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Medical Priority Dispatch System

The Medical Priority Dispatch System (MPDS) is a way of categorizing and prioritizing EMS incidents. The MPDS assigns a number-letter-number format code to each type of incident. The first character (one or two digits) indicates the category of the incident (e.g., breathing problem). The second character (letter A-E plus Omega) indicates the priority of the incident. Letter "A" indicates the lowest priority incident and "E" indicates the highest priority incident, however not all letters are used within each category. The the third character (one or two digits) indicates the subcategory of the incident. The MPDS codes are also commonly referred to as "Clawson Codes" because the MPDS categorization system was originally designed by Dr. Jeff J. Clawson.


MPDS Codes

Priority System

Note that the determinant level (Echo, Delta, etc) are classification of the medical needs of the patient while the level of response for specific types of calls is determined locally and so may vary from this sample. See, for example,

Determinant LevelBasic Life Support
Level of Response
Advanced Life Support
Level of Response
EchoHotHotLife Threatening = Closest Resources Dispatched
Eg: Fire Dept, Security with an AED, Lifeguard, ...
DeltaHotHotLife Threatening
CharlieHotColdPossible Life Threatening
BravoHotHotNon Life Threatening / Interventions needed
AlphaColdColdNon Life Threatening
Omega------Other Resources Dispatched instead of EMS
Eg: Police, Medical Examiner, ...

1 - Abdominal Pain

CodeSub Category
1D1Not alert
1C1Fainting or near fainting >50 y/o
1C2Females fainting or near fainting 12-50 y/o
1C3Males w/ pain above navel >45 y/o
1C4Females w/ pain above navel >45 y/o
1A1Abdominal pain

2 - Allergic Reaction

CodeSub Category
2E1Ineffective breathing
2D1Severe respiratory distress
2D2Not alert
2D3Condition worsening
2D4Swarm attack (bees)
2C1Difficulty breathing or swallowing
2C2Special medications or injections used
2B1Unknown status (3rd party caller)
2A1No difficulty breathing or swallowing
2A2Spider bite

3 - Animal Bites

CodeSub Category
3D1Unconscious or arrest
3D2Not alert
3D3Dangerous body area
3D4Large animal
3D5Exotic animal
3D6Attack or multiple attack
3B1Possibly dangerous body part
3B2Serious hemorrhage
3B3Unknown status (3rd party caller)
3A1Not dangerous body area
3A2Non-recent injuries >6 hours
3A3Superficial bites

4 - Assault

(A=Assault / S=Sexual Assault)

CodeSub Category
4D1Unconscious or arrest
4D2Not alert
4D3Abnormal breathing
4D4Dangerous body area
4D5Multiple victims
4B1Possibly dangerous body area
4B2Serious hemorrhage
4B3Unknown status (3rd party caller)
4A1Not dangerous body area
4A2Non-recent injuries >6 hours

5 - Back Pain

CodeSub Category
5D1Not alert
5C1Fainting or near fainting >50 y/o
5A2Non-recent injuries >6 hours

6 - Breathing Difficulty


CodeSub Category
6E1Ineffective breathing
6D1Severe respiratory distress
6D2Not alert
6C1Abnormal breathing
6C2Cardiac history

7 - Burn Subject

CodeSub Category
7D1Unconscious or arrest
7D2Severe respiratory distress
7D3Not alert
7D5Multiple victims
7C1Building fire w/ persons inside
7C2Difficulty breathing
7C3Burns >18% BSA
7B1Unknown status (3rd party caller)
7A1Burns 35 y/o
7A2Fire alarm unknown situation
7A3Sunburn or minor burn

8 - Hazardous Exposure

CodeSub Category
8D1Unconscious or arrest
8D2Severe respiratory distress
8D4Not alert
8D5Multiple victims
8D6Unknown status (3rd party caller)
8C1Alert w/ difficulty breathing
8B1Alert w/o diffuclty breathing
8A1CO alarm--EMS requested

9 - Cardiac Arrest

CodeSub Category
9E1Not breathing at all
9E2Breathing uncertain
9D1Ineffective breathing
9B1Obvious Death

10 - Chest Pain

CodeSub Category
10D1Severe respiratory distress
10D2Not alert
10C1Abnormal breathing
10C2Cardiac history
10C4Breathing normally >35 y/o
10A1Breathing normally <35 y/o

11 - Choking

CodeSub Category
11E1Choking verified/ineffective breathing
11D1Not alert
11D2Abnormal breathing
11A1Not choking now

