Calling 911

What do you do when you come across a medical emergency? If you’re like most bystanders, you watch and wait until someone else takes action. But for the few who step in, their response can mean the difference between life and death. On average, it takes first responders about seven minutes to arrive and begin care. In a high-traffic area, that wait could stretch longer. In remote areas with limited EMS coverage, you could be looking at 30 minutes or more before help arrives. That means you may be the only line of support during that critical window.

According to the American Heart Association, for every minute CPR is delayed, the chances of surviving a cardiac arrest drop by 10 percent. In this article, we’ll cover when to call 911, how to speak with the dispatcher, and what to expect when first responders arrive.

OPQRST Pain Assessment Mnemonic

• O Onset: When did the pain start? Sudden or gradual?
• P Provocation/Palliation: What makes it worse or better?
• Q Quality:What does the pain feel like — sharp, dull, stabbing, throbbing?
• R Radiation: Does the pain move or stay in one place?
• S Severity: On a scale of 1 to 10, how bad is it?
• T Time: How long has it been going on? Has it changed?

SAMPLE History Medical Assessment Mnemonic

S Signs/Symptoms: What can you see, and what is the patient feeling? A good place to use OPQRST for pain.
A Allergies: To medications, foods, insects, or environmental factors?
M Medications: What are they taking: prescription, over the counter, supplements?
P Past Medical History: Any chronic conditions, recent surgeries, or major diagnoses?
L Last Oral Intake: When and what did they last eat or drink?
E Events Leading Up to the Injury or Illness: What was happening before the problem started?

Calling 911

What should you expect when calling 911? The dispatcher will ask for the nature of the emergency and the exact location, so take a moment to identify street signs or nearby landmarks before placing the call. They may also ask for your name and phone number in case the call is disconnected.

Stay on the line until the dispatcher says it’s OK to hang up. In most cases, they’ll stay with you until first responders arrive. If you’re assisting an injured person or handling a medical emergency, it’s fine to switch your phone to speaker or hand it off to someone else. You can also ask a bystander to call 911 while you focus on providing care.

As a general rule, if you’re calling about a police or fire emergency, it’s usually best not to rush in. Avoid putting yourself in harm’s way and becoming a second casualty. For medical emergencies, though, there are several ways you can help before EMS arrives.

If you have no medical training, stay on the line with the 911 dispatcher. They can walk you through what to do. At the very least, you can provide updates on any changes in the person’s condition. If you do have some training, offer help based on your comfort level. Even if you’re unsure, keeping the injured person calm by talking to them and distracting them from their condition can make a difference.

Have you considered what to do if 911 services aren’t available? An electromagnetic pulse or natural disaster could knock out all communication systems, including dispatch. In a fire emergency, you may need to send someone directly to the firehouse. That takes time, and time may not be on your side. Hopefully, the fire stays contained, and no one is trapped inside.

If it’s a police emergency, you’ll have to rely on verbal de-escalation and conflict management. With any luck, you won’t need to fall back on combatives or weapons training to stop the threat. In a medical emergency, you do what you can — keep the person stable, communicate with them, and wait for help to arrive. Training for all three scenarios — fire, law enforcement, and medical — should be a priority. It can make all the difference when systems fail.

YOU are the Pre-First Responder

There are many situations where medical or ambulance assistance might be needed. These range from individual emergencies — like chest pain, difficulty breathing, or signs of a stroke — to incidents involving multiple casualties, such as a vehicle pileup. If you’re first on the scene or simply the first willing to act, there are a few steps you can take to help.

Start by assessing the scene for safety. Make sure you aren’t putting yourself or others at further risk. Once the area is secure, begin evaluating each patient. In trauma situations, I prefer to use the MARCH mnemonic: Massive hemorrhage, Airway, Respirations, Circulation, Head/Hypothermia. Stop major bleeding with a tourniquet before moving on to other casualties. If you reach the circulation step and find an unconscious patient, direct a bystander to begin CPR if appropriate. While they focus on that patient, continue assessing others.

