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This research evaluated the Emergency Medical Dispatch (EMD) code implementation in Livingston County, New York. The Livingston County Dispatch Office is an International Academics of Emergency Dispatch (IAED) certified agency that codes jobs for Emergency Medical Services (EMS) with EMD codes. Using data obtained from Livingston County EMS (LCEMS)’s emsCHARTS from 2015 to 2020, we evaluated the accuracy of EMD code implementation by both comparing the EMD code used to the impressions put on the patient’s chart and by comparing the resources sent to the patient with the resources that were needed to treat/transport the patient (disposition). In addition, we evaluated which EMD codes were undertriaged the most and which were overtriaged the most. In our sample, the EMD code matched the impressions on the patient’s chart about 47.30%. The appropriate resources were dispatched to patients roughly three quarters of the time. Undertriage and overtriage were found to be not independent of the EMD code. Four EMD codes were identified that were dispatched BLS but went ALS more often than others and it is our recommendation that, in EMS systems similar to Livingston County’s, these codes be dispatched ALS.

We prove that a diametral additive metric space is not ultrametric if and only if it contains a diameter attaining nonultrametric triangle.

We obtain several new characterizations of ultrametric spaces in terms of roundness, generalized roundness, strict p-negative type, and p-polygonal equalities (p > 0). This allows new insight into the isometric embedding of ultrametric spaces into Euclidean spaces. We also consider roundness properties additive metric spaces which are not ultrametric., 12 pages