It is the phone call none of us want to make. It means there’s an emergency and help is needed urgently. But do you know what to expect when you dial 999 and what you will be asked? Being aware of the protocols followed when you dial 999 could make you better prepared to react calmly and confidently in an emergency, when every minute could make a difference.
If you find yourself in a genuine emergency, where someone is seriously ill or injured and lives are at risk, don’t panic.
Call 999 (or 112 – the emergency service number for the UK and the rest of Europe).
When you call 999, a BT operator answers your call and asks –
Emergency, which service do you require? Fire, Police or Ambulance?
In a medical emergency, you should ask for an ambulance. In some situations you may require more than one service but the operator will get to that later. The BT operator transfers your call to the ambulance service control room.
Here a call handler asks for information from you in order to prioritise your call and identify how to help the patient until the ambulance arrives.
The call handlers log essential details about the patient’s condition and location onto a computer system. This information passes to an emergency medical dispatcher who decides the best course of action.
Call handlers and emergency medical dispatchers have to work under great pressure, multi-tasking and making vital decisions in life-or-death emergencies.
In some ambulance trusts the roles of call handler and emergency medical dispatcher are combined.
As the medical responders are on their way, the emergency medical dispatcher can update them with further critical information, so they are ready for action as soon as they reach the scene. The pace can be fast with dispatchers sending out up to 15 vehicles per hour, and simultaneously answering queries from ambulance crews.
Using their training, the dispatchers ask questions, known as a triage system, designed to assess which type of medical response is sent.
The response could be an ambulance, rapid response car or motorcycle, a cycle response unit, air ambulance or a community first responder who is a volunteer living within the community and able to get to you quickly. They are trained to deal with life threatening situations such as heart attacks and stabilise the casualty whilst waiting for the other ambulance response team.
The emergency medical dispatcher will take further information concerning your medical emergency and may advise you to head to A&E, doctors surgery or pharmacist, rather than sending an emergency vehicle to you.
The Control Assistant will ask:
What is the telephone number you are calling from?
Why: this is in case in case the call ends before it should, so the Control Assistant is able to call you back.
What is the exact location of the incident?
Why: the address/location that you give is very important in helping the ambulance to reach the patient as quickly as possible.
If you are in a rural countryside area, having your map reference or postcode to hand will be a big help. If you are unsure where you are look for street names, motorway markers or people to ask.
You will also be asked for information relating to the type of incident:
What has happened?
Why: so the ambulance service can work out the seriousness of the situation. Is it a major incident or is it a minor accident? They can alert additional emergency response professionals such as the police, fire service, coast guard or Hems.
How many people are involved?
Why: so size of emergency response required can be properly met.
What is the age, gender and medical history of the patient?
Why: this helps the ambulance service get context for the medical emergency and prepare specific kit for a baby, child, adult or elderly adult accordingly.
Is the person conscious or unconscious, breathing or not breathing?
Why: this assesses the level of urgency the situation requires and to direct you how to put your casualty in the recovery position if they are unconscious and breathing. They will talk you through how to give CPR if they are unconscious and not breathing. This is vital to start immediately to give them the best chance of survival.
What part of the body was injured?
Why: so that the ambulance service can identify the severity of the injury and bring appropriate kit from the ambulance.
Is there any serious bleeding?
Why: so that the ambulance service can provide best advice to control the bleed.
Does the patient have chest pains?
Why: Could they be having a heart attack, could it be angina, or have they had an accident? The call handlers need to prioritise quickly and will ask further questions around this to the urgency for the response.
If there has been an assault, is the area safe?
Why: this is so the ambulance crew can be informed and remain safe.
Is anyone trapped in the vehicle?
Why: the ambulance service can inform other relevant emergency services such as the fire brigade and police.
Dialling 999 doesn’t necessarily mean an ambulance will be dispatched.
If you arrive at hospital by ambulance this doesn’t mean you will be seen first. All casualties are triaged at A&E reception and they will decide on the priority of your treatment.
Nationally Agreed Categories
Each call is prioritised into nationally agreed categories, so that life-threatening calls made to the ambulance service are dealt with first.
Each category has a target response time.
For example Yorkshire Ambulance Service shows:
Category 1 (7 minutes) – Life-threatening injuries and illnesses
Cardiac arrest, serious allergic reaction
In the majority of cases the patient will be taken to hospital
Category 2 (18 minutes) – Emergency calls
Stroke, burns, epilepsy
In the majority of cases the patient will be taken to hospital, usually the nearest emergency department (ED) but sometimes the nearest ED will be bypassed so they can be taken to a specialist unit for the best care
Category 3 (90% within 120 minutes) – Urgent calls
Late stages of labour, non-severe burns, diabetes
In some instances patients may be treated in their own home by ambulance staff.
Category 4 (90% within 180 minutes) – Less urgent calls
Diarrhoea and vomiting, urine infections
In others cases patients may be given advice over the telephone or referred to another service such as a GP or pharmacist.
What can you do before help arrives?
After calling 999 and whilst waiting for a medical response unit you should:
- stay with the patient until the ambulance crew arrives
- call 999 back if the patient’s condition or location changes
- if your house name or number can’t clearly be seen from the roadside, open the front door and ask someone to wait outside for the ambulance to direct the crew where they should go
- if it is dark, turn on house lights and pull back curtains
- secure family pets so they do not interfere with the casualty’s treatment
- if possible, collect any medication being taken by the patient, write down the patient’s GP details or tell the paramedics about any allergies the patient has.
- if you are in your car, switch on car lights and hazards, wear a fluorescent vest and always carry a torch or ensure you have a phone charger.
First aid whilst waiting for the ambulance
You might also be given instructions about how to give first aid until the ambulance arrives. The emergency medical dispatcher may have to guide you through an emergency procedure, such as clearing an obstruction from someone’s airway or tell you how to perform CPR or use a defibrillator.
Read our article about giving emergency first aid while waiting for the ambulance to arrive here.
When the ambulance arrives
When medical help arrives, the patient’s clinical condition will be assessed and treatment given at the scene if necessary. If the patient needs further treatment, the hospital will be alerted so they can prepare for their arrival and patient will be transferred to the nearest A&E.
Having handed over the patient to the hospital, the ambulance crew prepare themselves and their vehicle for their next call out.
It is strongly advised that you complete an online or attend a practical or online first aid course to understand what to do in a medical emergency. Click here or call 0208 675 4036 for more information about our courses. First Aid for Life provides this information for guidance and it is not in any way a substitute for medical advice. First Aid for Life is not responsible or liable for any diagnosis made or actions taken based on this information.