12 - Seizures

CodeSub Category
12D1Not breathing
12D2Continuous or multiple seizures
12D3Irregular breathing
12D4Breathing regularly not verified >35 y/o
12C3Cardiac history
12B1Breathing regularly not verified <35
12A1Not seizing now & breathing verified

13 - Diabetic Problems

CodeSub Category
13C1Not alert
13C2Abnormal behavior
13C3Abnormal breathing

14 - Drowning

CodeSub Category
14D2Not alert
14D3Diving or neck injury
14D4SCUBA accident
14C1Alert w/ abnormal breathing
14B1Alert & breathing normally w/ injuries
14B2Unknown status(3rd party caller)
14A1Alert & breathing normally w/o injuries

15 - Electrocution

(E=Electrocution / L=Lightning)

CodeSub Category
15E1Not breathing/ineffective breathing
15D2Not disconnected from power
15D3Power not off
15D4Long fall >6 feet
15D5Not alert
15D6Abnormal breathing
15D7Unknown status (3rd party caller)
15C1Alert & breathing normally

16 - Eye Problem

CodeSub Category
16D1Not alert
16B1Severe eye injuries
16A1Moderate eye injuries
16A2Minor eye injuries
16A3Medical eye problems

17 - Falls

CodeSub Category
17D1Dangerous body area
17D2Long fall >6 feet
17D3Not alert
17D4Abnormal breathing
17B1Possibly dangerous body area
17B2Serious hemorrhage
17B3Unknown status (3rd party caller)
17A1Not dangerous body area
17A2Non-recent injuries >6 hours

18 - Headache

CodeSub Category
18C1Not alert
18C2Abnormal breathing
18C3Speech problems
18C4Sudden onset of severe pain
18C5Numbness or paralysis
18C6Change in behavior
18B1Unknown status (3rd party caller)
18A1Breathing normally

19 - Heart Problem

CodeSub Category
19D1Severe respiratory distress
19D2Not alert
19C1Firing of AICD
19C2Abnormal breathing
19C3Chest pain >35 y/o
19C4Cardiac history
19C6Heart rate 130
19B1Unknown status (3rd party caller)
19A1Heart rate >50 or 5 months
19A2Chest pain <35 y/o w/o symptoms

20 - Environmental Exposure

CodeSub Category
20D1Not alert
20C1Cardiac history
20B1Change in skin color
20B2Unknown status (3rd party caller)

21 - Hemorrhage

CodeSub Category
21D1Dangerous hemorrhage
21D2Not alert
21D3Abnormal breathing
21C1Hemorrhage through a tube
21B1Possibly dangerous hemorrhage
21B2Serious hemorrhage
21B3Bleeding disorder or blood thinners
21A1Non-dangerous hemorrhage
21A2Minor hemorrhage

22 - Industrial Accidents

CodeSub Category
22D1Life status questionable
22D2Caught in machinery
22D3Multiple victims
22B1Unknown status (3rd party caller)

23 - Overdose

(A=Accidental / I=Intentional / P=Poisoning)

CodeSub Category
23D2Severe respiratory distress
23C2Not alert
23C3Abnormal breathing
23C7Acid or alkali
23C8Unknown status (3rd party caller)
23C9Poison Control request for response
23B1Overdose w/o symptoms
23O1Poisoning w/o priority symptoms

24 - Pregnancy

CodeSub Category
24D1Breech or cord
24D2Head visible
24D3Imminent delivery >5 months
24D43rd trimester bleeding
24D5High risk complications
24D6Baby born
24C12nd trimester hemorrhage or miscarriage
24C21st trimester serious hemorrhage
24B1Labor >5 months
24B2Unknown status (3rd party caller)
24A11st trimester hemorrhage or miscarriage

25 - Psychiatric Problem

CodeSub Category
25D1Not alert
25B2Threatening suicide
25B3Near hanging
25B4Unknown status (3rd party caller)
25A1Non-violent & non-suicidal

26 - Sick Call

CodeSub Category
26D1Not alert
26C1Cardiac History
26B1Unknown status (3rd party caller)
26A1Non priority symptoms
26A4Cannot sleep
26A5Cannot urinate
26A6Catheter problems
26A9Cut-off ring request
26A20Object stuck
26A21Object swallowed
26A22Penis problems
26A23Rash/skin disorder
26A25Sore throat
26A27Transport only
26A28Wound infected

