1) The LOUDER you shout, the quicker the ambulance will come.
2) The QUICKER you speak, the quicker the ambulance will come.
3) Even though the call taker asked for the address of the emergency, what he really wants to hear is a detailed description of what happened, starting with the patient having his tonsils out in 1962.
4) The ambulance cannot possibly leave the ambulance station until you hang up, so it is imperative to hang up as soon as possible, even if the call taker is trying to tell you something. Hanging up several times will make the ambulance come twice as fast.
5) A good call taker should just take the address and send the ambulance. A bad call taker will find out what has happened, prioritise the call and give you instructions on what to do next, thus wasting precious time when you could have been running round the house screaming.
6) The call taker will never have taken a 999 call before so they need to be told that a man under a truck is a “serious emergency” and that “you’d better get there quick”. (Or more commonly, that a 29-year-old with belly ache is a “serious emergency” and that “you’d better get here quick”).
7) There is only one person who works for the ambulance service. That person takes the call and then jumps in the ambulance. If you call back, the person you speak to will know exactly which of the 2000+ calls that day you are talking about without you giving them irrelevant details such as the address.
8) The Nee Naw Service have an ambulance parked at the end of every road enabling them to reach any location within 30 seconds. If they take longer than this to reach an emergency, it is due to incompetence and slacking.
9) Ambulance crews who drink cups of tea outside A+E are terrible slackers, as those who work in emergency services should be expected to work a twelve hour shift without a single break.
10) Strokes are a heart complaint.
11) If you don’t know the answer to a question, provide an irrelevant piece of information instead: “Is he changing colour?” “He’s in a lot of pain”. “Has she passed out?” “She is upstairs”. “Is she conscious?” “She’s a black woman”.
12) “Conscious” and “unconscious” mean exactly the same thing. Common causes of unconsciousness include: being in too much pain to talk, Alzheimer’s disease, being a bit upset.
13) (Chat Magazine readers) Call takers work for British Telecom, they know nothing about medical stuff or ambulances, but a lot about switchboards. They also have the phone number for your local hospital, GP, social services, Pizza Hut…
13) Never say “please” or “thank you” — call takers find this highly insulting and will cancel the ambulance and send you the police instead.

Published Sep 28, 2005 - 36 Comments and counting

36 Comments on “Common Beliefs Held By The General Public about Calling 999”
  1. frankly Says:

    Hi
    Just picked up this blog, refered from Random Acts. As a NHS worker myself am nodding my head in agreement with loads of this stuff.

  2. Dave Goodman Says:

    Wow, Mark, this blog is cracking, really, really fascinating stuff, and well written too. I’ve just spent way too long reading it all at work. As I said in another post, Random Acts readers will be hitting this site en masse pretty soon, as he’s blogged about you.

    I read that you’re hungry for publicity – Get yourself to Technorati, PubSub, Weblogs.com and all the other indexers, and register the site.

    Cheers!

    Dave

  3. Dave Johnson Says:

    Again, arrived here from Random Acts of Reality.

    It’s a great read so far.

  4. Geoff Says:

    I’m from Random Reality as well – great blog. Use http://www.feedshot.com/ to get it networked super quick.

  5. Amanda Says:

    Found you via Reynolds at Random Reality. Well written & insightful. Keep up the good work!

  6. Hugh Macdonald Says:

    And yes, another over from Random Acts of Reality…

    Just read through your entire archive (okay, so it wasn’t that big… thankfully!) – a fascinating insight into the other side of the calls – I’ve found Reynolds’ stories about life in the ambulance (and RRU) very revealing – although more about the ambulance-calling population of London than those who work for the LAS….

    You’re already in my bloglines subscription….

  7. lynn ellen Says:

    yes also came from you-know-where….
    Great blog,love the way you put it accross…and if I ever have to phone for an ambulance I will be sure to remember your checklist. ;o)

  8. Mark Myers Says:

    Wow, lots of comments! Cheers, Tom :-) Welcome, new readers!

