IAED EMD common mistakes
IAED EMD · Understand the traps and how to avoid them.
Running the Case Entry questions together in one breath or out of order - asking 'Is he awake? Is he breathing? How old is he?' as a single stream, or asking the age before establishing whether the patient is conscious and breathing.
Nerves and the caller's urgency push candidates to compress the entry sequence; under time pressure they grab the details that feel most 'medical' (age, history) instead of the ones that drive the response (consciousness, breathing).
What to do instead
Treat the Case Entry questions as a fixed checklist and ask them one at a time with a deliberate pause after each. Rehearse the sequence out loud until the order is automatic, so that under stress you fall back on the sequence rather than on improvisation.
Accepting the ANI/ALI address with a leading tag question ('You're at 214 Oak, right?') and never reading the full location back to the caller, or failing to verify that the caller is actually at that address.
Candidates assume the screen data is authoritative, and a leading question invites a reflexive 'yes' from a stressed caller - especially a caller who is at a neighbour's house, on a mobile phone, or on a highway.
What to do instead
State the location in full and ask the caller to confirm it is where the emergency is happening right now. If anything is uncertain, get a cross street, unit number, or landmark before continuing. Repeat the callback number back as well.
Failing to establish whether the caller is with the patient, and then taking answers to scene-based questions ('Is he breathing?') from a caller who is not on scene.
Candidates assume the person on the line is standing next to the patient; third-party callers, callers sent out of the room, and transferred calls are common, and the mismatch is not obvious if you never ask.
What to do instead
Explicitly ask whether the caller is with the patient and whether anyone else is there who can help. If the caller is not with the patient, route the scene questions to whoever is, and treat second-hand answers as such when you assign a determinant.
Replacing the protocol's Key Question wording with a leading or reassuring version - 'He's breathing normally, isn't he?' or 'You're not having trouble breathing, are you?' - and accepting the caller's agreement as the answer.
Candidates want to reduce the caller's panic, and a soothing phrasing feels kinder; it also feels faster because the caller usually says 'yes' immediately, closing the key question without a real answer.
What to do instead
Read the key question as written and accept only the answer that the descriptor is built around. If the reply is ambiguous ('sort of', 'I think so'), re-ask the exact question once, then use the protocol's fallback question rather than interpreting the noise.
Choosing the determinant from the caller's emotional tone instead of from the specific answers given - upgrading a calm-sounding but critical case, or downgrading a hysterical caller whose answers actually fit a lower determinant.
Callers transmit urgency through volume and pitch, and candidates conflate 'this sounds serious' with 'this is a high determinant'. The reverse error happens when a dramatic caller makes a routine case feel exhausting and the candidate looks for the lowest plausible code.
What to do instead
Assign the determinant only by tracing the answers to the key questions through the card to a specific descriptor. If you notice yourself reacting to how the caller sounds, stop, restate the answers you have, and re-walk the card.
Stopping the Key Questions early once you think you already know the answer, or skipping the remaining questions on the card because the first answer 'obviously' puts the call in a high determinant.
Once a candidate hears something alarming, finishing the question set feels like wasting time on a call that is already clearly an emergency - but the skipped questions are often what select the correct code and trigger the right pre-arrival instruction.
What to do instead
Ask every key question listed on the card, in order, unless the card itself directs you elsewhere. Say the questions aloud from the screen rather than from recall, and do not leave the card until you have reached a determinant.
Delaying dispatch or the crew notification in order to start pre-arrival instructions - for example, staying with the caller to talk through compressions before the call has been dispatched or the responding unit notified.
The instinct to help the patient immediately is strong, and pre-arrival instructions feel like the 'real' emergency work, so candidates start them before completing the dispatch step the protocol order requires.
What to do instead
Follow the card's sequence: complete the determinant and dispatch step first, then move into pre-arrival instructions. If the card allows parallel action, state the dispatch out loud before switching to instructions so the order is deliberate and audible.
Paraphrasing or abbreviating pre-arrival instructions - summarising compressions as 'push hard and fast' instead of reading the scripted instruction, skipping the step where the caller is told to wait for the count, or dropping the check-back prompts and the instruction not to hang up.
Candidates memorise the gist of the instruction during study and then deliver the gist on the exam; the scripted wording feels repetitive and the caller seems to understand, so the read-back and confirmation steps get cut.
What to do instead
Read the instruction word for word from the card, including the questions that check whether the caller is able and willing and the prompts that ask them to say when they start. Never substitute your own phrasing for the scripted text.
Skipping the post-dispatch instructions entirely once the determinant has been read out and the crew is on the way, or delivering them before the determinant is selected because the call 'feels finished'.
The call's peak tension has passed, and candidates mentally close the case once the response is generated; the post-dispatch instructions look like optional reassurance rather than required steps with a fixed place in the sequence.
What to do instead
Treat post-dispatch instructions as a card that must be completed after the determinant, not a bonus. Work through each instruction on the card and only then move toward closing the call.
Not re-entering or escalating the case when the patient's condition changes while still on the line - the caller reports the patient has stopped breathing or gone unresponsive, and the original determinant and instructions are left in place.
Candidates lock onto the code they already selected and hear the new information as commentary rather than as a trigger to re-walk the protocol; re-entering feels like admitting the first determination was wrong.
What to do instead
Treat any reported change in consciousness, breathing, or bleeding as a signal to re-enter the case and re-run the relevant questions and instructions. Confirm the new determinant out loud and notify the responding unit of the change before closing the call.