27 - Stab/Gunshot/Penetrating Trauma

(S=Stabbing / G=Gunshot Wound / P=Penetrating Trauma)

CodeSub Category
27D1Unconscious or arrest
27D2Not alert
27D3Central wounds
27D4Multiple wounds
27D5Multiple victims
27B1Non-recent injuries >6 hours / central wounds
27B2Known single peripheral wound
27B3Serious hemorrhage
27B4Unknown status (3rd party caller)
27A1Non-recent >6 hours / peripheral wounds

28 - Stroke

CodeSub Category
28C1Not alert
28C2Abnormal breathing
28C3Speech or movement problems
28C4Numbness or tingling
28C5Stoke history
28C6Breathing normally >35 y/o
28B1Unknown status (3rd party caller)
28A1Breathing normally 6 hours

29 - Traffic Collision

CodeSub Category
29D1AMajor incident (aircraft)
29D1BMajor incident (bus)
29D1DMajor incident (train)
29D1EMajor incident (watercraft)
29D2AHigh mechanism (all-terrain)
29D2BHigh mechanism (motorcycle)
29D2CHigh mechanism (auto-pedestrian)
29D2DHigh mechanism (ejection)
29D2EHigh mechanism (personal watercraft)
29D2FHigh mechanism (rollover)
29D2GHigh mechanism (vehicle off bridge/height)
29D5Not alert
29B2Multiple victims (one unit)
29B3Multiple victims (addtional units)
29B4Serious hemorrhage
29B5Unknown status (3rd party caller)
29A11st party caller w/ non-dangerous injury

30 - Traumatic Injury

CodeSub Category
30AUnknown status (3rd party caller)

31 - Subject Unconscious

CodeSub Category
31E1Ineffective breathing
31D2Severe respriatory distress
31D3Not alert
31C1Alert w/ abnormal breathing
31C2Cardiac history
31C3Multiple fainting episodes
31C4Single or near fainting episodes & alert
31C5Female 12-50 y/o w/ abdominal pain

32 - Medical Nature Unknown

CodeSub Category
32D1Life status questionable
32B1Standing, moving, sitting, or talking
32B2Medical alert notification
32B3Unknown status (3rd party caller)

33 - Transfer

(T=Transfer / I=Interfacility)

CodeSub Category
33D1Suspected cardiac or respiratory arrest
33C1Not alert (acute change)
33C2Abnormal breathing
33C3Significant hemorrhage or shock
33C4Possible acute heart problems or MI
33C5Acute severe pain
33C6Emergency response requested
33A1No priority symptoms


In addition, some systems, mostly those who dispatch for Fire Departments who either have EMS responders, or areas where one centralized dispatch center dispatches both fire and medical calls, Advanced Medical Priority Dispatch System (AMPDS) codes may also be used. Fire codes start at 51, and expand to 73.

Priority is similar to medical dispatch:

Priority System

  • Alpha Response=Code 1--Low Priority
  • Bravo Response=Code 2--Mid Priority
  • Charlie Response=Code 3--Possible threat to life or property
  • Delta Response=Code 3--Immediately threatening life or property
  • Echo Response=Code 3--Fires or emergencies that involve an imminent threat to life
  • Omega Response=Code 1--Lowest Priority

Typically confirmed fires (Units on scene confirming flames visible) are encoded at the Delta level, and confirmed fires in occupied structures are encoded at the Echo level.

Fire codes: (51-73)