  9. Emily Says:

    I work for the NHS as well, and I can only imagine some of the ridiculous things people say to people in your job… It’s bad enough getting info out of people once the patient actually arrives at hospital, nevermind dealing with the people who ring for ambulances!

  10. Georgie Says:

    Another one from Random Acts..

    I’ll soon be joining you myself in NeeNaw Control, so will definatly be making this a regular! :D

    x

  11. Mark Myers Says:

    Cool! Let me know which watch you’re on and I’ll look out for you!

  12. Georgie Says:

    Start training in January :) Still a while to go..

    x

  13. Dan Says:

    guess where I came from!

    love your work!

  14. PT Says:

    OK, yes, another one from over on Tom’s blog.

    Really enjoy your writing – keep up the good work!

  15. pinkle Says:

    Hello… some bloke called Reynolds sent me.
    Really enjoyed reading everything, looking forward to more. It’s a rare thing, a good blog. This appears to be one. There goes my productivity level…down and down it goes!
    pinkle

  16. Ginger Mick Says:

    That Reynolds chappy suggested I drop in. Glad he did.

  17. David Says:

    I’ve been reading Nee Naw for a while and just wanted to say THANK YOU. I’m an EMT in the States and this entry nearly had me falling out of my chair. The saddest part is that all of these scenarios actually happen FREQUENTLY.

    I will say though, that as an American, the thought of drinking TEA during my shift was amusing. :)

  18. Dave M Says:

    great blog. can i use the common beliefs posting to teach the cadets in my SJA unit how to/not to make a 999 call.

    Tom from Random Reality was right that this is a good blog to read.

  19. Snoop Says:

    Hi. I’ve dropped in after seeing Reynold’s recommendation. Absolutely fascinating insights. Thanks for sharing your side of things with us.

    I live in Spain but recognised myself in some of your posts: I once witnessed a man being pummelled to near death with metal rods by a bunch of young pickpockets in Plaza Real in Barcelona. I was in a near panic when I called the ambulance service. The whole situation was bizarre: the victim’s wallet had been pinched and being a big guy (Finnish boxing champion in later transpired) he decided to try and get it back off them. He began by shouting at them, but they knocked him over from behind and started kicking him. At the start of the fight, he was slap bang in the middle of the square, which people familiar with Barcelona will know is a popular spot with tourists and has bars open till very late at night. There was a film crew in the square and all the bars were full. There’s a cop station very near by as well. Nobody did a thing to help the guy and it turns out I was the only one to call the emergency services. I was terrified when I called that the cops and ambulance wouldn’t get there in time to save him. I got a rushed version of events together as I made my way to the phone and just blurted it out at the poor call taker. His questions almost seemed an irrelevance. In my own mind I’d already decided what to say as regards what, who and where and wasn’t expecting to be interrupted in full flow by a series of questions. The fact that I lived at such and such an address and was watering my plants up on the rooftop when I witnessed what had happened seemed totally unnecessary information. Turns out the man survived, but he was in a very sorry state. He had one ear virtually torn off, his ankle was smashed and he was extremely bruised all over. I imagine the ankle injury put paid to his boxing career.

    I remember a whole hoo-hah not that long ago over absurd calls made to the police. Maybe the public needs to be educated not only as to what constitutes an emergency but also what to expect when they call.

  20. Mark Myers Says:

    I wish this thing would let me reply to comments individually!

    SJA cadets – certainly!

    Snoop — I think what you describe is very common. The call taker is trying to get the answers to some very specific questions and often the well-meaning caller is trying to tell them what they think is important. A lot of the questions sound irrelevant (eg. asking if someone with a sprained ankle is conscious) because we’re trying to establish that things definitely haven’t happened. This is because some people insist on only telling us half the story: one call was given to me as “he’s slit his wrists”, on further questioning, it turned out the patient had slit his wrists, hung himself, taken an overdose and been dead for two days. If we don’t ask, they don’t tell us…

    I wish they would educate people about calling ambulances. I saw a very good children’s programme about calling 999 the other day (The Tweenies) — now they just need one for adults!

