Why are 999 call handlers like this?

[NotADailyMailJournalist]

Hello

I came across a man collapsed and bleeding heavily from a head wound in the street today. Literally a thick puddle of blood. I slammed a folded, fabric shopping bag on the wound to stem the bleeding.

Me: Hello, I've found a collapsed male, conscious but with heavy bleeding
Call Handler: what age is he? Do you know his name? Did you see him fall?
Me: 60-ish maybe, not sure on name, Davie he says, maybe, no I didn't see it happen. Is the ambulance on its way?
Call Handler: YOU NEED TO ANSWER THE QUESTIONS, LISTEN TO ME! Further questions about when did this happen etc etc.
Me: he's very distressed, can I tell him the ambulance is coming?
Call Handler: FINALLY says ambulance is on way.

Speaking to friends, they say this is common. Why can't the call handler just say "it's ok, ambulance is on way, answer these questions in the meantime"?

Thanks

Ex police call handler here.... its likely because a lot of people (you'd be amazed how many) would immediately end the call as soon as they heard the words "an ambulance is on the way". The call handler needs as much information as possible to be able to prioritise and decide on the speed/type of response. Ambulance call handlers also have a list of questions on a 'script' and they need to get the information required by that script.

Day 1 of my police training was "get the address before getting any other information". Which makes total sense; how else can we get officers on the way to the incident if we don't know where they need to go? But when someone is in a blind panic they just want someone there/then. They completely forget that we need to know the location.

I'd imagine, in serious/grade 1 cases, the ambulance is already well en route by the time the call ends. We certainly had response officers en route while we were still talking to the person making the call.

People genuinely do believe this. I remember one night around Christmas time, a caller insisting that his wife was a much higher priority than anything else we "might have going on" (she wasn't). He took the phone out of the house, despite me asking him to remain with the patient, walked down to the nearby ambulance station (insisting the entire way that there were loads of ambulances sitting there and I was refusing to send them), and then got there and asked "why are there no ambulances here?" 😵‍💫

I had to call 999 for DH, on a few occasions, as he had various health problems.

I knew that they needed coherent and calm answers to questions, so did that.

I followed their instructions if they wanted me to do anything.

They were nothing but helpful and kind to me, and ambulances arrived swiftly.

DH died last year, but I’m incredibly grateful for the help I got.👍

Its a difficult job, I imagine.

How ridiculous. And even more stupid to take the word of a potential murderer that the person is actually dead.

If you had even a tiny clue what you're talking about you'd know that CPR has an extremely low rate of success, and that's when it's done by a trained professional. CPR by an amateur is worse than useless and likely to cause more damage than it prevents.

What a load of rubbish you talk.

You’re talking pure bollocks.
CPR has a low success rate yes, but at the point your doing CPR it’s not possible to do any more harm because <hint> the person is already clinically dead.

Firstly, you can't get deader than dead. If they need CPR, you can't do any more damage than you're preventing.

Secondly, I've met patients who were saved in part by CPR given using the instructions I provided over the phone. It's definitely not "worse than useless", it buys time to get an AED on scene.

I had an awful one when I rang for an ambulance as it was clear a friends mum was on her last legs and near to death. We had no way of getting pain relief in her so I called an ambulance.

When I explained that I thought she was close to death the handler sarcastically said 'what makes you think that then?' I did really want to call back about 6 hours later when she had in fact died. Awful man.

I’ve had to call 999 a couple of times and I’ve always gone along with what they’ve asked of me, I would assume an ambulance is coming if one is needed, so why do you need their confirmation? They’ve got a job to do and I’m sure they do things the way they do with good reason and based on decades worth of previous calls to get the best outcomes, and they don’t need you making it harder for them.

They probably also get their fair share of difficult/rude/abusive/pedantic callers so they need to ask questions to decide whether an ambulance is actually needed.

No! Obviously not. The crew were brilliant. But Wednesday lunchtime is not a busy time for ambulances (it’s not a Saturday night). Ten / 15 years ago the average response time was under 9 minutes and it had got significantly worse since 2020. There must have been a reduction in finding or something that has caused there to be fewer ambulances on standby. With stroke victims every minute counts because their brain tissue dies when starved of oxygen.

