The two new studies conclude that “hands-only” chest compression is enough to save a life. They are the largest and most rigorous yet to suggest that breathing into a victim’s mouth isn’t needed in most cases.

The American Heart Association has been promoting hands-only CPR for two years, though it’s not clear how much it’s caught on. The new studies should encourage dispatchers and bystanders to be more aggressive about using the simpler technique.

“That could translate into hundreds if not thousands of additional lives saved each year. What are we waiting for?” said Dr. Arthur Kellermann, a RAND Corporation expert on emergency medicine.

An estimated 310,000 Americans die each year of cardiac arrest outside hospitals or in emergency rooms. Only about 6 percent of those who are stricken outside a hospital survive.

Read the full story here.

Luisa Goodwin, a dispatcher with LAPD for 8 1/2 years,  argues that the current staffing levels are already insufficient to handle the agency’s call volume and that the problem will be compounded by furloughs  and layoffs that will be imposed on dispatchers in the coming months.

Part of her reply is excerpted below:

The headline on Andrew Blankstein’s article on July 3, “LAPD’s 911 operators stage a sickout,” has a glaring omission: The sickout was not the idea of dispatchers who work for the Communications Division. I know because I am one.

While some of those employees participated, this sickout was staged and directed by the Coalition of LA City Unions. It focused on a wide range of city workers in danger of being furloughed or laid off, not just dispatchers. It is unfair for Blankstein to lay the blame on our shoulders alone.

Read the full article here.

Researchers from the Michigan Department of Community Health surveyed 4,814 adults in the state to assess whether they knew when to call for an ambulance when stroke symptoms have been observed. They found that only 14 percent would dial 9-1-1 for three common stroke symptoms, and 37 percent reported that they would not call 9-1-1 for any of the stroke symptoms.

Participants were asked to report their first reactions to five hypothetical situations. Three situations — sudden slurred speech, sudden numbness on one side of the body or sudden blurry vision — were symptoms of a stroke. The other two were a high fever or an injured leg, which are not stroke symptoms. The survey didn’t include other stroke symptoms, such as sudden trouble walking or severe headache with no known cause.

Participants could respond that they would first “give medicine or first aid,” “call the doctor,” “take them to an emergency room,” “call 9-1-1,” “stay with them until they felt better;” or “something else.” Calling 9-1-1 was deemed the only correct response.

Additional results showed that:

• Of the 27.6 percent of the participants who knew all three stroke warning symptoms, only 17.6 percent said they would call 9-1-1 for all three stroke symptoms.
• Fifty-one percent of all respondents would call 9-1-1 for someone having sudden trouble speaking or understanding; 42 percent would call 9-1-1 for someone having sudden numbness or weakness on one side of their body; and 20 percent would call for someone who had sudden trouble seeing out of one or both eyes.
• In four of five of the hypothetical scenarios, taking patients to the emergency room — not calling for an ambulance — was the most common response.
• Older people were more likely than younger people to dial 9-1-1 for all three stroke situations — 6.1 percent of those 18 to 24 years old compared to 17.6 percent of those ages 65 to 74.

Gender, race, education, household income and insurance status were not significantly related to a person’s intent to call 9-1-1.

The findings indicate a “disconnect” that could be improved with greater public awareness efforts focused on connecting the signs of a stroke with calling emergency medical services (EMS), researchers said.

“Respondents appear to be unaware of the advantages of EMS transport, and the fact that public health recommendations advise the use of EMS over private transport,” Fussman said. “Calling 9-1-1 gets you to the hospital fast and allows the paramedics to communicate with the hospital so staff are prepared for your arrival.”

The earlier the treatment begins, the greater the chances of recovering from stroke — the No. 3 killer and a leading cause of adult disability in the United States. The clot-busting drug tissue plasminogen activator (t-PA) is the gold standard treatment for stroke; however, most patients aren’t eligible to receive it because they don’t get to the hospital in time. Current stroke treatment guidelines call for patients to arrive at a hospital within 4.5 hours after symptoms begin in order for tPA to be effective.

Fussman cautioned against applying these findings broadly to other states. Previous research found that, depending on the stroke symptoms, between 33 percent and 72 percent of respondents in upstate New York would dial 9-1-1 and between 41 percent and 51 percent of people in Montana would.

It’s unclear why people are reluctant to call an ambulance despite being aware of the signs of stroke, Fussman said. Future studies should address possible barriers such as denial, embarrassment, cost, and cultural attitudes toward calling for an ambulance.

