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

If you just answered their questions it would be quicker. A lot of the time, a bleeding head wound is not the highest priority so they can't just dispatch an ambulance instantly. Also they are not the ones dispatching, they need to get all the relevant information so the dispatchers can categorise it and dispatch appropriately.

I had the same. A gentlemen had a huge stroke in front of me. They kept asking inane and irrelevant questions. It took 20 minutes for the ambulance to arrive, even though it’s located a 5 minute drive away.

Because they read off of scripts. It's a symptom of managerialism. Everything has a procedure and many tiny processes, and then those processes have many tiny subprocesses. This is what happens when things are made into a system with suffocating bureaucracy. People suffer, but as long you can put people in jobs, it doesn't matter.

Tony Blair was shocked in that session on QT, I think in the 2005 election season. That target he set for GPs where GPs must see patients within 48 hours; he didn't quite realise the extent of the chaos he created. It resulted in people not being able to book an appointment for beyond that day, but that still meant that people saw their GP within 24 hours, thus beating the 48 hour target. So they've not only met a target, they've beaten it. Looks perfect on paper and that's all they care about.

they were very calm the few times i have called,
i think they apologised and said they had to ask, and then the routine/standard questions.
one time i called but hung up and then when i went to call again it was still connected.
one time my curious 6 year old called and they called back and were lovely

They won't call an ambulance until they've ascertained you definitely need one. Ambulances are a scarce resource, often high in demand, and need to allocated accordingly. For a non-emergency this may include a long wait until,one is available.

You have to answer a series of questions so the call handler can determine what category to put you in, or if an ambulance is even the right next step.

I have been thinking about this a lot since I first posted on the thread. I immediately disclosed my own disability when she started the script. I had already managed to give the address, age and unknown but conscious and breathing (because I could hear them) details. I told her I am autistic, you know a condition (insert your word of choice if you want I'm not here for language arguments) which leaves me with communication difficulties, among other things. I told her I cannot do x/y/z and i do not know etc. I ended up mute and unable to tell her anything further due to her brutal attitude with the questions. There has to be some level of understanding and awareness of callers who have their own difficulties. She was rude to me and placed a level of expectation on me that I had already disclosed I did not possess. As I said before, by the time the ambulance arrived one of the paramedics came need duo tending to me because I was so distraught. There was no need for that to have escalated to such a level had the handler listened to me and taken on board my disability.

They will have already dispatched the ambulance but questions are helpful for the paramedics, they have to ask them.

would they still ask all these questions about age and what happened etc BEFORE starting to order the ambulance to the scene

They will be still organising help, before they tell you sometimes.
They still need the other information to ascertain it's definitely an ambulance you need and if it's a priority.

Sadly the demand for medical help often outstrips the supply, so what might feel,like an emergency to you may well not be the highest priority to the call hand,er and the ambulance service.

Wow
I’m pretty shocked at the number of people not understanding why call handlers ask what they do and thinking they know better. Saying things like “well they should just work it out from what I’ve said”

these people are doing an incredibly difficult job, in a highly trained way that is the best way to get help quickly prioitised and sent, but you know better!

I did role play calling emergency services on my first aid course.

Right. So the point of the thread being, why can't they tell us this information at that point?

Ambulance services use a system called Pathways in order for the call handlers to get the most appropriate and timely care for patients. It has a strong clinical evidence base and is updated regularly based on new evidence. Some of the questions may not seem necessary but they do serve a purpose. It has nothing to do with management practices, lack of empathy etc. The call handlers are not medically trained so have to stick to the Pathways script, this ensures that patients are being dealt with safely, they can't go asking random questions because they are not qualified to do so. It is an incredibly stressful job and burnout rates are high. They might seem robotic over the phone but believe me, they are deeply affected by some of the calls that they deal with. I work for an ambulance trust.

