at this time — is as a result of I feel the order by which they select to do it’s incorrect.”
MPDS is proprietary software program made by a Salt Lake Metropolis firm and licensed in B.C. The system directs 911 operators by means of questions and protocols that embrace what first assist measures to advise over the cellphone and when to dispatch paramedics.
McIntyre-Starko, 18, died of an unintentional fentanyl overdose in her College of Victoria scholar dorm room in January 2024.
The inquest into her loss of life was known as after her dad and mom went public with issues over the response of UVic campus safety and the size of time it took to provide naloxone and CPR.
Kurz mentioned primarily based on peer-reviewed analysis, the American Coronary heart Affiliation suggested a extra simplified protocol than what MPDS employs. The AHA system is known as “no-no-go.”
He mentioned no-no-go saves lives as a result of 911 operators are faster to dispatch paramedics and instruct CPR to be began.
“There is no such thing as a extra time-dependent sickness that emergency medical companies reply to than cardiac arrest,” he mentioned. “The period of time we’ve to make a distinction in whether or not or not that particular person survives is vanishingly small.”
With no-no-go, the 911 operator asks two questions: Is the affected person acutely aware, and is the affected person respiration usually? If the reply to both query is not any, CPR is suggested and a precedence paramedic response triggered, based on Kurz.
Kurz mentioned no-no-go can lead to a level of over-response of sources, however that the margin of error is appropriate when life is within the stability.
Software program not the difficulty, says MPDS adviser
The scholar who known as 911 when McIntyre-Starko and one other feminine scholar fell unconscious didn’t instantly reveal that medication had been concerned. As a substitute, she mentioned the 2 had been seizing and turning blue.
The report of seizures put the 911 operator into the MPDS seizure protocol, the place she was directed to inquire if the unconscious college students had been pregnant, amongst different situations.
It took seven minutes for the 911 operator to dispatch paramedics to McIntyre-Starko and 13 minutes to direct Narcan.
An adviser for MPDS, which is made by an organization in Salt Lake Metropolis, defended the software program on the inquest.
Brett Patterson, requirements council chair of the Worldwide Academies of Emergency Dispatch, mentioned the difficulty with the 911 name for McIntyre-Starko was not the MPDS software program protocols, however relatively the outline given by the caller.
“The decision-taker listens to that description and chooses one of many chief grievance protocols,” he mentioned.
“We don’t encourage the call-taker to query what the caller is telling us. If the affected person is seizing, then we count on sure behaviours primarily based on the presentation of that affected person which can be handled on the seizure protocol,” he mentioned.
Patterson mentioned no-no-go is oversimplified and doubtlessly harmful.
Fentanyl overdose impacts the a part of the mind that controls respiration. Absence of respiration will, inside minutes, set off mind harm and trigger the center to cease beating.
CPR chest compressions can preserve an individual in cardiac arrest alive by forcing oxygen into the lungs and blood circulation.
The inquest is scheduled to run into subsequent week.
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