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Week of 24 October 1997

Vol. I, No. 9

Health Matters

Quick! Call an ambulance!

When should I call 911? What happens when I do?

Since its inception in 1968, dialing 911 has provided a quick, reliable method for reporting emergencies in most areas of the country. The service is designed to provide the fastest possible response to urgent medical emergencies, such as heart attacks, strokes, and aneurysms, as well as emergencies where the patient should not be moved, such as spinal injuries. "If you think you ought to call 911," says Larry Mottley, M.D., FACEP, director of the Emergency Medical Services at Boston Medical Center, "then you probably should. Don't let embarrassment or denial make you change your mind."

Because large metropolitan areas field more 911 calls than do their suburban or rural neighbors, many cities have developed a formal telephone triage protocol to cope with the large volume of calls. "The system is designed to decrease the wait on the line and provide the fastest possible service to the most urgent cases," explains Mottley. "In a serious medical emergency, the ambulance is out the door and on its way within one minute from the time the call is placed."

The first thing the dispatcher will ask is the location and type of emergency, which will determine if the call is routed to the fire department, the police, or emergency medical services (EMS). Keep in mind that the majority of major cities have "enhanced 911" services, which can pinpoint the site from which you are calling. In the event that you are not in the same place as the patient, make sure that the dispatcher knows immediately where to send the ambulance.

If you are routed to EMS, an emergency medical technician (EMT) will ask a short list of basic medical questions to help determine the seriousness of the situation and how best to respond. "Don't worry that answering these questions will hold up the dispatch of the ambulance," says Mottley. "Their first priority is to send an ambulance to take care of the patient, and talking to the caller does not impede this." Once you have answered the EMT's questions, you may be given some basic instructions on how to help the patient while waiting for the ambulance. Sometimes these instructions will be vital to the patient, so be sure to stay on the line until you're told to hang up.

If possible, someone should be outside ready to flag down the ambulance. If no one else is available, you could be instructed to hang up and go outside.

Finally, if the patient has an existing relationship with a particular hospital, you should ask the ambulance service to take the patient there. Unless there is an urgent medical reason requiring transport to the nearest hospital, the ambulance should comply. "Patients get better care when they interact with doctors whom they know," notes Mottley. "They're probably happier about being served by familiar faces as well."

There are claims that 911 service is abused; however, Mottley is skeptical of this. "Big cities have slightly more overuse of 911 than more rural areas, but recent studies have shown that there's really very little abuse of the system. The truth is simply that most people have good judgment and use the system accordingly."

"Health Matters" is written in cooperation with staff members of Boston Medical Center. For more information on emergency health or other health matters, call 638-6767.