How are EMS personnel asking for police response to unsafe scenes

Lee County EMS conducted a short survey of EMS leaders to determine if code words or plain language are used to request police to an unsafe EMS incident


Lee County Public Safety has re-opened a short survey on crew communication on unsafe scenes to better understand how field personnel can best convey the gravity of an unstable situation by radio to receive a proportionate law enforcement response. This article is based on 90 responses received in December 2018. Additional survey responses are welcome.

By Benjamin Abes

Lee County Emergency Medical Services, Fort Myers, Florida, has been working to follow the guidance from the U.S. Department of Homeland Security to use plain language in dispatch communications.

In 2006, a Department of Homeland Security guide on making the transition from 10-codes to plain language noted that, while “the NIMS Integration Center does not require plain language for internal operations, it strongly encourages it, as it is important to practice every day terminology and procedures that will need to be used in emergency incidents and disasters.”  

Moving away from coded language – used for years to reduce radio traffic and add a layer of privacy while communicating – has been difficult for many agencies. (Photo/Pixabay)
Moving away from coded language – used for years to reduce radio traffic and add a layer of privacy while communicating – has been difficult for many agencies. (Photo/Pixabay)

Moving away from coded language – used for years to reduce radio traffic and add a layer of privacy while communicating – has been difficult for many agencies. Lee County EMS has made progress since the effort first began in the wake of the events of Sept. 11, 2001, but challenges remain. 

The transition away from coded language has left some messages lost in translation. Leadership from both EMS and the communications center met to discuss one specific issue: challenges in clearly communicating the need and urgency of a law enforcement request by EMS field providers.

The agency does not use codes and signals for this need unless it is a life-and-death emergency. These emergencies are designated by pushing the radio’s Emergency Alert Button or using a code phrase, like "Code 3" or "10-54."

Lee County EMS and Communications leadership wanted to learn more about the best practices adopted by peer agencies. Were others agencies across the country having the same struggles?

In early December 2018, the agency distributed a short email through the NEMSMA listserv with a link to an online survey, asking three yes/no questions and two short-answer questions. The survey had a typical completion time of about three minutes.

What did Lee County hope to learn?

We had two main areas of interest. First, have agencies successfully made a complete transition away from codes and signals? Second, and more direct to the specific issue, we hoped to learn how other agencies make the distinction between routine, urgent and emergent requests for law enforcement support on emergency medical scenes, through either plain language or codes and signals.

Survey response

Agencies were helpful with their responses and every agency that began the survey finished it. Lee County received 92 responses in about 10 days. Of those, the majority (73 percent) dispatch for fire, EMS and law enforcement from the same center. 

About 23 percent of agencies reported that they have made the transition away from codes and signals entirely. Of the remaining 77 percent, most (65 percent) make use of a small set of codes and signals to supplement plain language radio transmissions.

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While the survey used a convenience sample, it demonstrates the challenge in both practicality and efficiency in moving to plain language, even in the face of recommendations from federal policymakers.

Regarding the distinction between routine, urgent or emergent requests, the responses varied. Some agencies have specific codes or code words to use to indicate escalating emergency scenes. Some of the code words or phrases respondents reported using include:

  • Code 3
  • Priority 4
  • Code 5
  • Code 82
  • Signal 5
  • Signal 49
  • Signal 50
  • Signal 1000
  • 10-33
  • 10-54
  • 10-78
  • 11-10
  • 11-11

Most agencies ask for plain language, but use codes or code words to more clearly define the level of urgency. Some agencies only use codes or signals to make the request, and the request is honored by law enforcement.

What Lee County – and others – can take away from this information

It appears that most, if not all, agencies have tried to move toward plain language as much as possible. Operationally, many agencies have struggled to make a complete transition. The need to clearly define the urgency may be best served with codes and signals when plain language is not feasible or would jeopardize the message or messenger. It was encouraging to see that Lee County is not alone in its attempts to move away from codes or in encountering some challenges to that effort.

The best practices shared through the survey, including the use of a simple code of 1, 2 or 3 to distinguish between routine, urgent or emergent when necessary, will be helpful as Lee County continues to emphasize the importance of plain language communication.

About the author

Benjamin Abes serves as the Lee County (Florida) director of public safety for emergency response and communications and chief of the Division of Emergency Medical Services. He is responsible for providing senior leadership and management to emergency response and communications programs in the Department of Public Safety, including EMS and Emergency Communications.

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