By Jennifer Mehigan
If you’ve ever called 911 in Boston for a medical emergency, you may have spoken with EMT Elaine Gallagher.
EMT Gallagher has been with Boston EMS for more than 7 years and has been working at Boston EMS Dispatch Operations for more than a year. Though she prefers working “on the street,” she knows the importance of what she does every day while working at dispatch.
At the moment, it’s close to 2:30 p.m., the board is filling up with calls and almost every city ambulance is busy. As the dispatcher, EMT Gallagher sits at her terminal watching 3 different computer screens, headset on, and manages what every city ambulance is doing. She can see which crews are heading to a patient, which crews have a patient and are on their way to the hospital, and which crews are clear. A highlighted red number on her screen tells her a crew has been at the hospital more than 20 minutes.
“A7, your status at Mass General, Ambulance 7?”
(The crew reports back they are delayed at triage.)
“Thank you 7.”
When a 911 call is entered into the computer system, depending on the priority, the dispatcher will assign a crew and have them on the way in less than a minute. If a call with a higher priority comes in, EMT Gallagher can divert a crew from what they were doing to go to the new call. There’s a cardiac arrest on Dorchester Ave. The closest ambulance crew, called “A10,” is clear and is immediately sent with Paramedics in P3.
“P3, A10, cardiac arrest, ## Dorchester Ave. ## Dorchester Ave. P3?”
“P3, ## Dorchester Ave.”
“A10, ## Dorchester Ave.”
At Boston EMS, members who work at dispatch are certified EMTs who have had an additional 19 weeks of specialized training in EMS dispatching, the computer aided dispatch system (CAD), and mass casualty incident coordination. (During a mass casualty event, an additional Dispatcher would be assigned to solely manage that event).
There are three essential jobs up at dispatch – Call taker, C-Med Operator and Dispatcher. Each position is essential and can be very stressful, so the staff switches off during the shift. Call takers answer 911 calls and enter the information into CAD. The dispatcher reads CAD, communicates with and sends ambulance crews to scenes. The C-Med Operator coordinates ambulance to hospital communications between 61 cities and towns surrounding Boston and within Boston itself. For example, an ambulance in Framingham is bringing a patient to Brigham and Women’s – that ambulance crew can call C-Med and we can connect them with the Emergency Department at the hospital via a direct radio link.
As the person who answers 911 calls, it is the call taker’s job to get as much information about the patient and scene as possible. The first thing the call taker will ask is the address and phone number of the person calling. This is the most critical information, because even if the call is disconnected an ambulance can still be sent.
EMT Gallagher said she understands it can be frustrating to the person calling that the call taker asks several questions, but since she can’t see what is happening, she needs certain information. This is not only to provide the patient with the appropriate resources, but to make sure crews headed to the scene will be safe.
“If someone on the phone delays in explaining the problem, if the person isn’t cooperating, time is ticking,” she said. “It’s crucial. If they can’t stay calm and tell us what’s going on, it’s wasting resources.” Ambulances are often sent even while the call taker is still on the phone.
The more dramatic the incident, EMT Gallagher said, the more the Call taker has to work to keep the caller calm and focused. “Everyone freaks out at car accidents,” she said, for example. “But I need to know if the car is still running. Are there any fluids coming out? Is it smoking?”
“The Call taker is also vital because you’re giving pre-arrival instructions,” she added.
Pre-arrival instructions are given on every call that comes in to dispatch operations. If someone is in cardiac arrest, the Call taker will talk you through CPR and to get an AED if there’s one in the building. If someone has fallen, the call taker may tell you to protect their head, but not to move them. If someone is choking, the call taker will talk you through the Heimlich maneuver. Sometimes it’s as simple as unlock the front door, open a window for fresh air, or to call back if there’s any change in the patient as help is on the way.
The most important thing to know about calling 911 is that the person who answers is there to help you. In Boston, we have certified EMTs talking to you and they know exactly what the patient needs. EMTs just like Elaine Gallagher who chose EMS as her career because she wanted to help people.
“I love my job,” she said. “You’re calling us for help, let us help you.”
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Jennifer Mehigan is the director of media relations for Boston EMS. Did you know Boston EMS is a division of the Boston Public Health Commission?