EMS rules vary by county

Unlike some nearby county agencies Orange County does not always send an ambulance in response to 911 calls.

Orange County's 911 dispatchers use the same software as Wake and Mecklenburg counties but resources dictate how protocol is applied.

Orange County EmergencyMedical Services' treatment protocols have received increased scrutiny after the Aug. 12 death of 17-year-old Atlas Fraley a football player and rising senior at Chapel Hill High School.

Fraley died a few hours after calling 911 at 1:45 p.m. to complain of full-body pain and possible dehydration.

EMS arrived at Fraley's house at 1:53 p.m. but details of his treatment are under investigation. EMS officials have consistently declined to comment on the Fraley case or the investigation.

Orange" Wake and Mecklenburg counties all use the software program Advanced Medical Priority Dispatch System to assess the chief medical complaint of each caller.

Dispatchers then follow a county-established procedure based on that assessment.

County procedure is based on the EMS medical director's review of the 34 different kinds of complaints established by the software.

Capt. Dinah Jeffries of Orange County Emergency Services said Orange County dispatches a paramedic for all calls to prevent mistakes.

""Every county sets up their responses differently"" Jeffries said.

You look at the (suggested) responses ... and modify them.""

In Wake County"" an ambulance responds to every 911 call.

""We go through a questioning process" we make a recommendation from the system and then we dispatch our units based on that recommendation" Jeffries said.

Barry Bagwell, assistant director of operations for Mecklenburg County's EMS, said mistakes happen if responders don't follow procedures precisely.

If you don't ask the questions in the right way" you could miss something" he said.

The consequences for misinterpreting a 911 call range from minor inconvenience for paramedics to life-threatening situations, said James Barrick, director of the Simulation Center at UNC-Chapel Hill's School of Medicine.

The consequences can be all over the board" Barrick said. I don't think they miss too many life-threatening issues" and they always err on the side of caution and upgrade it to worst-case scenario.""

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