51 - Aircraft Emergency
51-O-1 Airborne Aircraft
51-A-1 Stand BY
51-B-1 Unknown Situation (Investigation)
51-C-1 Aircraft Incoming - Full Emergency (Alert II)
51-C-2 Aircraft Incoming - Minor Emergency (Alert II)
51-D-1 Aircraft Crash (Alert III)
51-D-2 Aircraft Crash Involving Structure (Alert III)
51-D-3 Aircraft Fire on Ground (Alert III)
52 - Alarms
52-O-1 Burglar Hold-up Alarm
52-O-2 Medical Alarm
52-B-1 Residential (Multiple)
52-B-2 Residential (Single)
52-B-3 Non-Dwelling Structure (Shed, Garage, Call Box)
52-B-4 Mobile Home, House Trailer, Portable Office
52-B-5 Unknown Situation (Investigation)
52-C-1 High Life Hazard
52-C-2 High Rise
52-C-3 Commercial Structure
53 - Citizen Assist / Service Call
53-O-1 Locked Out of Vehicle (Unoccupied)
53-O-2 Down Trees and Objects
53-O-3 Hydrant Problems
53-O-4 Sewer Problems
53-O-5 Water Main Break
53-O-6 Other
53-A-1 Locked in Vehicle (Non-Medical Assistance)
53-A-2 Locked In/Out of Dwelling (Non-Medical Assistance)
53-A-3 Citizen Assist (Non-Medical Assistance)
53-A-4 Animal Rescue
53-A-5 Water Problem
53-B-1 Locked In Vehicle (Possible Medical Assistance)
53-B-2 Locked In/Out of Dwelling (Possible Medical Assistance)
53-B-3 Citizen Assist (Posibble Medical Assist)
53-B-4 Unknown Situation (Investigation)
53-C-1 Water Problem with Electrical Hazard
54 - Confined Space / Structure Collapse
54-B-1 Entrapment (Unconfirmed)
54-C-1 Entrapment (Unconfirmed) with Hazardous Materials
54-D-1 Entrapment (confirmed)
54-D-2 Entrapment (Confirmed) with Hazardous Materials
55 - Electrical Hazard
55-A-1 Transformer Outside (Wire or Pole)
55-A-2 Appliance with No Odor Present
55-B-1 Electrical Arching
55-B-2 Wires Down with No Smoke or Arching
55-B-3 Appliance with Odor Present
55-B-4 Electrical Odor
55-B-5 Unknown Situation (Investigation)
55-C-1 Electrical Hazard with or near Water
55-C-2 Wires Down with smoke or arching
56 - Elevator / Escalator Rescue
56-O-1 Elevator Malfunction - No Occupants Inside
56-O-2 Escalator Incident - Not Caught (with or without injuries)
56-A-1 Elevator Malfunction - Occupants Inside
56-B-1 Elevator Malfunction - Occupants Inside (Medical Condition Present)
56-B-2 Caught (Escalator) with no injuries
56-B-3 Unknown Situation (Investigation)
56-D-1 Entrapment (Escalator) with injuries
57 - Explosion
57-B-1 Vehicle Explosion
57-B-2 Non-Structure Explosion
57-B-3 Unknown Situation (Investigation)
57-D-1 High Life Hazard
57-D-2 High Rise
57-D-3 Commerical Structure
57-D-4 Residential (Multiple)
57-D-5 Residential (Single)
57-D-6 Large Non-Dwelling Structure (Barn, Storage Building)
57-D-7 Small Non-Dwelling Structure (Shed, Detached Garage)
57-D-8 Large Fuel/Fire Load Vehicle
57-D-9 Mobile Home, House Trailer, Portable Office
58 - Extrication / Entrapped (Machinery, Vehicle)
58-B-1 Entrapment (Unconfirmed)
58-B-2 No Longer trapped
58-D-1 Entrapment (Confirmed)
59 - Fuel Spill
59-B-1 Uncontained Spill <50 Gallons
59-B-2 Contained Spill <50 Gallons
59-C-1 Uncontained Spill >50 Gallons
59-C-2 Contained Spill >50 Gallons
59-C-3 Unknown Situation (Investigation)
60 - Gas Leak (Natural and LP Gases)
60-B-1 Outside Tank Leak <5 Gallons
60-B-2 Outside Odor
60-C-1 Outside Tank Leak >5 Gallons
60-D-1 Inside Rupture/Tank Leak (Odor)
60-D-2 Outside Rupture (Odor)
61 - HazMat
61-A-1 Abandoned Waste
61-B-1 Small Spill (<5 Gallons)
61-C-1 HazMat (Contained)
61-C-2 Illeagal Drug Lab
61-D-1 HazMat (Uncontained or moving)
61-D-2 HazMat Fire (Outside)
61-D-3 Illeagal Drug Lab Fire (Outside)
61-D-4 Illeagal Drug Lab (Uncontained or Moving)
62 - High Angle Rescue