“I don’t think that a lack of stroke knowledge is the problem here.” Fussman said. “The problem is what people do with the knowledge they have,” he said. “The public needs to be reassured that EMS is the best option when dealing with stroke.”

Co-authors are: Ann P. Rafferty, Ph.D.; Sarah Lyon-Callo, M.A., M.S.; Lewis B. Morgenstern, M.D.; and Mathew J. Reeves, Ph.D. Individual author disclosures are on the manuscript.

The study was funded in part by the Michigan Department of Community Health Cardiovascular Health, Nutrition, and Physical Activity Section and the Centers for Disease Control and Prevention.

— From the American Heart Association

“I called 911, but the operator thought I was playing on the phone,” Jayla said. “She kept telling me I’d get in trouble if I didn’t stop playing. She told me to put an adult on the phone.”

Emergency operators in some cases have disregarded children’s calls, experts said, because operators aren’t properly trained on dealing with children. A March case in which a Detroit dispatcher was disciplined for the way she talked to an 8-year-old girl whose mother lay dying of gunshot wounds may highlight what some say is inadequate education.

Read the full story here.

Laurie Helgason said she’s disgusted by Tuesday’s brutal attack on Heath Proden, a Manitoba man on an extended visit to Sydney, Australia.

But, she said, she’s not surprised that it happened.

Proden, 35, was stomped, beaten and hit with a metal bar stripped from his own wheelchair by two teenaged boys as he tried to leave a train station to escape his attackers, police said.

He remains in hospital in serious condition, but is expected to make a full recovery. The attack has made headlines around the world.

Read the full story here.

Nate Lee – the husband of Denise Amber Lee, who in 2008 was kidnapped, raped and murdered by Michael King – and his family struggled with the state’s decision to make public Denise’s call to 911 on her killer’s cell phone just before her death.

But Lee also credits public access with making a difference when it came to reviewing the Charlotte County Sheriff’s Office bungling of the call that some believe could have helped save her life.

“I’m not really a big fan of this bill,” Lee said. “I think it’s a bad bill.”

Read the full story here.

The debate has received fresh attention in the wake of a recent incident in North Carolina. A woman called 9-1-1 after finding her daughter beaten to death in her driveway. After hearing a replay of her 9-1-1 call on a local news broadcast, she became so distraught that she vomited.

Missouri, Pennsylvania, Rhode Island and Wyoming already keep 9-1-1 recordings private. Lawmakers in Alabama, Ohio, Wisconsin  and Florida are now looking at enacting similar legislation.

Supporters of this legislation say that making 9-1-1 calls public may scare people from calling the service for fear of their calls being publicized. Opponents of keeping 9-1-1 calls private say that prohibiting their release will allow government agencies to cover up calls where errors were made.

Several recent news stories on this topic are linked below:

States eye ban on public release of 911 calls (AP)

Florida House Weighing Ban On Releasing 911 Calls (CBS4)

Wisconsin lawmakers debating whether or not to release 911 emergency calls (Pierce County Herald)

Editorial: Silencing 911 Calls (Orlando Sentinel)

Poll: Would you still call 911? (Tallahassee Democrat)

•  Know the signs of a heart attack: pain in the chest, neck and arms, chest tightness, shortness of breath, nausea and extreme fatigue
•  Never assume: A heart attack can happen to anyone, at any age.  Heart disease is the third leading cause of death among women aged 25-44 years and the second leading cause of death among women aged 45-64 years.
•  Stay current: Make sure your dispatcher’s are up to date with their Emergency Medical Dispatch certification and CPR protocols
• Know your community: Familiarize your organization with locations of local hospitals and clinics.  This is essential in bad weather situations, desolate areas or when it may be difficult to get a responder to the victim quickly
• The Journalistic- Investigative approach: Find out as much information as possible such as who is home, age of the victim, etc.
• The Where within the Where: Is this person in a retirement community?  Is there one centralized address with numerous apartment numbers?  This information is critical, as precious minutes can be lost trying to pinpoint a precise location.
• Communication: Encourage inter-office conversation.  Employees who talk to one another, have an easier time dealing with Critical Incidents, such handling heart attack or suicide calls.
• Training: Encourage your agency to send your call takers to Stress Identification and Management courses.  These classes are designed to help your dispatchers cope with the daily challenges they face.  Less stress = less risk of a heart attack for your employees.

Knowing the signs, symptoms and how to handle heart attack calls are an essential part of crisis communications training and instrumental in saving lives.

• Has your dispatch center done anything to highlight the importance of American Heart Month? 
• Can you offer other agencies suggestions to maximize the safety of heart attack victims?   

