Emergency Calls

A while back, I was called to a library for an employee who was having chest pain.  I arrived to find a 55-year-old female librarian in the back office.  She looked generally okay, and one of her coworkers was on a cell phone.  “Oh, good. They’re here,” she said.

I assumed she was talking to the calltakers at the communications center, so I asked her to hang up the phone.  The 911 calltakers’ calls are recorded, after all, plus they have other calls to take.  “Oh, no.  This is her husband.  Tell him where you are taking her,” she said as she tried to hand me the phone.

Why do people feel the need to do that?  Why do they want to call the patient’s loved ones and tell them nothing?  They know nothing!  What is that urge?  I don’t get it.  (Obviously.)  At that point in a call I usually don’t even know if the patient is going to the hospital, let alone which one.  Give me a minute. 

I can think of a bunch of reasons to not call family members.  For the most part, the patient can do that when my physical exam and clinical history have been done.  Most calls have a break point where I have all the information I need, but we aren’t at the hospital yet.  If that break point never occurs, the hospital can take care of calling people the patient knows.  The worst part of it is that people expect information before I know anything. Finally, I am the professional expert that you called to help you during this emergency situation.  It is unlikely that you called 911 so that I would arrive and talk on the phone with the librarian’s husband.  I need to do my paramedic thing.

But there are calls, on rare occasions, in which I need to talk to the family on the phone.  For example, once I was working at the airport when the report of a sick female on a diverted flight came in.  A diverted flight is one that isn’t supposed to be landing here; it was supposed to be passing over from Point A to Point B.  My airport is Point A-and-a-half.  Diverting a flight is a really big deal.  The airport has to make up all of the missed connections on the flight, pay landing fees, refuel, and so on.  So if a flight crew decides to divert, something on board really scared them.

In any case, this diverted flight involved a 17-year-old who was flying alone.  A bystander on the plane explained that she had chest pain and shortness of breath, but kept getting worse and worse.  Nobody on board could register a blood pressure, but they gave her two nitroglycerin tablets anyway.  Now the girl was having a seizure.

When I met her, she was experiencing a raging anxiety attack.  Apparently the carpopedal spasms were misidentified as a seizure.  She had a respiratory rate above 80 per minute with clear breath sounds.  She was normotensive (I had no problem with hearing the BP) and a little tachy.  She had a room air sat of 100% and an end-tidal CO2 of 5mmHg.  Rock on, little rocker.  Hyperventilation is a bear.

Anyway, I worked through the call while I waited on the transport ambulance.  The patient couldn’t talk to me, though.  She could tell me that she couldn’t talk, but that was all she would say.  I tried to point out that telling me her medical conditions took just as much talking as telling me that she can’t talk, but to no avail.  I was still vaguely considering the risk of PE, so I wanted to know about birth control use, smoking, previous anxiety issues, and such.

With the girl’s permission, I got into her bag, found an iPhone, and called her emergency contact.  It was her mom, who was supposed to be picking her up at another airport in a different time zone.  I explained what was going on, got a medical history, medication list, and such, and let her know that her daughter would be off to the hospital.  I gave her information about the hospital like contact numbers and generally explained everything.  Mom was nice.

In that case, calling the emergency contact was helpful.  But I did it for a reason – I needed information.  But it is pretty rare to find someone who is unable to clearly communicate, when I need information, and they have a cell phone.  I realized that not a lot of medics know how to get into the ICE (in case of emergency) stuff on smartphones.

For iPhones:

Slide to unlock.  It will ask for a code.  Just tap ‘Emergency’ on the bottom left of the screen.

You are at an emergency call screen.  Tap ‘Medical ID’ at the bottom left.

Assuming the iPhone user has their phone set up, it shows the owner’s name and birthday, medical conditions, allergies, and an emergency contact.

Tap the emergency contact’s phone number and the phone will call it, locked or not.

For Android:

Android owners can set up emergency contacts as part of the phone’s owner information. 

Alternatively, some Android owners take a picture of emergency information and set it as their lock screen photo.

Finally, there are third party apps that can function similarly to the iPhone system.

In the end, it is hard to tell which system your patient used (if any). 

I have no idea how to get to the emergency contacts on Motorola's DynaTAC 8000x.  Sorry.
(Photo Credit Redrum0486 via Wikimedia Commons)

I hope this helps.  It isn’t often that we need to access a phone, but those situations do arise.  As far as I am concerned, letting emergency contacts know that you are taking an adult patient to the hospital is unnecessary and may violate confidentiality.*  I avoid that.  But sometimes, rarely, whatever medical information you can get is a big help to the performance of your job. 

*Conversation to avoid: “Who owns this phone?  Oh, your husband, huh?  Well, we found him without clothes, wearing an inflatable Viking helmet, passed out in a puddle of urine in a cheap whorehouse.  Do you know if he has a seizure disorder or diabetes?  No, huh.  Well, there must be other drugs besides meth in his system, then.  Cool.  Thanks for your help.  Have a good one…”