In mass casualty scenarios, I recommend using a triage system with color designations. Green is for the walking wounded. Yellow indicates delayed care — these patients need attention but can wait without serious harm. Red is for those needing immediate intervention, as they’re unlikely to survive without it. Black is for those who have already died or are expected not to survive. In these cases, instruct some of the green-coded individuals to stay with the black-coded patients and provide comfort care.

When EMS Arrives

Emergency medical teams will perform their own assessments upon arrival. In a mass casualty situation, direct them to the red triage group first, as those individuals need immediate transport by ambulance.
One tool EMTs and paramedics often use is the SAMPLE mnemonic: Signs/Symptoms, Allergies, Medications, Past medical history, Last oral intake, and Events leading up to the injury or illness. This is especially useful for single-patient assessments, though it becomes harder to apply in large-scale incidents. If you’ve applied a tourniquet, record the time and location on the body. If CPR was started, note the time it began.

Another helpful tool is OPQRST, which is used to assess pain. It stands for Onset, Provocation/Palliation, Quality, Radiation, Severity, and Time. These questions can help paint a clearer picture of the patient’s condition and guide further care. Once first responders arrive, ask how you can assist. Step back when needed and always defer to those with greater training or medical authority.

When Law Enforcement Arrives

Reasons to call for police assistance can include an active crime, violence against an individual, a burglary, or a traffic accident. In situations where law enforcement is needed, it’s usually best not to get directly involved. Your role is to observe and report.
If a crime has occurred, try to gather a detailed description of the offender. Note their approximate height, weight, skin tone, hair and eye color, clothing, and direction of travel. If a vehicle is involved, record the color, make, model, and license plate — including the issuing state. Count how many people were involved.

When you call 911, be ready to give your exact location, the nature of the emergency, your name, your phone number, and everything you’ve observed. Don’t be surprised if a responding officer follows up to include your statement in their report.

When the Fire Department Arrives

Fire departments typically respond to calls involving smoke, fire, gas leaks, or downed power lines. Many departments also have EMTs on staff who can assist with medical emergencies. If you’re inside a building where there’s smoke or fire, you might be tempted to grab a fire extinguisher or smother the flames yourself. But remember, a fire can double in size every minute. If it’s anything more than a small kitchen mishap, don’t try to fight it. Get out immediately. Don’t waste time gathering valuables. In the case of a gas leak, leave the building and move well away from the property. Stay out until officials say it’s safe to return.

When calling 911, be ready to give the exact address and describe the emergency — whether it’s smoke, visible fire, a gas leak, or something else. They may also ask about the fire’s location and whether anyone is trapped inside. After firefighters arrive, you may be asked for details about what happened. Above all, never re-enter a building that’s on fire or filled with smoke. Conditions change fast, and going back inside could cost you your life.

Color Code for Mass Casualty Triage

• RED: (Immediate) Immediate care and transport (e.g., open fractures, chest wounds)
• YELLOW: (Delayed) An injury that may need attention, but that can be delayed without significant harm to the patient (e.g., stable single organ wounds, CNS injuries)
• GREEN: (Walking Wounded) Walking wounded (e.g., sprain, fracture, laceration)
• BLACK: (Expectant) Deceased or those who are expected not to survive their injuries (e.g., unresponsive, high spinal cord injuries)

In Summary

Clear communication is critical when relaying information to first responders — EMS, police, or fire. The accuracy and detail you provide can literally be the difference between life and death. Never underestimate the value of your observations. Don’t stand by and watch. Help where you can.
The best way to prepare is through training, especially in basic medical skills. There are courses available across the country and online that can give you the knowledge to act confidently when it counts. You might be the reason someone survives.

Read More From Issue 69

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• Issue 69
• Editor's Letter Issue 69
• Knives By Nuge
• All-Purpose Road Trip Pack
• Review of The Guerilla’s Guide to Signals Intelligence
• ZOLEO Review
• Signal to Noise: Crisis Communication
• Gear Up: Desk to Dawn

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Editor's Note: This article has been modified from its original version for the web.