Calling 911 From a Job Site So They Find You

Why this matters

A field-service crew calls 911 from somebody else's address. The tech knows the job by the customer's last name and the ticket number, the house is in a subdivision he first saw an hour ago, and the person who is hurt is in a backyard, an attic or on a roof that nobody can see from the street. Ambulances routinely lose minutes not on the drive but on the last hundred feet: the wrong house in a row of identical ones, a locked gate, a crew pounding on the front door while the patient is behind the garage.

This card owns the call itself. What to do in the minutes around it belongs to The First Five Minutes After Someone Is Hurt. It follows how public safety answering points (the 911 centers, often called PSAPs) actually take calls, and it is not training: hands-on first aid and CPR certification is what makes someone a responder.

Before anyone is hurt: carry the address

Step 0, every job: know the street address and unit before you start work. It sits on the ticket, but under stress people reach for it and find a customer name. Put the full address, the unit or lot number, and the cross street in the first line of the job notes, and say it aloud at the morning huddle for a remote or unusual site. What breaks if skipped: the first question the call-taker asks is where you are, and "the Hendersons' place off Route 9" starts a search instead of a dispatch.

The call, step by step

1. Dial 911 and lead with the location, then the emergency. Most centers open with "911, what is the address of your emergency?" because a call that drops after the address can still get an ambulance sent. Give the street number, street name, city, and the unit. Then one sentence on what happened: "a man fell off a ladder and is not moving", "heavy bleeding from the leg". What breaks if skipped: leading with the story means the address comes last, and calls drop.

2. Give the access, not just the address. The address gets the ambulance to the curb. Access gets the crew to the patient. Say where the person is and how to reach them: "he is in the backyard, the side gate on the left of the garage is unlocked", "she is in the attic, the hatch is in the hall closet", "on the roof, there is a ladder on the east side". Give the gate code for a gated community, name a dog that needs to be put away, and say which door to use. What breaks if skipped: paramedics carrying a stretcher and a monitor to the front door, then back to the truck, then around the house.

3. On a rural or hard-to-find site, give landmarks and coordinates. Driveways off county roads, unnumbered barns and new construction without a posted number all look the same at speed. Give the nearest crossroad and which side of the road, a mile marker if there is one, a landmark ("the long gravel drive past the red church, mailbox with reflector tape"), and the latitude and longitude from your phone's map app, which on most phones shows when you press and hold your own location dot. What breaks if skipped: a responder who is in the right area but cannot see the drive, and a dispatcher who cannot tell them which one it is.

4. Send someone to meet the ambulance. The person who meets the rig at the street is worth more than any description. Turn on the porch light and the van's hazards, open the gate, move any vehicle blocking the driveway, and put a person at the curb waving. If you are alone, ask the dispatcher whether you should leave the patient to do it; on a bleeding call the answer is usually no. What breaks if skipped: a dark street at night with house numbers on the mailbox side the ambulance is not on.

5. Stay on the line, and do what the call-taker says. Many centers give pre-arrival instructions: how to do compressions, where to press on a wound, whether to move someone. Put the phone on speaker so your hands are free. Answer questions even when they seem slow; the call-taker is often dispatching while talking to you, and the questions are not delaying the ambulance. Do not hang up until you are told to. What breaks if skipped: losing the CPR coaching, and losing the callback path if the address was misheard.

6. Give a callback number and say who you are. "My name is Ray, I am the plumber working here, this is my cell." If the call drops, the center calls back that number. If you called from a customer's landline or your office phone, say so. What breaks if skipped: a center trying to call back a number that belongs to a phone nobody is near.