The 999 system as it stands doesn’t permit the responder to bypass questions about irrelevancies when the reason for the call is clear. Someone who is standing and talking one second. Then loses all movement and ability to support themselves on one side of their body, including the ability to speak, starts vomiting due to paralysis, etc, is clearly suffering from a catastrophic stroke. His symptoms were textbook. He survived because I was there, but the level of scarring of the brain could have been reduced if he had been reached more quickly. That includes bypassing irrelevant questions when speed is of the essence and having enough slack in the system to reach people in under 10 minutes.

Yeah, you're right. I guess my 15 years as an Emergency Medical Dispatcher for three different NHS Trusts means I know nothing about the processes. My bad. Carry on.

@Genevieva it does
You would just switch to the stroke protocol from whatever you were doing previously. The questions don't matter as they don't delay the help, the call handler (and I have done before) can stay on the phone for as long as they like without causing a delay
I've sat on a call for 2hrs before because there was no ambulance as it kept being diverted to a higher priority

The number of questions doesn't make a difference in how long it takes to dispatch for a suspected stroke. It will usually generate a Cat 2 / Amber response if the patient is awake and breathing - that means that cardiac arrests, active choking etc will take precedence; less than 5 minutes to answer questions will not delay help.

There are important questions in ?stroke dispatch like time from onset of symptoms - it's also important to establish exactly what's happened, because people will just say "he's having a stroke" but the patient is in cardiac arrest, or say "it's a stroke" when it's a seizure. Asking questions allows for safer dispatch. The call handlers may not be healthcare professionals, but the dispatch systems are written and continuously reviewed by doctors and medical councils to ensure that they are appropriate.

Also, the idea of Wednesday lunchtime not being a busy time for ambulances is a thing of the distant past. Winter pressures were a year-round thing three years ago; it's always a busy time for ambulances. If you aren't having a cardiac arrest or similar Cat 1 / Red emergency (or you drop lucky), you're going to be waiting.

Going on a tangent there.

Is there a planned question around the person having signed a DNR (like do you know if … or Do they have a doc in their bag/wallet?)

Im organising all the docs arund that atm and have been wondering what would happened if I fall unconscious in the street (different issue at home/with family etc….)

Crew don't have the time to check for DNRs so will continue treating as appropriate unless medically indicated.

This. There's no such thing as a quiet time any more. Crews can barely get back to base for a meal break, or to a standby point before the next call is in.

And right there, there's that attitude that this whole thread is about. 🙄

It's patronising and rude, and if a 999 call handler was rude to me, I'd put the phone down.

No-one is obliged to help a stranger in medical distress, but people do it out of the goodness of their hearts.

You forget that.

Which is a clear indication that demand exceeds supply. They should not to be working insuch pressurised conditions. Emergency services should have slack in the system to ensure that, unless there is an unusual event, they do get back to base for a meal break. The fact that average response times have increased from under 9 minutes to over 18, indicates there is a severe shortage of staff.

Thanks everyone, esp those who have been especially kind!

I did manage to get some sleep and I feel better today. Had a shower and got on with my housework.

When the ambulance arrived, they did say thanks, I'd done a good job of stemming the blood with the folded up shopping bag! (Better than tissue btw as it doesn't stick to a wound). Once they lifted him up I could see the gash and it's pretty clear it would need stiches but not life-threatening. They did mention that a head injury bleeds a lot esp if the person has been drinking! And good point someone made - think how much mess a spilled pint of milk makes - but people donate that much and are fine.

I think it was the distress the guy was in the bothered me. Plus there was something really shocking about having my hands covered in someone else's blood.

But I certainly learned something from the experience. I'll know what to expect if/when I call an ambulance again.

thanks for proving my point

I was asked the same when I found a dead man who'd been dead for about a week, my answer was absolutely bloody not.

Head injuries do bleed like mad. Well done you for controlling the bleed!

If you're struggling to switch off as the adrenaline and shock wears off and calms down, Tetris really does help - it isn't one of those urban myths, it was my go-to for dealing with tricky calls that stuck in my mind. I became a Tetris whizz after a while 😅

They can't dispatch until triaged, they need certain key pieces of information. If someone isn't breathing they talk you through cpr

Well...duh? Same can be said for all medical professions but it's not like they have chosen to have an inconceivable increase in demand and no help with budget....

They were not helpful and they were not kind. In fact two if them were downright rude.