  21. dwaas76 Says:

    wow, Reynolds has a lot to answer for! I’m another one here. Interesting blog you’ve got here. I’ll try to keep these comments in mind if I ever need to call you guys (the stress might make it a bit difficult though, who knows how I’ll react then)

  22. Chubby Bat Says:

    Oh dear. I’m sure working for the emergency services is very trying and I imagine it’s easy to lose sight of the fact that the majority of us appreciate the work that you do. But perhaps there’s a need for a list of Common Beliefs Held By Emergency Services Workers About The General Public. People in a panic because a loved one is seriously ill might well give erroneous answers to straightforward questions, forget their pleases and thank yous, and be too preoccupied to stay on the line as long as you’d like. That’s human nature. Lay people might also be forgiven for not recognising the distinction between the symptoms of a stroke and those of a heart attack. If I’m ever in that unfortunate situation myself, it’ll make me feel a lot worse knowing that my call might be answered by an unsympathetic, judemental cynic.

  23. Mark Myers Says:

    Chubby Bat — Hmm… point well made. What I would like to say is that doing these things when calling 999 have a far more serious impact than frustrating the call taker. They can actually hurt the patient. For instance, if you hang up on a call taker who is trying to give you resuscitation instructions, the patient can die in the time you are waiting for the ambulance. If you answer “yes” to “does he have any heart problems?” because the patient has had a stroke in the past, which is nothing to do with the heart, the first thing the crew will look for is signs of a heart attack. If you say the patient is unconscious when they are not, the call will take twice as long because the triage will have to start all over again (which delays you getting back to the patient and me taking the next call).

    It’s not what the call taker ends up thinking of the caller that matters but whether they did the best for the patient. The call that prompted me to write this list was one where a caller quite possibly contributed to the death of a relative by doing many of the above things. I didn’t write about the details of the call for obvious reasons but it was incredibly frustrating and disturbing.

    I am never rude or sympathetic to callers (well, I have to admit, I was a bit short with the guy who asked for Pizza Hut’s phone number) and, while we’re not paid to take abuse, I do realise that you have to cut people a bit of slack and realise that they’re not going to be on their best behaviour when they call 999 because they’re upset. But I do feel very frustrated when things like this happen, and it’s not because people have forgotten their manners or said something stupid, it’s because I know that the caller’s behaviour is preventing me doing my job — and my job is to help the patient.

  24. Chubby Bat Says:

    Mark,

    The stroke/heart attack thing: I could understand your frustration if they said he had heart problems because he’d once had an ingrown toenail, but a CVA is a circulatory problem and I suspect a sizeable proportion of the general public do not see a distinction between the heart and the system it powers. I’d be interested to know exactly what is included in the rather woolly term “heart problems”? I assume congestive cardiac failure would count as a heart problem in most people’s books, but that doesn’t cause heart attacks either, so the person on the phone could legitimately answer yes, and the paramedic would still be wasting their time. If “does the patient have any heart problems” is secret code for “should the paramedic waste valuable time checking for a heart attack”, it’s a pretty blunt tool.

    When you talk to a member of the public phoning in a 999 call, you are not taking the medical opinion of an expert, you are conducting a triage-by-proxy, over the phone, under very trying circumstances. Surely you’re prepared for some anomalies, wrong answers and misunderstanding.

    Personally, I don’t think posts like this one have a place on a public blog. All it says to me is that, should I ever need to phone 999, I’d better be cool as a cucumber and a medical expert to boot, or the person I’m talking to will think I’m an idiot and then mock me on his website. Not big, not clever. :-(

  25. Mark Myers Says:

    Chubby Bat — For the record, a “heart complaint” is anything that affects the heart itself, not the circulatory system, not the blood (high blood pressure is another one). Checking for a heart attack isn’t the only reason we ask if a patient has heart problems (perhaps a paramedic/EMT could answer and let me know in what ways a cardiac patient is treated differently?), in many cases a call will get a higher priority if the call is a cardiac patient (because heart problems kill FAST), so saying that a patient is a cardiac patient when they are not might make them jump the queue and take an ambulance away from someone who needs it more.

