Tell, don't ask: Simple change in 911 procedure saving lives
Longtime Mesa 911 operator LeAnn McLaws was skeptical at first.
After 17 years of asking callers if they wanted to start giving CPR to a cardiac arrest victim, the department told her and others last fall to stop asking and begin telling: “I need you to start CPR.”
“They’re very excited, they’re wanting help and you have to bring their focus to it,” McLaws said of the process of walking callers through CPR. “We are assertive … and have a calm voice and say, ‘This is what you’re doing,’ and not give them the option.”
So are state health officials, who hope to spread “dispatch-assisted” CPR program statewide from a handful of departments, like Mesa, that are doing it now.
Under the program, dispatchers are trained to more quickly get a caller administering “hands-only” CPR, where appropriate, and to walk them through the process.
Unlike traditional CPR, in which chest compressions alternate with breathing into the patient’s nose and mouth, hands-only CPR just involves rapid pushing on the chest only. It is easier for bystanders to perform, and it keeps blood flowing for the five to eight minutes that it can take for paramedics to arrive.
The survival rate for cardiac arrest cases drops 10 percent for every minute that the victim goes without treatment, according to the state health department, which said an average of 15 people a day go into cardiac arrest in Arizona.
Dr. Ben Bobrow, the medical director for the health department’s Bureau of Emergency Medical Services and Trauma System, played a big role in the creation of the new program in Arizona. State health director Will Humble said Bobrow brought him the idea for the program last year.
“It’s promoting bystander CPR in the community,” Bobrow said. “And working with dispatchers so that they can give callers real-time CPR instructions over the phone.”
The health department began inviting dispatchers from around the state to training conferences last year. Shirley Dunlap, a spokeswoman and longtime Phoenix Fire Department dispatcher, has been a supporter of the new procedure since she was trained in it last year.
“I couldn’t support it more,” Dunlap said. “People are now walking out of the hospital on their own. We bring them in the back and they walk out the front.”
Although keeping callers calm and on the phone has always been part of McLaws’ job, directing a reluctant and scared caller to perform CPR can be difficult.
The switch from traditional CPR to hands-only made it easier for both the caller and the dispatcher, McLaws said, because even people who are nervous are “more apt to do it, rather than finding their pulse and doing the breath” as they would with traditional CPR.
In addition to the change in dispatch protocol, the program asks dispatch centers to keep data on the survival rate of cardiac arrest cases. Officials said the records are an important part of the program because they point to the success of the new method.
Bobrow said he is continuing his outreach and hopes that the lives saved will encourage those departments that have not joined to do so.
“It’s definitely on-going. There are dozens of dispatch centers and many different people to reach and work with,” Bobrow said. “We’re hoping that early success … will help others move along.”