7. Know your phone's location limits. A cell call gives the center an estimated location, and modern handsets usually do much better than they used to, but in some places it is still off by a block or more, worse indoors, in rural areas and in multi-story buildings, which is why steps 1 and 3 matter even though the phone is "sending your location". Know three more limits:

• Text to 911 works only where the local center has turned it on, and text is slower than voice. Call if you can talk.
• Office and internet-based phones report the address the system was registered to, which may be your shop, not the job. Under federal law (Kari's Law and Section 506 of RAY BAUM'S Act, enforced by the FCC), multi-line systems installed or manufactured from February 2020 must let a user dial 911 directly without a prefix, and systems installed from 2021 onward (2022 for non-fixed devices) must also convey a dispatchable location, but older systems may not do either. Ask your phone provider how your system behaves; never find out by dialing.
• No signal. A phone with no plan can generally still reach 911 on any carrier's network that it can see, but with no signal at all it cannot. Move toward the road or higher ground, or use the customer's landline, and know in advance whether the site has coverage. See related: The Remote Job Emergency Plan SOP.

A worked call: backyard, side gate, no house number

A two-person crew is regrading a yard behind a house in a development of nearly identical homes. The helper, digging near the fence, is struck in the head by a swinging excavator bucket and is lying on the ground, breathing, not answering questions. The lead tech has already stopped the machine and taken the key. He calls with the phone on speaker and kneels beside the helper. The address is at the top of his job notes.

CALLER: 911, what is the address of your emergency?
TECH:   4418 Larkspur Court, in Millbrook. Cross
        street is Fenwick. My guy got hit in the
        head and he is not answering me.
CALLER: 4418 Larkspur Court. Is he breathing?
TECH:   Yes. He is breathing. Eyes are closed.
CALLER: Is he in the house?
TECH:   No, backyard. Do not go to the front door,
        nobody is home. Gate on the right side of
        the garage, it is open. There is a yellow
        excavator in the yard.
CALLER: Okay. Help is on the way. Is he bleeding?
TECH:   A little from the scalp, not a lot.
CALLER: Do not move him. Keep his head still. Is
        there anyone who can meet the ambulance?
TECH:   No, just me. My van is in the driveway,
        white, hazards are on.
CALLER: Stay with him. What is your name and the
        number you are calling from?
TECH:   Dale, this cell, 555 0148.
CALLER: Stay on the line with me, Dale.

Why each line was there. The cross street went with the address because Larkspur Court might exist in two towns the center serves. "Do not go to the front door, nobody is home" saves a crew a knock that would never be answered. The yellow excavator is a landmark visible from the street over a fence, which a house number on a mailbox is not. And "van in the driveway, hazards on" replaces the person at the curb he could not spare, because a head-injured person who is not answering must not be left alone and must not be moved. See related: Head Injuries and Concussion on the Job.

What changes the answer. With a second uninjured person, Dale sends them to the street on the dispatcher's go-ahead and the hazards become backup. At night, he adds "porch light is off, look for the van". On a rural site without a numbered address, his first line becomes the road, the crossroad and the coordinates, and he reads the coordinates twice. And if the excavator had still been running or the bucket still hanging, the call would wait the few seconds it took to shut it down and take the key, because a second person hurt by the same bucket helps nobody.

The failure this call avoids. The natural first sentence is the story: "my helper got hit by the excavator, I think he is hurt bad, he will not wake up". Panicked callers often never get past it, and the call-taker has to drag the address out of them one piece at a time. Training the first words to be the address is the single most useful thing a shop can rehearse.

How to rehearse it without calling anyone

Never place a test call to 911; it ties up a line someone may need. Instead, at a huddle, one person plays the call-taker with the opening question and the other answers for the job they are on that day, address and access, out loud, in under 20 seconds. A good drill answer covers the four things in the worked call: address with cross street, where the patient is, how to get there, and who or what is meeting the ambulance. If anyone reaches for the customer's name instead of the street number, put the address in the first line of their job notes and run it again the next day.

References

• Federal Communications Commission, guidance on wireless 911 location, text-to-911, Kari's Law and RAY BAUM'S Act Section 506 dispatchable location.
• National Emergency Number Association, public education material on calling 911.
• See related: The First Five Minutes After Someone Is Hurt.
• See related: The Remote Job Emergency Plan SOP; Working Alone: Staying Safe When No One Is Watching.
• See related: The Ambulance That Went to the Wrong Street.