    Fortunately in the time between me writing this entry and publishing it publically, the protocol has changed so we now ask *which* cardiac complaints they have. (And no, I don’t think they are an idiot if they say “he’s had a stroke” — I don’t even correct them, there is a time and a place to further people’s medical knowledge and this is not it.) I disagree that you have to be a medical expert to know that strokes are not a cardiac condition, though. It’s a fairly basic piece of information.

    I am sorry you got the impression that I am mocking the callers who behave in a less than textbook fashion. This is not the case at all. Very rarely are callers cool and collected, and by definition 999 callers are NOT medical experts (medical people have their own line for ordering ambulances). A lot of our callers are extremely upset and it’s my job to calm them down and get the required information out of them. Sometimes the silly things callers come out with are endearing, sometimes it is frustrating but I know it is my job to get them to listen. Please don’t think this post is a judgement of people who panic in emergency, it isn’t that at all. The things they do may be totally unhelpful, but that doesn’t make them “idiots” — or maybe it means that everyone becomes an “idiot” in the face of great stress?

    What is worrying me is that you don’t seem to realise that retaining a modicum of calm and having a basic awareness of medical terms can mean the difference between life and death. I won’t think you’re an idiot if you call me and babble irrelevantly at me, but I’ll think you’re a hero if you save someone’s life. And if someone dies because you lost your marbles and slammed down the phone three times before giving the address, swore at the dispatcher until the crew requested police assistance and preferred running around screaming to performing CPR, I think your own guilt would outshadow any worries as to what the dispatcher thought of you.

  26. Chubby Bat Says:

    Mark,

    I don’t want to argue semantics with you. Suffice to say that if you, a trained professional, can come out with a generalised statement like “heart problems kill FAST” (CCF kills very slowly!), the average Joe in the street might be forgiven for similar slips. (I’m sure you mean that some heart problems can kill fast, and that given endless time to compose a reply you might have phrased it differently – which is sort of my point!)

    I don’t want you or any of your other readers to think I’m putting you down, either. I have enormous respect for the job you do, and I’m certain that I couldn’t do it myself. It must be immensely frustrating at times, especially in the circumstances you describe where people slam the phone down, abuse emergency staff, etc, while you’re trying to do your best for the patient.

    You’ve vented some of these frustrations in a light-hearted way in this blog post, and I would not want to deny you the means to let off a little steam, either. I feel as though I understand your position better for having had this little tete-a-tete in the comments, although I still just have this basic problem that stuff like this can easily be misconstrued by the rest of us as contempt for your callers. I realise now that this is not the case, but I would still question whether, in making posts like this, you do yourself any justice. You’ve clearly struck a chord with other people working in the same field, but to me as an outsider your post makes you sound arrogant and insensitive. Your replies to my comments, however, suggest that that is far from the case.

  27. Mark Myers Says:

    Well, thanks for your comments, and I have taken them on board. I’m not going to stop writing posts like this one, because if people learn from reading them, then it could save lives, but any future posts on this subject will come with more of a disclaimer/explanation. I did toy with the idea of including a description of the call that inspired me to write this, but I decided against it because it was particularly harsh on the actions of the caller, whose relative had most likely just died, and I’d hate to think of him stumbling across it and recognising himself.