62-B-1 Unknown Situation (Investigation)
62-D-1 High Angle Rescue
63 - Lightning Strike (Investigation)
63-B-1 Residential (Single)
63-B-2 Non-Dwelling Structure (Shed, Garage)
63-B-3 Mobile Home, House Trailer, Portable Office
63-B-4 Outside Lightning Strike
63-B-5 Unknown Situation (Investigation)
63-C-1 High Life Hazard
63-C-2 High Rise
63-C-3 Commerical Structure
63-C-4 Residential (Multiple)
64 - Marine Fire
64-B-1 Extinguished Fire
64-D-1 Threatened Structure or Other Boats
64-D-2 Docked in Coastal Water
64-D-3 Docked in Inland Water
64-D-4 Beached in Coastal Water
64-D-5 Beached in Inland Water
64-D-6 Coastal Water
64-D-7 Oceanic Water
64-D-8 Inland Water
64-D-9 Dry Dock
65 - Mutual Aid / Assist Outside Agency
65-A-1 Mutual Aid to Incident (Single Unit)
65-A-2 Assist Outside Agency (Single Unit)
65-A-3 Mutual Aid Move Up/Cover (Station Assignment)
65-A-4 Mutual Aid to Staging Area
65-B-1 Mutual Aid to Incident (Single Unit)
65-B-2 Assist Outside Agency (Single Unit)
65-D-1 Mutual Aid to Incident (Multiple Units)
65-D-2 Assist Outside Agency (Multiple Unit)
66 - Odor (Strange / Unknown)
66-A-1 Odor Inside
66-A-2 Odor Outside
66-C-1 Odor with Patients
67 - Outside Fire
67-O-1 Controlled Burn
67-A-1 Transformer (Wire or Pole)
67-A-2 Extinguished Fire
67-B-1 Small Outside Fire
67-B-2 Small Outside Fire with hazardous materials present
67-B-3 Unknown Situation (Investigation)
67-D-1 Wildland Fire
67-D-2 Brush/Grass Fire
67-D-3 Large Outside Fire
67-D-4 Large Outside Fire with hazardous materials
68 - Smoke Investigation (Outside)
68-A-1 Light Smoke
68-A-2 Odor of Smoke
68-C-1 Heavy Smoke
69 - Structure Fire
69-C-1 Appliance Fire (Contained)
69-C-2 Extinguished Fire
69-D-1 High Life Hazard
69-D-2 High Rise
69-D-3 Commerical Structure
69-D-4 Residential (Multiple)
69-D-5 Residential (Single)
69-D-6 Chimney
69-D-7 Large Non-Dwelling Structure (Barn, Storage Building)
69-D-8 Small Non-Dwelling Structure (Shed, Detached Garage)
69-D-9 Mobile Home, House Trailer, Portable Office
69-D-10 Unknown Situation (Investigation)
69-E-1 Person on Fire (Inside)
69-E-2 Trapped in Structure Fire
70 - Train / Rail Incident
70-O-1 Moving Train
70-B-1 Unknown Situation (Investigation)
70-D-1 Structure Involved
70-D-2 Derailment Below Ground
70-D-3 Derailment Elevated (Above ground)
70-D-4 Derailment at Ground Level
70-D-5 Derailment in Tunnel
70-D-6 Fire on Board Below Ground
70-D-7 Fire on Board Elevated (Above Ground)
70-D-8 Fire on Board at Ground Level
70-D-9 Fire on Board in Tunnel
70-D-10 Vehicle(s) Involved
71 - Vehicle Fire
71-A-1 Vehicle Fire (Extinguished)
71-B-1 Vehicle Fire
71-B-2 Large Fuel/Fire Load Vehicle (extinguished)
71-C-1 Vehicle Fire Threatening Non-Structure
71-C-2 Vehicle Fire in Parking Garage (Parkade)
71-D-1 Vehicle Fire with Threatened Structure
71-D-2 Tanker or Tractor-Trailer (Semi) with Flammable Cargo
71-D-3 Large Fuel/Fire Load Vehicle
71-E-1 Vehicle Fire (Occupants Trapped)
72 - Water Rescue
72-A-1 Animal Rescue
72-B-1 Stranded Motorist (Non-threatened)
72-B-2 Unknown Situation (Investigation)
72-E-1 Sinking Vehicle
72-E-2 Ice Rescue
72-E-3 Swift Water Rescue
72-E-4 Scuba Dive Accident
72-E-5 Swimming Pool Rescue
72-E-6 Coastal Water Rescue
72-E-7 Inland Water Rescue
72-E-8 Oceanic Water Rescue
73 - Watercraft in Distress
73-B-1 Out of Fuel
73-B-2 Engine Will Not Start
73-B-3 Run Aground
73-B-4 Flare Sighting (other than Orange or Red)
73-D-1 Taking on Water
73-D-2 Person Overboard
73-D-3 Flare Sighting (Orange or Red)
73-D-4 Unknown Situation (Investigation) test

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