Ottawa paramedics launch new 9-1-1 ambulance dispatch system

Ottawa's ambulance dispatchers are using a new system for dispatching emergency medical responses on Wednesday, designed to more accurately triage calls and improve response times for life-threatening emergencies.

The Ottawa Central Ambulance Communications Centre launched the new 'Medical Priority Dispatch System' (MPDS) overnight, a medical call triage and decision support tool that "improves the assignment of paramedics," according to the city.

"This new decision support tool will assist our communication officers in assigning the paramedic resources to 9-1-1 calls," Ottawa Paramedic Service Chief Pierre Poirier said. "MPDS is very good at assessing the severity of patient illness or injury. Paramedics will be dispatched immediately for high-acuity patients experiencing life-threatening events such as a heart attack, unconsciousness, breathing problems and severe allergic reactions."

The 'Medical Priority Dispatch System' will rank calls within five levels of severity, allowing dispatchers to better determine what resources are needed and when.  The emergent and immediate life-threatening calls will be classified as "code purple," while the least severe calls will be classified as "code green" for non-urgent, not serious and no immediate threat to life calls.

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"Essentially, the old system only had two codes. This new system has five different color codes, and it is much better at determining life-threatening events and also determining what isn't a life-threatening event. So that we can better manage our resources to get to the patient in a timely manner," Poirier said.

"The highest priority call code is called purple, that's been determined by the province, that'll be a very small percentage of the calls we receive. So the purple calls may be somewhere between 2 and 5 per cent of all the calls that we do. Whereas the old system, our highest priority designation, 77 per cent of our calls were considered highest priority. So it really is a much more effective and efficient tool, whereas the old tool was a very blunt instrument." 

Paramedics say when someone calls 9-1-1 to request emergency medical assistance, they will be asked more detailed questions designed to help dispatchers gather specific information about a patient's condition to make effective dispatch decisions.

"There is one thing that is very important is that for those individuals who are calling 9-1-1 to know, the call questioning will be different and not just that it will be different, that it just may be more specific, and there may be more questions. So please be patient with our ambulance communications officers because they are trying to get the best service to you as a patient in the most timely manner," said Poirier.

"MPDS can successfully identify patients in life-threatening situations, such as a cardiac arrest, unconsciousness or a stroke, who require an immediate response," the city said in a statement. "Patients who have a non-life-threatening presentation may receive a delayed response from paramedics. Delaying the response for some patients is safe and clinically appropriate."

A 9-1-1 operator at the dispatch centre in Ottawa, Ont. on April 10, 2024. (Leah Larocque/CTV News Ottawa)

The old Dispatch Priority Card Index used by Ottawa paramedics only had two triage levels. A report says that 77 per cent of 9-1-1 calls placed to the Ottawa Central Ambulance Communications Centre in 2023 were triaged by the system as 'Code 4' response. However, after a paramedic assessment on the scene, only 12 per cent of those calls required emergency transport to hospital with lights and sirens, according to paramedics.

A coroner's inquest into the death of Ottawa resident Alice Martin in 2005 recommended that the Ministry of Health "immediately take steps" to implement the new 'Medical Priority Dispatch System' in Ottawa.

"The Ottawa Paramedic Service has been advocating with the province for the implementation of MPDS in Ottawa for more than 20 years," Poirier said. "We believe MPDS has a greater level of precision, accuracy and efficiency compared to the current system."

When it comes to "level zero" events in the city, Poirier says it can help, but isn't the entire solution.

"Indirectly, it will help with level zero because it'll give us the ability to better manage our paramedic resources that are out in the community so that they will be available for those highest priority calls. Will it solve the problem? Absolutely not. There's many factors that go into level zero, including the offload delay, our actual call volume, those kind of determinants."

But Poirier believes this can help deliver better care in our city.

"I absolutely believe that will improve the care to our community. And because we're better able to ascertain the medical presentation and whether or not something is life threatening- is really important to us."  

The city of Toronto implemented the Medical Priority Dispatch System in 1992. The system was expanded to the Niagara Region in 2007. It was expanded to communication centres in Mississauga in 2022 and Kenora in 2023.

--With files from CTV News Ottawa's Leah Larocque.