Now Reading
Tell, don't ask: Simple change in 911 procedure saving lives
local

From the archive: This story is more than 10 years old.

Tell, don't ask: Simple change in 911 procedure saving lives

  • Instruction by dispatchers can significantly increase the likelihood that a bystander will perform CPR in the minutes before paramedics arrive, which can significantly increase a victim’s chances of surviving cardiac arrest.
    Mesa Police Dep'tInstruction by dispatchers can significantly increase the likelihood that a bystander will perform CPR in the minutes before paramedics arrive, which can significantly increase a victim’s chances of surviving cardiac arrest.
  • Since last year, the Mesa Police Department has required that 911 dispatchers tell callers to perform hands-only CPR on some cardiac arrest victims and to walk them through the process. The change is believed to have already saved lives.
    Mesa Police Dep'tSince last year, the Mesa Police Department has required that 911 dispatchers tell callers to perform hands-only CPR on some cardiac arrest victims and to walk them through the process. The change is believed to have already saved 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.”

That seemingly simple change saved 13 lives from November to January in Mesa alone, according to the Arizona Department of Health Services, and McLaws is now a believer.

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.”

Video

Hearts by the numbers

  • As many as 70 percent of Americans do not know how to or do not feel comfortable performing CPR in an emergency situation, according to the American Heart Association.
  • It says that four out of five cardiac arrests happen at home.
  • Immediate bystander CPR greatly increases the likelihood of survival for cardiac-arrest victims, yet only a third receive it, according to the AHA.
  • Survival rates increased from 5 percent for victims without CPR to 11 percent for those who got immediate hands-only CPR, according to the University of Arizona Sarver Heart Center.
  • The Arizona Department of Health Services estimates that as many as 660 people a year could be saved by dispatch-assisted hands-only CPR if it was used statewide.
  • The association has a video that teaches hands-only CPR (above).

Read more about

cpr, will humble

— 30 —

Top headlines

Best in Internet Exploder