Emergency Communication Nurse System (ECNS)

The International Academies of Emergency Dispatch's (IAED) certified Emergency Communication Nurse System (ECNS) is a comprehensive nurse triage system comprised of over 200 protocols. It is designed to be implemented within an Emergency Medical Services (EMS) communication center and used alongside the IAED’s Medical Priority Dispatch System (MPDS), which was developed over 35 years ago. Not every emergency call needs a lights-and-siren response. In fact, not every call even needs a COLD ambulance response. ECNS, when used with the MPDS Protocol and Priority Dispatch Corp.'s internationally-recognized gold-standard dispatch and QI software—ProQA Paramount and AQUA—can provide optimal ALTERNATIVE CARE for vetted low-acuity ALPHA and OMEGA Determinant Codes, giving EMS systems new options to care for patients and their communities. Responses to OMEGA determinants are locally defined based on MPDS-approved codes.

ECNS is considered IAED's "Fourth Pillar of Care" along with Emergency Medical Dispatch, Emergency Fire Dispatch, and Emergency Police Dispatch. Accreditation as a Center of Excellence is an integral part of superior care standards with current medical accreditation required before a center can use the ECNS Protocol. Other prerequisites for ECNS include implementing Paramount dispatch software and AQUA quality improvement software.

The overall ECNS procress is comprehensive, yet simple. First, a call comes into the communication center and Paramount is launched by the Emergency Medical Dispatcher (EMD). If, after EMD questioning, the patient is assigned a pre-determined and locally-defined "low code" (OMEGA Code), the call is transferred to the Emergency Communication Nurse (ECN) desk. This desk is staffed by an experienced, specially-trained, ECNS-certified Registered Nurse who uses LowCode software developed by Priority Solutions Inc. (PSI), which seamlessly integrates with Paramount, to assess the patient. For numerous reasons, it is imperative that the ECN be co-located within the communication center. After verifying there are no priority symptoms, additional information is gathered such as co-morbid conditions, medications, and allergies. An ECNS symptom-based protocol is then selected and additional assessment conducted.

LOWCODE nurseBased on the caller’s answers, a Recommended Care Level is achieved, which includes tiered response levels from Send an Ambulance Now to Self-Care Instructions. From here a second-tier disposition is available that is customer definable. This tier represents resources available in the customer’s community, e.g., urgent care centers and primary care physicians. Users can engage a third-tier disposition called a directory of services that will identify a specific list of health care resources near the patient.

Priority Solution's LowCode software has been in use for over 15 years throughout the world, and more than two million calls have been processed without an untoward incident.

ECNS has been designed to specifically meet the following two goals:

  1. Appropriately manage and support caller access to an increasingly burdened health care system by better allocating resources to meet their nonemergent, non life-threatening health situations.
  2. Help EMS communication centers, ambulance services, and all EMS providers optimize their resources and outcomes by sending, when necessary, the
    • right place, at the
    • right personnel, to the
    • right time, with the
    • right equipment, using the
    • right resources, to get the
    • right care, in the most clinically appropriate way; thereby facilitating the
    • right cost, to patients, providers, and payers.

ECNS Nurse Patch

Key Points:

  • ECNS currently has user centers on 4 continents
  • More than 1,000 clinicians have been trained throughout the world
  • ECNS currently has over 200 protocols—each containing clinical rationale along with a reference list for additional information

Benefits of ECNS:

  • Effective and standardized clinical assessment and assignment of appropriate Recommended Care Levels
  • Safely manages the growing demands on health care providers
  • Reduces the demand on ambulance transportation services
  • Reduces unnecessary ER visits and wait times
  • Numerous integration efforts completed with third party software
  • Brings appropriate care closer to patients while being responsive to their needs
  • Establishes efficient and effective use of EMS and community provider resources
  • ECNS is considered “The Fourth Pillar” of the International Academies of Emergency Dispatch, along with EMD, EFD, and EPD, and is regulated by its Standards Council
  • Established quality assurance/quality improvement process, with the software integration availability of AQUA Evolution
  • Data-driven approach with proven safety and efficacy with over 14 years of QA/QI data

ECNS Benefits


As shown below, many organizations utilize ECNS and LowCode.

Organization Location
Botswana Medical Rescue International Gaborone, Botswana
East of England Ambulance Service NHS Trust United Kingdom
Ireland Health Service Executive Dublin, Ireland
Las Vegas Fire and Rescue (City of Las Vegas) Las Vegas, Nevada, USA
MedStar Emergency Medical Services Fort Worth, Texas, USA
Memphis Fire Memphis, Tennessee, USA
Netcare 911  Johannesburg, South Africa
Northwell Health Syosset, New York, USA
Notruf NOE 144 Lower Austria, Austria
Queensland Health/13 Health Brisbane, Australia
Regional Emergency Medical Services Authority (REMSA) Reno, Nevada, USA
South Western Ambulance Service NHS Foundation Trust United Kingdom
Vienna Communication Center Vienna, Austria
Vorarlberg Emergency Medical Services Vorarlberg, Austria



International Academies of Emergency Dispatch

Gigi Marshall, MSN, RN, Program Administrator
Phone: +1 801-746-5664
Email: gigi.marshall@prioritysolutionsinc.com
Web: www.prioritysolutionsinc.com

Priority Solutions Inc.

Conrad Fivaz, M.D.
Director of Operations, International
Phone: +1 801-875-8755
Email: conrad.fivaz@prioritysolutionsinc.com
Web: www.prioritysolutionsinc.com