I didn’t intend to call 911 recently. But while putting my phone in the pocket of pants that are a bit snug, I must have accidentally pressed the volume button “five times in rapid succession”. I was puzzled by the alert tone sounding from my posterior. By the time I got the phone fished out and understood what was happening, the screen giving me the option to cancel the 911 call was flashing off. And my phone was dialing 911.
As embarrassing as it is to “butt dial” 911, we take for granted that an ambulance will come when we call. Still, in rural areas, we know it can be a while before it arrives. So we take CPR classes, note the location of AEDs in our communities, and remind loved ones to make good choices.
Nevertheless, things happen. When you live out here, you kind of learn to accept certain risks (rough roads, ticks, cell phone dead zones). But anything we can reasonably prepare for brings some peace of mind.
So here are some simple, no-cost tips for being slightly more prepared for when a 911 call is a true emergency, not a butt-dial.
What 911 might ask. Emergency communications specialists are trained to coach callers through CPR and emergency childbirth and get information from people in highly stressful situations. But even miracle workers are hamstrung when a breathless caller blurts out a vague need at an even more vague location, then hangs up.
If you’re the caller, stay on the line. If you’re in a moving vehicle and know you’re approaching a cellular dead zone, tell the 911 operator. If your cell phone battery is at 14%, tell them. But if at all possible, stay on the line.
Expect a 911 dispatcher to ask where you’re calling from, who you are, and the nature of the emergency. Your responses lead them through a series of if/then considerations.
Practice situational awareness. That’s just fancy talk for being aware of your surroundings and what your observations might mean. We pay to practice situational awareness in the fantasy worlds of video games. You can also practice scenarios in real life, even if you aren’t dodging zombies.
For example, imagine you’re driving down a country road and come upon a motor vehicle collision. You’re about to become the eyes and ears of the 911 operator who has to decide what resources to send to the scene, and how urgently they are needed. Where are you precisely? How many vehicles are involved? Does it appear that people might be trapped? Is anything blocking the road? What kind of vehicles are involved? What position are vehicles in (i.e. upright, upside down, separated, together). Can you see if the airbags are deployed? What is notable about vehicles or their loads (i.e. logging truck, propane tanker, liquid manure hauler, tractor, ATV/UTV, Amish horse and buggy, electric cybertruck, flatbed trailer loaded with beehive boxes, barking dogs in the car, injured bear/moose/horse, even “there’s a crane truck upside down on top of a pickup truck”).
Now imagine you’re calling for help for a neighbor. What’s the location – precisely? Approximate age, gender, and weight of the patient? Are they conscious? Able to talk? Oriented or confused? Ill or injured? What’s the chief reason for calling an ambulance? Were they recently hospitalized? Were they felling a tree and cut by the chainsaw, or trapped under the trunk when it fell? Do you observe bleeding, vomit, loss of bladder or bowel control? Shortness of breath? Pallor? Is there someone available to stand at the end of a long driveway to direct the ambulance to the patient? Will additional manpower be needed to carry them down a narrow flight of steps and out to the ambulance?
Who you gonna call? It’s great to be the neighbor folks can count on when they need a hand, and to have family, friends, and neighbors you can count on when you need help. But sometimes, it’s not in anyone’s best interest to spend time seeing if there’s someone who can help lift, move, or drive.
Two of the most capable women I know have had to call an ambulance in recent months. One needed cardiac care. The other needed pain management. Both briefly considered the marginally quicker option of having someone drive them to the hospital. But a driver can’t perform CPR while operating a motor vehicle. And a driver isn’t necessarily trained or equipped to help move someone in extreme pain through a house, down steps, and into a seated position, liable to make the pain even worse on the long drive to the hospital.
There are other conditions, as well, that might warrant an ambulance call, including, for example, heavy bleeding, excessive vomiting, shortness of breath, and the F.A.S.T. signs of stroke.
And when you live far from a hospital, you really, really need to read and heed the warnings about what circumstances require what interventions after a hospital stay or outpatient surgery. In other words, read the discharge papers (all the way through). Have another trusted person read them, too, in case they need to act on your behalf.
Also consider weather and road conditions when making a decision about who to call. Icy roads, blinding snow, dense fog, road construction (especially bridge projects), and other factors may impact whether it makes sense to go to the emergency room by private vehicle or call an ambulance.
ICE and your lock screen. Most of us are more or less perpetually attached to a cell phone nowadays. So it makes sense to use it to communicate important information for emergency care providers – especially for someone who is unconscious or otherwise unable to answer questions about medical conditions, medications, and emergency contacts.
It makes even more sense to ensure those who need that information can access it, even if the phone is locked.
This came up in conversation one day among the knitters who gather weekly at a local coffee shop. It was the first time some had ever heard that you can go into a phone’s Settings to customize your Emergency Information (sometimes called ICE for In Case of Emergency). People helped each other get set up. It’s actually easier than picking up a dropped stitch.
Sometimes, though, there’s information so important it needs to be flagged just in case someone has to call 911 for you. After my friend Lynn had a stem cell transplant, if she needed a blood transfusion, it had to be irradiated blood. We have both seen enough motor vehicle collisions on country roads as EMTs to recognize the elevated risk of so much travel on rural highways to a regional cancer center. So she added text to the image on her lock screen to flag her medical status and blood transfusion needs.
PNB. In 911 parlance, PNB is short for pulseless non-breather. When someone calls for an ambulance for a person who appears not to be breathing or have a pulse, the 911 operator will probably try to help the caller or others at the scene perform CPR, if they can, until EMS arrives.
A few years ago, a neighbor called us late one night to help her husband, who had fallen. When we arrived, he was not breathing, had no pulse, and his coloring was gray. Knowing something of his age and medical history, it appeared he had met a welcome end as he had wished, in the house where he was born.
With no cell signal to step outside to make a call, we used her landline to call 911. When the dispatcher asked if we could begin CPR, I stumbled over how to respond. I’ve done CPR other times for the benefit of family members, so they would know we tried even if there was little chance of bringing the patient back. In this situation, it seemed unnecessarily intrusive. But the call earlier made it seem like she thought he just needed help getting back to bed. Finally, she reached over to pat my shoulder and said, “I know he’s gone.” It was a comfort to me to be able to speak openly then with the 911 dispatcher.
Here’s what might happen next, in a similar situation: The ambulance continues en route unless someone else authorized to call it a death (law enforcement, off-duty EMS) arrives first. Wait for them to arrive before doing things like turning off an oxygen concentrator, removing tubing, or repositioning the body.
Law enforcement may need to call in the coroner to make an official declaration. I don’t know how long that takes in a city, but at the far edge of a county, it’s a good while. In the meantime, they may take photos, ask questions – even ask to gather up the deceased’s medications. That last may be less for investigative reasons than to reduce incentives for break-ins or pilfering. Once the coroner has done their job, there’s another wait for the funeral home to arrive to collect the body.
One of the blessings of living in a rural area is seeing the kindness from law enforcement toward the bereaved, who might spend much of that wait trying to sort out several generations of connections to establish which branch of a family the duty sergeant belongs to. Those officers may stay to help the funeral home move the deceased with dignity. They may stay even longer to put the furniture and other things that had to be shifted for moving the body back into place.
Longtime readers may recall that deputies were dispatched to my home not once but twice for welfare checks when our former landline confused power outages with emergencies. That was even more embarrassing than butt-dialing 911 because my pants are too tight. But I’m grateful to the 911 operators who answer and the deputies and EMS personnel who respond – even when it’s a false alarm.
Donna Kallner writes from Langlade County in rural northern Wisconsin.
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