Emergency Medical Services
This article gives details on what to expect when you are dealing with medical professionals in a situation where someone has overdosed.
Please note: the article is US-focused, but contains information relevant to Australia and Canada as well.
This article is still a work in progress. Corrections and updates welcome.
Credits
From the Emergency Medical Services FAQ, written by Orlando. Special thanks to: BigTrancer, Catch-22, Exx_head, Halo99, nursey and phase_dancer
Introduction
Many of us have been or will be present at a drug-related medical emergency (overdose). As scary as the overdose may be, calling for an ambulance or taking someone to the hospital can be just as frightening.
The purpose of this FAQ is to provide information to people so they know what to expect and how to conduct themselves should they ever have an emergency situation. The idea is that if people are somewhat familiar with the process, they will not avoid getting medical assistance due to fear or ignorance. This is not meant to be a first aid guide.
When should I ring an emergency number?
- If you think that you or someone else is experiencing an overdose or other serious medical condition.
- If the person has symptoms of advanced cardiopulmonary/nervous depression (unconscious, not breathing, changing colours or has a weak/nonexistent pulse)
- If the person has symptoms of advanced cardiopulmonary/nervous excitement (overheating (>39°C/102°F, may be difficult to tell), manic behaviour, heart attack, etc.)
- If the person requires medical care, and driving them to the hospital is impractical or would take too long.
Basically, if the situation is a medical crisis that you cannot handle, then it’s time to make the call.
If you have not already done so, please familiarise yourself with the emergency number in your area. This number is often different for hard lines and mobile phones, so take the time to learn both. The call is free to make from both mobiles and hard lines.
What will happen when I ring an emergency number?
If you are calling from a hard line, the call taker will be provided with your location and phone number. If you are calling from a mobile phone, this information may not be available.
The call taker will ask a series of questions. Try to stay calm, and speak in as clear and concise a manner as you can manage. Refrain from using slang, i.e.: "my mate shot a point of blow" (besides, who really talks like that?).
Answer the questions to the best of your ability, and be honest. Answer exactly the question that is asked, and do not confuse or impede the call taker with superfluous information.
Also, do not hamper the call-taker with questions of your own. They are a professional, and do this on a somewhat daily basis. They know what they need to ask, and do not need to waste time deflecting your questions. Often, help will be on the way while they are still asking questions. In most situations, call takers will gather enough information to make an accurate dispatch in approximately 30 seconds.
Never hang up on the call taker. Wait until they have terminated the connection, then hang up your phone.
What will the operator need to know? What will they ask me?
- What is the emergency? (Do you need medics, police, or fire-fighters?)
- Where is the emergency? They will ask this even if you are calling from a hard line, although in that case the question may be phrased: “Is this emergency at [location of phone from which you’re calling]?”
- What happened? This may come as a series of questions or as a broader single question. The call taker will probably ask a series of follow-up questions.
- When did this happen?
- Other questions – The call taker may ask your name, how many people are there, and if there are any other special considerations or obstacles that need to be noted.
- Instructions – They may provide you with instructions, such as clearing the airway or performing rescue breathing.
Can I dial the number and then run?
Yes. However, dialling and then running is not a good idea as the dispatcher will probably send police to investigate the call. This is bad both because you have now involved the police in a drug-related incident and because this will probably delay the arrival of emergency medical services.
What should I do after making the phone call?
There are two big post-call priorities:
1. Keeping the person alive – The call taker may give you some instructions to this end or you may be free to act on your own. If and only if you are capable of doing so, you should perform CPR/rescue breathing as necessary. If you elect to perform CPR, please be aware of the potential to receive or transmit disease via body fluids. If you are trained in CPR/First aid, consider carrying a mouth shield and a pair of gloves. They fit into basically any pocket/wallet/etc.
2. Sanitising the scene – Basically, this means getting your drugs out of sight. Although this is not nearly as important as the first item, it is probably unrealistic to think that people will not be concerned about this. Don’t waste time trying to diligently hide them, just discard them somewhere out of sight. If it is not practical to discard the drugs, then place them in a opaque bag and send them along with the casualty; indicating to the medics that the bag contains personal items.
This raises the possibility that a helper may fall on the wrong side of the law for handling controlled substances. phase_dancer shed some light on this problem (limited to Australia):
"After expressing concerns that [harm reduction organisation] volunteers had in the past been faced with similar situations, I enquired at a departmental meeting as to what was considered the correct course of action to take i.e. of least consequence for both the helper and the casualty.
We were advised that if a situation occurred where workers had to remove personal items, and something came of it law wise, under duty of care the volunteer/worker would not be liable for prosecution. This did not come from a policeman, but the person was definitely someone who should be able to advise on such matters.
I would imagine this should also apply to the general public, but I couldn't be sure. To be honest I don't know whether this would stand up in court at all. There's never been a precedent that I'm aware of."
