In October, the Saratoga County Sheriff’s Department switched to ProQA, a computerized version of the Medical Priority Dispatch cards used to process EMS calls. This will allow implementation of several new dispatch protocols, some not previously available. The first is Protocol 33, the Transfer/Interfacility/Palliative Care protocol. Calls from medical facilities such as doctor’s offices or nursing homes where the patient is being cared for by a nurse or physician will be processed using Card 33. Patients not arresting or post-resuscitation who, in the opinion of the healthcare provider do not require a Priority One response, will now be dispatched as a Priority 2-Alpha response. This change will more efficiently screen calls from medical facilities and significantly decrease inappropriate dispatch of first responders to healthcare locations. Healthcare facilities have long requested that we accept their professional appraisal of the need for emergency versus non-emergency responses. Now, we can. It is important to advise crews of this change as there is a tendency to associate the response determinant (i.e., Alpha) with a non-acute patient. Using Card 33, the only thing that an Alpha determinant tells you is that healthcare professionals are currently caring for the patient and do not require immediate assistance. It in no way implies that the patient does not require ALS or extra manpower. If you are unsure of what additional resources may be needed, please ask EMS Dispatch. One of the caller questions elicits needs for special equipment (such as a bariatric stretcher or helicopter) and another question determines whether additional personnel (such as ALS providers) are necessary. Please refer any questions to Mike McEvoy, EMS-1 at email@example.com.