In this month’s feature Training Tactics post, PowerPhone CEO Chris Salafia discusses some important tips for managing emergency calls from children.

My Daddy is hurting my Mommy! That was the title of an article that PowerPhone founder Phil Salafia wrote in 9-1-1 Magazine in October of 1998 and eleven years later were the exact same words spoken by a scared and perhaps traumatized young girl on the phone to 9-1-1 recently.

In today’s society, children are encouraged from a young age to “Call 9-1-1″ and we are seeing examples time and again of young children reaching out for help via the 9-1-1 system. Your public education programs are working!

In just about all PowerPhone training classes we spend time focusing on communication techniques with “special callers.” Be they the elderly, foreign language, altered mental status or child callers, these special call types present unique challenges for public safety call-takers.

It’s vitally important that 9-1-1 call takers recognize that child callers are indeed special. Children can easily be intimidated and frightened, so engage your active listening skills from the onset of the call. What may appear as a hang-up or an open line could in fact be a scared child afraid to ask for help. Listen carefully and focus on your voice tonality, inflection and rate of speech. Children often perceive things differently, so try your best to use age-appropriate vocabulary (“what color car does daddy drive” vs. “what’s the make and model of the vehicle”) and whenever possible use association skills and familiar frames of reference (“was he taller than your dad”) in trying to elicit descriptive information.

Unfortunately, children are often witness to and reporters of domestic violence. Studies indicate that more than 3 million children witness acts of domestic violence every year.* Special care must be taken when handling calls from children reporting domestic violence. As we’ve already discussed, use words and phrases that the child can understand. Try and avoid “rapid fire questioning” and do your best to keep the child calm, avoiding words that may further frighten the child.  Praise the child (“you did the right thing by calling us”) and affirm what they are feeling (“it’s OK to be scared”). Don’t be afraid to use terms of endearment, (“it’s OK honey”), especially when dealing with a younger child. As one of our student’s put it best, “I went into Mom mode.”

Last, remember that children are not only witnesses, they may also be victims of domestic violence. Research indicates that 50%-70% of men who abuse their female partners, also abuse children in the home.* Using PowerPhone’s Investigative Questioning techniques remember to also determine the following:

• How many children are present?
  
• What are their ages?
• Where are they in the house?
• Has this happened before?

Always keeping in mind that the children may also be in physical danger.  Domestic disturbances can be highly volatile and represent tremendous risk to all involved. You must try and determine if there are weapons present (“does Daddy own a gun?“) Listen carefully for noises in the background and update your responders with as much scene specific information as you can. Caller, victim AND responder safety must be of paramount concern.

As the clip below illustrates, child callers can represent our biggest challenge, yet can also be incredibly rewarding. I’ve personally attended a number of award presentations were a child has been the only lifeline to help and a professional dispatcher has made all the difference. As your agency invests in educating children about when to call 9-1-1, those on the front line must also be educated in how to best assist these young citizens.

*Source: The Domestic Violence Sourcebook

About the author:
Chris Salafia is the President and CEO of PowerPhone. He is the co-inventor of Computer Aided Call Handling (CACH), a revolutionary approach to emergency and non-emergency call taking, and Incident Linked Multimedia (ILM), the first system that intelligently processes cell phone multimedia messages sent to 9-1-1 centers. Mr. Salafia holds a U.S. patent on “Call Handler Systems and Methods” and is the co-author of several patents relating to emergency communications response systems. His company is recognized as the nation’s leading dispatch trainer, having trained over 150,000 9-1-1 professionals worldwide. He can be reached via e-mail or 203.245.8911.

Once again a major disaster has highlighted the growing use of social networking sites as the primary means of communicating in the aftermath of a crisis. Following the collapse of traditional channels of communication in Haiti, services like Twitter and Ushahidi have become the main source of contact and visual maps detailing aid and damage.

Just as during the initial hours of the Virginia Tech shooting in 2007, the first images from the scene of the earthquake came from citizens capturing video with mobile phones.

Ushahidi is a particularly interesting system. Created by a Kenyan lawyer in South Africa it is an open source on-line system that allows users to submit eyewitness accounts or other relevant information for disaster zones via e-mail, text or Twitter — and then visualize the frequency of these events on a map. By Friday of this week, Ushahidi, which means “testimony” in Swahili, had received nearly 33,000 unique visitors regarding events in Haiti, and several hundred personal reports that mainstream news organizations might not hear about. Relief agencies are able to also tap into this data to help coordinate their relief efforts. More details can be found here.