This also applies to Canada, one may remove and possess illegal substances or objects i.e. weapons, in an emergence or if found by happenstance, but they must deliver them forthwith to a peace officer.
What if the person recovers before the ambulance arrives?
In this case, ring the emergency number again and tell them that the person seems to have recovered. Emergency calls are prioritised, and someone who has OD’d and is near death is a pretty big priority.*Canada: any call with risk to life or limb is put into the highest priority and generally run across EMS, Police and Fire dispatch due all having some medical training* Letting them know that the person now seems to be okay may free the ambulance to save another life.
The call taker will tell you if an ambulance is still being sent, if you should take the person to the hospital, etc.
Under what circumstances will the police become involved?
USA: Usually, police will only become involved for one of these reasons:
- The medical personnel fear for their safety. This is applicable to emergency responders and hospitals. It is not uncommon for ambulances to request police escorts when entering dangerous parts of town, or going to a dangerous location. This means that calling from a party could bring the police.
- There is a reasonable suspicion that a crime has been committed. Although this is more likely come into play when responding to violent crimes, police have been known to attend calls responding to drug related incidents (this is usually not the case in larger cities).
- You hang up the phone and run; or just dial and run without telling the call taker what you need. In this case, police will most likely be sent.
Australia and UK: According to Flexistentialist: in Australia (and in the UK as well, also I'd bet other countries too, just haven't had the time to actually check) there are policies about routine police attendance at overdose call-outs. In Australia, the police will only attend if there's a risk to the safety of the ambulance drivers. This might occur if they are being called out to an address where there is a history of violence, or if they are being called to a public place.
Canada: Duty of care provides the ability for a first responder to take control of an illegal substance or object from a person without fear of prosecution, generally. however, that means you need to turn it over to authorities. (getting the other person in trouble). Drugs can be destroyed quickly and discreetly however... and many LE staff would be sympathetic to your plight and take it away amnesty. But thats up to the LEO, dept policy and the scene overall.
Police often attend most/all 9-1-1 calls in major centers in Canada. However, unless its incredible (ounces of coke or illegal handgun) they are not likely to prosecute/charge. Once again that's situation dependent. EMS staff and hospital staff will not share info with LE, unless its gunshot/stab wound/child abuse kind of thing.
And most of the time, the police will arrive well after EMS has left...simply due to having more pressing matters that are higher priority sequence on their mobile data terminal, that they are required to attend and clear first. It will only be high priority if caller indicates violence at the scene or EMS arrive and call for police. Otherwise, they'll perhaps roll up and take a short report and you'll never hear of it again.
main message: EMS calls in Canada for an OD tend not to become legal problems.
What will happen when they arrive? Will I/we be subject to search?
At the time of this writing, the FAQ team was unsure of the legally correct answer to this question. The following answer is based on the experiences of people on all three sides of this situation (users, medics, police):
If the police accompany an ambulance, they are basically there to make sure that things don’t get out of hand. They will probably stay with the medics and only intervene if it is obviously necessary - like if someone becomes violent. They will most likely not search the location or your person, but will act if something is in plain sight (don’t leave your drugs in view).
When should I take someone to the emergency room
You should drive someone to the emergency room for the same reasons that you would ring an emergency number; except that in this case it is practical to drive them yourself.
If you have not already done so, please take some time to familiarise yourself with emergency-care centres in your area. This is not something you’ll want to figure out in the middle of an emergency.
Can I drop them off at the door and run?
Yes, but this is not recommended for several reasons:
- Treatment will be hampered. The medical personnel will have an incapacitated and uncommunicative person on their hands. This means that they will have to spend time and effort figuring out what’s wrong with them, as opposed to you being able to tell them what happened.
- The medical facility may make efforts to contact the person’s family, or the police, or both. In any case, this is probably an undesirable outcome.
- When they recover, the person may be awfully teed off about what you did.
Will the doctors call the police?
USA: In almost every case: No. Most hospitals see their share of drug cases and never call the police. Medical personnel are more concerned with providing adequate treatment than they are with reporting crimes.
Besides, police involvement is usually an undesirable situation at a hospital as it adds confusion, saps resources, increases stress and possibly frightens other patients. Some reasons they may call the police are:
- You are acting in an unruly fashion. If you are causing such a scene that they would normally call the police (regardless of cause) or they fear for their safety, expect to see blue lights.
- They have a strong enough suspicion that another, more violent crime was committed. Most hospitals are required to report things such as gunshot wounds, stabbings, etc.
Canada: EMS staff and hospital staff will not share info with LE, unless its gunshot/stab wound/child abuse kind of thing.
Your doctor cannot share any information with the police unless a court orders them to do so. Straight from Exx_head: “There is a doctor-client privilege that can only be broken by court order, and that is very difficult.”
