Anatomy of a 911 call: Prepare ahead of time

Almost everyone knows to call 911 when a medical emergency occurs, but just making the phone call may not be enough to help prevent a crisis from becoming a tragedy.

According to Sgt. Eric Flowers at the Indian River County Sheriff’s Office, people need to prepare ahead of time to maximize the effectiveness of emergency response.

Topping Flowers’ list of things to do before a crisis occurs is to always know and clearly communicate your location, especially if you’re using a cell phone. (More on that later.) This isn’t usually an issue if you are at home, but if you witness a medical emergency away from home, taking time to glance at street signs and address numbers before calling can speed up response time by precious seconds or minutes that could make all the difference

Next, Flowers urges everyone – and seniors in particular – to come to the Sheriff’s office on 41st Avenue or to the substation in the Indian River Mall for a free “Vial of Life” emergency kit. Included in that kit is an over-sized prescription bottle that is big enough to hold all of your regular-size prescription bottles so they’re all in one place, and paramedics can quickly determine both the drugs and the dosages you are taking, thereby avoiding dangerous drug interaction during emergency treatment.

The Sheriff’s kit also includes a brief form to fill out that will give paramedics other important information they’ll need should emergency care be necessary.

The form, which comes with a “refrigerator magnet” pre-attached, asks for information such as name, sex, date of birth, age, blood type, glasses or contacts, pacemaker, native language, religion, doctor’s name and phone number, emergency contacts and phone numbers, allergies to medicines, medication currently being taken, whether the person has ever been treated for certain diseases or conditions including Alzheimer’s, diabetes, high blood pressure, hepatitis, angina, HIV/AIDS, stroke, as well as medical insurance provider/Medicare number and whether or not there is a “do not resuscitate” order. It all fits on the two sides of an 8” wide by 5 1/2” high green card.

That form alone, says Flowers, could help save your life.

The 911 emergency network is surprisingly new. It wasn’t until 1999 that President Clinton signed Senate Bill 800, designating “911” as the nationwide emergency phone number. In the ensuing 15 years, telecommunications have changed dramatically. Some changes have helped solve problems with the system but others have actually created new ones.

Last year the Indian River Sheriff’s office received more than 13,000 emergency 911 fire and rescue calls. Of those, 2,177 were from the City of Vero Beach while 10,830 came from the rest of the county.

911 calls from an address in the City of Vero Beach are usually routed automatically to the Vero Beach Police Department. The police automatically dispatch an officer, but if the call is about a medical emergency the call is also passed on to the Indian River County Sheriff’s Office, where dispatchers will seek additional information and then send an ambulance and paramedics to the scene. The same dual procedure holds true in Sebastian.

In areas of the county outside of Vero and Sebastian, calls automatically go straight to the Sheriff’s Office public safety dispatch center where Sandy Fox, a 29-year veteran of the department, is the unit supervisor. She and her team and their Computer Aided Dispatch (CAD) system have the county broken down into approximately 240 sectors so that emergency services can be routed more efficiently.

Most people in the midst of a medical crisis probably don’t know or care who is routing their emergency calls as long as help arrives quickly, but today’s new technologies do pose some new risks.

Those risks include Sgt. Flowers’ concern about calls from cell phones. Whatever cell tower your phone “pings” off of can sometimes enter the CAD system as your location and unless you happen to have an unobstructed sightline to an orbiting satellite for an accurate GPS reading, that location can be off by quite a bit.

When former FCC Chairman Julius Genachowski was appointed to the top job at the Federal Communications Commission, he wanted to find out about cell phones and 911 calls. He went to a call center not unlike the one at the Sheriff’s Office here. At the suggestion of call center personnel, Genachowski used his own cell phone to test the system’s response. Instead of showing the FCC chairman sitting right next to the dispatcher, the system showed the call was coming from a grocery store about a quarter of a mile away.

Had Genachowski’s call been a real emergency, first-responders might well have been rushing through supermarket produce aisles looking for a person who wasn’t really there at all. That’s why Sgt. Flowers says knowing your location, including cross streets or an address, is so very important. Knowing exactly where you are means dispatchers can get help to you faster.

Then too, sometimes computers almost 2,000 miles away can wreak havoc on 911 systems, including ones here in Florida.

Last week, the Washington Post reported that a software glitch in the servers of Intrado, a Colorado-based company that owns and operates a routing service for 911 calls that is supposed to direct those calls to the most appropriate “Public Safety Answering Point,” caused the service to fail.

It failed miserably.

For six hours, some 11 million Americans in seven states, including Florida, were totally without 911 services.

The Federal Communications Commission ruled the event was “an entirely preventable software error.” It seems Intrado had set an arbitrary number of calls its PSAP system would take that day and once that number was reached, it basically hung up on all subsequent calls. The company now says it has corrected the problem.

Despite Intrado’s system failure and confusion about patient location caused by ricocheting pings, the overall reliability of the 911 system is remarkable given the sheer volume of calls it handles. While Indian River County may have accounted for only about 13,000 fire and rescue calls in 2013, the FCC estimates that a total of more 240 million 911 calls are placed nationwide each year.

A large number of the problems that are reported with 911 emergency medical calls can actually be traced to the caller rather than the system. “You’ve got to get control of the call,” said supervisor Fox, while acknowledging that’s easier said than done when someone is calling about a spouse or loved one facing a potentially life-threatening situation. It can be even more difficult when victims of heart attacks or strokes attempt to make such calls themselves as speech itself may be difficult or impossible for the caller.

Nonetheless, Fox says she’s proud of her team and confident about their expertise in handling calls. “They are all emergency medical dispatchers trained to ask the right questions.”

That training, Fox reports, is extensive. She cites five-to-six weeks of classroom training followed by “a couple of months” of close supervision by previously trained dispatchers followed by another month of observation that exceeds the Bureau of Labor Statistics’ training guidelines for 911 operators.

So despite some 911 problems, Vero residents should feel reassured about the likelihood of a quick response in a medical emergency – especially if they prepare beforehand.

In the darkened call center at the Sheriff’s Office on 41st Avenue, banks of computer monitors glow 24 hours a day, seven days a week.

Each incoming call is handled by Fox’s dispatchers using carefully-constructed protocols, pre-set questions and procedures with the aim of streamlining response times and getting all of Indian River County’s residents and visitors the emergency medical assistance they need as quickly as possible.

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