    Also, if you have a read through my other posts, you’ll see this one was made at one of my most fed up, frustrated, pack-it-all in moments. I won’t lie to you, there are moments like that, but there are also moments when callers are so brave and heroic that it brings tears to my ears (big wuss, I know) like the 7 year old and the pensioner who successfully resuscitated the little girl’s granddad, and moments where panicking and not listening to call taker are totally and utterly understandable, like the woman who saw a child fall under the train. Another thing you should bear in mind is that not all of our calls are life-and-death emergencies (according to the bosses, 60% don’t really, require an ambulance at all, and out of those who do, probably a third (I am guessing) are immediately life threatening. Even though the way I speak to the callers is always the same (I have heard people being rude to them, and it makes me cringe), if they are rude or obstructive to me, I am less likely to think “oh, they’re upset, it’s an emergency” if they’re ringing about a boil on the bottom. And yes, they do ring about boils on bottoms ;)

    Anyway, hope we understand each other better now. Funnily enough, the first call I took at work today was a woman worried about her husband’s breathing, and I asked if he had heart problems… and she said “He’s had a stroke!” Heh.

  28. Tim Worstall Says:

    Umm, not from Random, from Black Triangle. Lovely piece, ta.

    To reply to comments individualy? You should be able to edit comments, (usually used to scratch out bad language etc rather than delete a whole comment) and if you open up a comment to do that then put your response in in italics and save again itworks as you wouldwish…you’re getting your response to hte comment just where you want it, with the comment.

    Okay, testing testing 1 2 3… Yes, that seems to work! Cheers!

    Mark

  29. Tim Worstall Says:

    Britblog Roundup # 34

    Here we are again, the Britblog Roundup. Your nominations for the best blogging of this past week in the UK and Irish internetwebbie thingummajig. You can make your nominations for next week to britblog AT gmail DOT com. This is

  30. Mike Cunningham Says:

    Not many people leaving comments to the effect that in general, we are extremely lucky to live within a society which supports Emergency services such as the various Ambulance organisations!

    We are not all totally calm and collected when dialling 999, as the very nature of the call suggests that there is something wrong happening close to home, and all the caller wishes is for the problem to be solved! But we promise to do better in the future!!!

  31. Peter Says:

    Just a question. I’m a Cub Scout Leader and we try and train the Cubs how to call 999.

    Anyone got any suggestions for a script that shows the basic routine (I’m not expecting the medical details, just the order that things like addresses, phone numbers and details are asked).

    Thanks

    Peter

  32. H.G.McCarthy Says:

    Also directed to your blog by randomacts

    Your site and your writings give a very good incite into the mind, thinking and actions of a good control operator!

    While on the road, I often wondered what it must be like to experience trauma over the telephone lines and also have the resposability for taking some sort of control in desperate situations. Well done and keep up the good work

  33. 2005 Blogged: Dispatches From the Blogosphere Says:

    Nee Naw.

    Nee Naw is another of the professional bloggers, in the sense of bringing to us the specifics of professional life in a manner not really available to us before. Here, some useful tips from an ambulance dispatcher on how

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  36. Laura Says:

    This is great. I pretty much died laughing (but neglected to call 911 for resuscitation). I work at a call center as well, and though we don't handle emergencies, we do handle "leaves" for people that are unable to work due to medical incapacity. This example of yours, number 11, " If you don’t know the answer to a question, provide an irrelevant piece of information instead: “Is he changing colour?” “He’s in a lot of pain”. “Has she passed out?” “She is upstairs”. “Is she conscious?” “She’s a black woman”." is so true. Every day i ask, "will you be missing work sporadically or in a block of time?" and get the answer, "Oh I've had this condition for years". It's a wonder these people don't hear my teeth grinding loudly in the background towards the end of the day. Just to clarify though, I realize that these people usually don't know what they're getting in to when I start a leave for them, and their main priority at the time is to work on getting to a point where they're healthy enough to work, but sometimes it just drives me crazy (especially on the extra high call volume days with extra tasks to process from people reporting absences on holidays).

    Nee Naw
    Nee Naw was a blog about life in the London Ambulance Service control room. It was written by Suzi Brent from 2005 to 2010. The blog is no longer being updated, but the archives will remain here.
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