I think you need to reframe this. This is very much a transaction of information. Your role is to get appropriate help there asap and their role is to get the information from you. If they were to tell you yes an ambulance is on its way many people would then hang up without giving the information - these questions also help focus the caller because if they need to give cpr and have never done it before they need to be as calm as possible and be able to listen to instruction.

i can’t imagine the number of people the ambulance call handlers have to speak to daily, but they have no idea of your circumstances so need to be quite unemotional with regard to the information they need.

it may seem unsympathetic to some but these are often life / death situations and they need to respond quickly and ensure they can file the casualty without delay.

The thing is, it's probably quicker for the call handler to ask again than it is for them to write the info down that you've given them which is likely in the wrong order for their form and then manually dissect it all and put it into the right box without making a mistake, while on the phone to somebody who is panicking and maybe asking questions in your ear and wondering why you aren't talking to them.

The call handler will be going through the questions in order so that they can get the information to put into the form in the right order which minimises making a mistake. For example if they put 60s as the age but had accidentally put it in another box like how much blood the caller thinks the patient has lost, that could have a dramatically different meaning and mislead the crew.

It might feel like time wasting at the time but actually, asking for factual/objective information is more likely to calm a caller rather than simply trying to reassure them.

And I hadn't even thought about the possibility that the caller will just hang up if they think the ambulance is coming without giving any further info.

The phrase used in this area (which is reassuring)

Let me get some more details and I will get the right help to you
And
Help will be coming soon

Both imply help is coming but doesn't SAY its coming now

I had to ring 999 when one of my nursery pupils fell and hit her head... her eyes were rolling and she was losing consciousness.. eventually the dispatcher said "I'll see if I can book her into the walk in within the next 4 hours".

Poor child ended up in hospital for a few days with severe concussion and subject to loads of tests.

I was shocked at the blase attitude of the dispatcher and the fact they didn't send an ambulance at all! The child was barely conscious, eyes rolling back in her head and I then had to reply this info to her shocked parent who had raced to school! We advised taking her straight away and she was seen as an emergency and immediately transferred to the specialist hospital!

I can see from the many responses that people are quite shocked at the response they get during 999 calls. I think I might have been too, if I didn't know why they do it. However, for work I needed to do extensive first aid courses every couple of years. During the courses the trainers also handled the topic op triage, which is what 999 call dispatchers do.

Some posters have said that there are a limited number of ambulances available and this is part of the reason for all these questions. The dispatchers need to know how urgent it is, as they may need to divert an ambulance already enroute to another incident. That is why you get questions such as "How did it happen?", because the cause of the injury/accident can help them determine how long a patient can wait. As awful as this is, there is a good chance there are more urgent cases with patients who are much closer to death.

Another reason they ask all these questions is because they can't know how knowledgable you are in medical care and first aid. They want to know if they need to give you information in what you might do to reduce the risk of further injury or to prolong someone's life long enough for the ambulance to get there in time.

Please trust their expertise. They know what they are doing. But I would alo love it if the government would spend some air time on making people acquainted with this information, so it's not such a shock when the stakes are high.

For those of you who would like to take a look at the other side of the phone call, I can recommend the game in the link below. It's enjoyable to play, but also a rude awaking to the reality of limited resources when it comes to emergency responders:

https://store.steampowered.com/app/503560/911_Operator/

So the point of the thread being, why can't they tell us this information at that point

Many will say that help is being organised, but won't always be specific.
Experience tells them, backed up by posters working in the field, that often once someone is told the ambulance is coming they hang up and/or stop listening. But the call handler still needs more information.

Sometimes they simply can't tell you as demand outstrips supply and there may not be a free ambulance, even for a cat A situation.

They can't just send one without knowing as much as possible nor say it's on it's way and it's not.
But it does not encourage strange people to help rather than just walking by!

(I called the police once to a brawl outside an old lady's house and the questions just went on and on).

