Knowing how to make 9-1-1 calls can be a matter of life and death

HEALTH MATTERS

By: Marilyn Anderson, RN
   Emergency situations often crop up without advance warning, making it all the more important that members of the community know how to handle making 9-1-1 emergency phone calls and what to expect from dispatchers who receive these calls. This knowledge can lead to more effective communication with the dispatcher, and ultimately to a more timely and appropriate response from medical personnel, police officers and/or firefighters.
   The moment a 9-1-1 dispatcher answers a call, emergency response begins. Calls to 9-1-1 should be made only to save a life, report a crime or report a fire. The dispatcher will ask the caller a series of questions related to the particular emergency that is being reported.
   In situations requiring medical attention, the dispatcher will send to the scene either a Basic Life Support ambulance, an Advanced Life Support ambulance, or both, depending on the answers provided by the person placing the emergency call. The BLS crew can do Cardiac Pulmonary Resuscitation and transport patients, while the ALS team has graduated from a course in advanced cardiac life support and can begin IVs in addition to doing CPR and transporting patients.
   It is extremely helpful to have use of a cordless phone when reporting a 9-1-1 emergency. The mobility of a cordless phone enables the caller to be an eyewitness who can tell the dispatcher exactly what is happening and answer the dispatcher’s questions.
   Once a call is received, dispatchers need to evaluate the different situations in order to help prompt the EMS response team. For medical emergencies, various questions determine the status of patients who are suffering from breathing problems, are unconscious, in cardiac arrest, experiencing chest pain or heart problems, or having unknown problems.
   The dispatcher will always ask if the patient is alert and breathing normally. You will be asked to report the age, sex, specific location, chief complaint, pertinent related symptoms, medical/surgical history, if any, of the patient needing care; whether other agencies are responding, and whether there is any danger to the units who will be responding to this crisis. After this, the questions become more specific and the answers help the dispatcher know which team to send to the scene.
   For example, if the person in question is suffering from an apparent cardiac arrest and the caller is unsure about consciousness, the dispatcher will ask the following questions:
   

  • Does the patient respond to you? Talk to you? Answer questions? Hear you?

   

  • Does the patient move? Flinch? Move arms or legs?

   

  • Are the patient’s pupils fixed and dilated?

   If the caller is unsure about breathing, the dispatcher will continue to instruct the caller as follows:
   

  • Go to the patient and see if the chest rises.

   

  • Listen for the sound, frequency and type of breaths.

   The dispatcher is interested in learning if the patient is taking ineffective breaths which occur after cardiac arrest; these are referred to as "agonal respirations." Signs of agonal respirations are often reported as gasping, snoring, or gurgling; barely breathing; moaning weakly or heavily, and occasional breaths being taken.
   If the dispatcher learns that the patient is unconscious or not breathing adequately or at all, he or she will call for simultaneous ALS and BLS ambulances to be sent to the scene.
   After learning about the patient’s status, the dispatcher will then issue pre-arrival instructions to the caller that may include keeping the patient calm, having the patient lie down or sit up, starting CPR, loosening tight clothing and gathering medications to the EMS squad upon arrival.
   Clearly, being able to answer these questions can make all the difference to the life of a patient needing emergency care.
   If you find yourself having to make a 9-1-1 call, keep this order of events in mind and do your best to remain calm and focused by taking deep breaths and speaking slowly and clearly.
   Remember that 9-1-1 calls should be made only to save a life, report a crime or a fire. Know that communications personnel receive information on a screen that tells them of your location, phone number and name of the person who owns the phone. This information is available regardless of any blocking devices placed on the phone.
   If calling from a cellular phone, be prepared to state your type of emergency and give the dispatcher your name, cell number and your location in case you get disconnected.
   Unless you have a life threatening emergency or need medical attention, do not dial 9-1-1, but instead, notify your police department on the regular seven-digit telephone line.
   To keep up-to-date on your own life-saving skills, consider signing up for one of the many CPR courses offered to the public.
   Be sure to teach your children how and when to place 9-1-1 emergency calls.
Marilyn Anderson, RN, is the Director of Nursing at Princeton House, a unit of The Medical Center at Princeton. This article was prepared in collaboration with Lorraine Seabrook.