Kuwait has one of the best ambulance services in the region and today I was invited to pass by the Emergency Medical Service (EMS) Control Center in Subhan for a tour of their operation and a behind the scenes look to how their system operates. Around three years ago Kuwait literally demolished and rebuilt the EMS Control Central from the ground up which how they became to have the most advanced state of the art system in the Gulf.
The EMS Control Center are responsible for dispatching ambulances during emergencies. When you place a call to the emergency hotline 112 and request an ambulance, 112 will forward your call to the EMS Control Center. Their goal is to have an ambulance reach your location in under 8 minutes. This is not a dream goal, this is something they have to do for every call no matter where you are in Kuwait. Even if you’re on Failaka and you request an ambulance you will get it in under 8 minutes. How do they do that? Well I was taken through the whole process and I’ll try my best to explain it below. In summary, it’s one hell of a system!
The EMS Control Center is made up of three groups that sit in the department in three rows. The first row are the Call Takers, the second row the Dispatchers and their are the Supervisors.
Call Taker
When you call the EMS or have your call forwarded to the EMS, the “Call Taker” is the person who will answer your call. Their job is to take all the information from a caller, pass it to the “Dispatcher” and then stay on the line with and pass the callers instructions on what they can do to help (CPR instructions, how to slow down the bleeding etc..). The Call Taker’s have three screens in front of them. One of the screens is basically the phone, it has a number pad, a list of important phone numbers and a call history. The middle screen is where the Call Taker fills in information like the type of event that occurred (accident, heart attack, fainting etc..), event address, and caller information. The third screen has a map of Kuwait which updates live zooming in based on the address being inputted in the previous screen.
This system is all automated and very efficient. Pinpointing your location is one of the most important things since it’s what allows them to get to you so quickly. They have a number of ways of finding out where you are even if you don’t know the exact address. For example they can find you using a landmark. Say you’re in Salmiya and the accident happened near Sultan Center. They can then type Sultan Center in their system and the area Salmiya and they’ll have the location displayed on their map. Say you’re on the highway on the way to Wafra and an accident occurred but there are no landmarks around just an empty desert. Then they will instruct you to find the nearest lamppost and read the numbers on the side of it. Each lamppost has a unique number which the EMS can use to pinpoint your exact location. Once they have your location the Call Taker will send it to the Dispatchers (more on them in a bit) and a new screen then pops up with step by step instructions the Call Taker can pass on to the caller. The step by step instructions depend on the over the phone diagnosis so in case a person is suffocating the following instruction would pop up:
a. (ECHO) I’m sending the paramedics (ambulance) to help you now. Stay on the line
e. (Suffocation) Remove anything covering the face or in the mouth, then tell me if she/he’s breathing
f. (Critical Caller Danger) (If it’s too dangerous to stay where you are, and you think you can leave safely) get away and call us from somewhere safe
The Call Taker ends the conversation after the ambulance arrives. Due to the fact that people who call are usually in a state of panic, only around 25% of them actually listen and follow the instructions.
Dispatcher
The Dispatchers work behind the scenes and don’t communicate with the callers. Once the Call Taker takes down the problem and address they instantly pass it on to the Dispatchers. While the Call Taker stays on the line with the caller and follows up on the situation, the Dispatcher’s work in the background trying to get ambulances to the callers location. They have a similar set up to the Call Taker’s but with added features. For example the Dispatcher can visually see where all the ambulances are located in Kuwait along with information on each ambulance like their availability or even the speed they’re traveling. When a Call Taker passes an event to the Dispatcher an annoying (an a bit freaky) siren goes off in the whole department alerting the Dispatchers. Once a Dispatcher accepts the event on their screen the siren shuts off. The Dispatcher then does two things, first he sends the event to all the ambulances in the area of the incident, and the second is he sends the event to the “Regional Ambulance Center”. Kuwait is divided into six parts and every part has their own Ambulance Center. All the ambulances are fitted with laptops and once they receive the event on their screens the first one to answer the event in that area takes the mission. If for some reason no ambulance answers the event within 2 minutes, the dispatcher is alerted who then contacts the Regional Ambulance Center to find out why there is a delay. The Dispatcher also has the ability to assign specific ambulances to the events. So say for example an ambulance is needed on the Gulf Road near the Kuwait towers and the Dispatcher notices on his map that there is Ambulance #171 that’s just 0.78km away he could assign the ambulance to the event directly.
This whole process is done practically instantly since to get an ambulance to a scene in under 8 minutes they can’t waste any time.
Supervisor
Supervisors are stationed on a third row behind the Call Takers and Dispatchers in the emergency control room. Their job is to monitor and overlook all the calls that take place. They make sure everyone is performing their duty to their best and they also make sure the diagnosis the Call Taker’s make over the phone are accurate.
This whole system is called Computer Aided Dispatch System (C.A.D) and was developed locally by CyberMAK (Intergraph Kuwait). The system is more advanced then any other in the region (including Dubai). The system is robust and I left extremely impressed. I had no idea how advanced our EMS was. What I wrote above is just the general flow but there are a lot of little things as well that are handled automatically. For example once an ambulance drops a patient off to a hospital they can then set their status as “Ready” or “Not Ready”. If they’re not ready then they have to list a reason (from available pre-sets) like they need to go get petrol or they are heading to the garage. There’s also the gory reason which is the ambulance contains blood and needs to be cleaned. The ambulances also get real time information updates so when a Call Taker gets new information from the caller the ambulances get to see the new information updated live on their screens. Another cool feature is once an ambulance picks up a person the paramedics have a form they fill digitally on the laptop where they list their diagnosis of their patient. That form gets sent to the hospital ahead of their arrival so they can be ready to receive the patient. Then there are other features to make things quicker, I mentioned earlier that the Dispatcher can assign a specific ambulance to an event, to do that all the Dispatcher needs to do is drag the specific ambulance icon on the screen to the event icon and the event gets dispatched to that ambulance. You also have training rooms at the center, another ambulance dispatch room for non emergency cases and even seminars and workshops that take place all the time. While I was there I passed by a seminar that was taking place. The seminar was being given by American doctors to paramedics and I think the subject had to do with radiation effects on pregnancy (I guess they’re expecting something?). Something I forgot to mention, the paramedics are from ALL nationalities not just Kuwaiti.
I always complain about how Kuwait used to be better and how Kuwait needs to fix things and I have to say that Kuwait’s EMS is an example everyone needs to look at. It’s one of the first government services I’ve experienced that has left me impressed.
I’d like to thank Mr Mohammed for inviting me on this tour.