However ...
Bless you for helping, you quite possibly saved his life.
And no excuse for those people who did walk by, annoying phone calls or not.
Would be amazing if you can find out (for yourself) how he's doing (you occasionally see post in fb group re ('thanks to that person, it was my mum, she is doing fine')).

I found 999 actually quite obstructive on one occasion. As I approached a bus stop, an elderly woman staggered out saying "help, I've fallen" and she had a massive flap of skin hanging from her face and there was blood everywhere. I phoned 999 and had to deal with the questioning while trying to stop this clearly confused woman from boarding a bus while bleeding profusely. Driver refused to move off when he saw the state of her. Woman said she didn't want an ambulance so 999 told me "we can't send one if she doesn't want it". I said that she could be confused due to head injury, dementia or both - I could hardly just leave her there to bleed to death a the bus stop. I had to trick the woman into saying the word 'yes' so the call handler would hear it and send an ambulance.

999 callers deal with non stop, traumatic calls all day long. They have questions they need to ask and I'm sure they have built up a resilience to be able to ask them and try and separate emotion from the scenario. A team of them work in the same building I am in and it seems like a tough job.
Fair play to you OP stopping and getting him help. Someone's son/brother/friend is now hopefully going to be ok thanks to your help.

Did you find out how your bleeding stranger got on? He’d probably love to thank you for showing him some kindness and helping him.

In hindsight if he was distressed and you wanted to tell him an ambulance was coming, it would have been fine to reassure him that you were getting assistance without getting frustrated with the call handler.

I think most people calling 999 are panicked and that comes out as anger with the call handler. They assume the operator’s calm methodical approach means they don’t understand This Is An Emergency!

The level of verbal abuse ambulance call handlers receive is shocking. She was just doing her job.

On the 999 TV programmes, and in real life, I've always been assured that they are 'arranging help' they haven't just clicked a button that says dispatch an ambulance as soon as you say bleeding head wound. As has been proven on this thread, people are squeamish and one person's LOADS OF BLOOD is another's small puddle... They have to make sure.

Also ambulance call handlers are not medically trained so they have no way to figure out what you're saying in a garbled panicked mess, they have to get you to answer the questions so that the medically trained ones can dispatch, and plan care appropriately.

You see that in the programmes that the calls come through as 14 year old cardiac arrest, when actually it's a 14 year old who has fainted but the call has been panicked so no one knows what's actually happened.

The level of understanding on this thread is seriously lacking.

I can only talk directly to doing it for the police, but obviously there’s similarities.

It’s a really bloody difficult job. It’s also rewarding and amazing and I’m so glad I did it.

Shift life - this either works for you or it doesn’t. I couldn’t do it long term. I was well paid for the shifts though - is there a shift allowance and have you taken that in to account?

It’s immensely stressful. You can talk someone down from suicide, then get a call saying they’ve been overcharged for their pizza, then get someone who is absolutely distraught and can’t speak English and you have to figure out what language they speak and get a translator on the line, then a child ringing because their dad’s beating up their mum and they’re terrified, then someone who wants us to arrest the prime minister, then a psych patient who has locked themselves in a supply cupboard and is terrified that the people banging on the door are going to kill him, then a woman who has been raped and dumped and left at the side of the road - she has no idea where in the country she is and the system can only give you a mile radius, then a bloke wanking. And you have to be content with the fact that your bit ends when a police officer gets there - you don’t know how it’s resolved. That’s the bit a lot of people find really difficult and I expect is very relevant to the ambulance service too.

I think I found police easier than I would have found ambulance. Police don’t have a script, you can use your initiative a lot more. There is a huge amount to memorise.

One thing to check is whether it’s just handling 999 calls or handling all incoming calls. So my above list would all have been 999, but in between that we’d get 101 calls, any calls to a general police station number, calls from police themselves needing other departments. Etc etc. Sometimes this was ok because they were slower paced, but it also made it difficult to adjust to the pace of calls going up and down.

for what it’s worth, I rang once with a choking baby and they didn’t fuck around then.