23.12 — Calling for Help

The first question the call handler asks is not "what is wrong".

It is "what is the address of the emergency".

Because if the call drops, if the caller collapses, if the phone dies — an ambulance can still be sent. Everything else is recoverable. The location is not.

Which means: give the address first, clearly, before anything else, even if you are frightened and the words want to come out in a different order.

The emergency numbers

112 works across the European Union and in a large and growing number of countries worldwide, and it works from any mobile phone.

999 — UK, Ireland, and several other countries. 911 — US, Canada, and much of the Americas. 000 — Australia. 111 — New Zealand. 112 or 108 — India, where 108 is the dedicated ambulance number in most states. 119, 120 — parts of East Asia.

And two things worth knowing about mobile phones:

112 and 911 are recognised by most mobile networks worldwide and will route to the local emergency service, even in a country whose number you do not know.

Emergency calls connect on any available network, even without a SIM card, without credit, and where your own network has no signal — the phone will use whichever network it can reach.

Save your local number in your phone, and know it without looking.

What to say

Stay on the line. Do not hang up until told to.

Speak clearly and answer the questions in the order they are asked. The questions are scripted for a reason — the order gets an ambulance moving at the earliest possible point.

1. Location

Full address, including the postcode or equivalent.

Then the details that save minutes: flat or apartment number; which floor; the entry code or where the key is; which entrance; and any landmark.

On a road: the road number, the direction of travel, the nearest junction, and any marker post.

In open country: use a location app. Most smartphones can show your coordinates, and several countries have dedicated systems — what3words, which names every three-metre square with three words, is used by emergency services in a number of countries and is genuinely useful when there is no address.

Many services can now locate a caller's phone automatically, and confirming it verbally is still faster and more reliable.

2. Phone number

In case the call drops.

3. What has happened

One sentence. The most important thing first.

"A man has collapsed and is not breathing.""My wife has chest pain and is sweating.""My daughter's face has dropped on one side.""He is having an anaphylactic reaction."

Use the words that trigger a specific response: cardiac arrest, not breathing, chest pain, stroke, anaphylaxis, severe bleeding, seizure, unconscious.

These words route the call to a higher priority and, for some, pre-alert a specialist hospital.

4. The person

Age, or approximate age. Sex. Whether they are conscious. Whether they are breathing.

Those four answers determine almost everything about the response.

5. Then follow the instructions

Call handlers are trained to guide you through CPR, through controlling bleeding, through childbirth, and through choking.

They will count compressions out loud with you for as long as you need.

Let them. Bystander CPR guided by a call handler saves lives, and people who have never been trained perform it adequately when talked through it.

Put the phone on speaker and set it down beside you so your hands are free.

While waiting

Send someone to meet the ambulance — at the gate, the road end, the lobby, the lift. Crews genuinely lose minutes finding addresses, particularly at night and in flats.

Switch on outside lights. Open the curtains.

Unlock the door. If you are alone with a collapsed person and cannot leave them, unlock the door first, before you start CPR.

Clear a path. Move furniture. A stretcher and a crew of two need space, and stairs and narrow hallways matter.

Put the dog in another room. This is a serious point — crews are bitten regularly, and an anxious dog protecting an unconscious owner is a real problem.

Gather: their medication, in the actual boxes; a list of their conditions and allergies; their glasses, hearing aids and dentures if going to hospital; and a phone and charger.

Write down the time things happened — when symptoms started, when they collapsed, when you started CPR, when you gave adrenaline or aspirin.

Keep them warm and keep talking to them.

What to tell the crew

Have this ready, because they will ask it in the first thirty seconds:

What happened, and when exactly.

What you have done — any drug given, and the time.

Their medical conditions.

Their medications.

Their allergies.

Whether they take anticoagulants — which changes management for any head injury or bleed and is one of the first things asked.

Whether there is a DNACPR decision, an advance decision, or a treatment escalation plan, and where the document is. This matters enormously and is frequently not found.

Who you are and how to contact you.

When it is not an ambulance you need

And knowing the alternatives keeps ambulances available for the calls on the previous pages.

Non-emergency medical advice lines — 111 in the UK, similar services elsewhere, staffed around the clock.

Out-of-hours GP services.

Urgent care and walk-in centres — for injuries and illnesses that need seeing today and are not emergencies.

Pharmacists — free, no appointment, and genuinely expert on minor illness and medication questions.

Poisons information services — for any poisoning question (Chapter 23.6).

And the balance to strike: do not use these when someone is seriously ill.

If any of the following are present, it is an ambulance: unconsciousness, absent or abnormal breathing, chest pain over 15 minutes, stroke symptoms, severe bleeding, a seizure over 5 minutes or a first seizure, anaphylaxis, serious injury, or a baby under 3 months with a fever.

And the rule that resolves every borderline case: if you are unsure, call. The call handler decides. That is their job, and no service is annoyed by a call that turns out to be minor.

If you cannot speak

Because of injury, because of a medical condition, or because it is not safe to be heard.

In the UK, the Silent Solution system: call 999, and if you cannot speak, listen to the automated question and press 55 when prompted. This tells the operator it is a genuine emergency and transfers you to police. Coughing or tapping the handset may also be recognised.

Registering with the emergency SMS service in advance allows text messages to 999 — essential for deaf, hard of hearing and speech-impaired people, and useful for anyone in a dangerous situation. Registration must be done in advance, so it is worth doing now rather than needing it later.

In the US, text-to-911 is available in many areas.

Many countries have equivalent schemes, and they all require setting up in advance.

And most smartphones have an emergency SOS feature — usually pressing the side button several times — which calls emergency services, shares your location and notifies your emergency contacts. Learn how yours works before you need it.

Getting ready in advance

Medical information on your phone

Both iPhone and Android support a medical ID accessible from the lock screen without a passcode.

Fill it in. It takes five minutes and it is the first place a paramedic will look.

Include: conditions, medications, allergies, blood type if known, emergency contacts, and any advance decisions.

Add emergency contacts under a name a stranger would recognise.

A written summary

A single sheet on the fridge or in a wallet:

Name, date of birth, address.Medical conditions.Current medications and doses.Allergies.GP and hospital details.Next of kin.Any advance decision, and where the original is.

Several countries run formal versions of this — the message in a bottle scheme, or a fridge information card — and ambulance crews are trained to look for them.

Medical alert jewellery

For anaphylaxis, diabetes on insulin, epilepsy, anticoagulation, adrenal insufficiency, and serious allergies.

It works when you cannot speak, which is exactly when it is needed.

Advance decisions

Worth doing while well rather than in a crisis.

An advance decision to refuse specific treatment; a lasting power of attorney for health decisions; and a DNACPR decision if that is what you want.

Tell your family. Tell your doctor. Keep the document somewhere findable and tell people where.

A decision that cannot be located does not exist as far as an emergency crew is concerned.

Learn the skills

A first aid course — a few hours, and it turns knowing into doing.

CPR and defibrillator training.

And find out where your nearest public defibrillator is, before you need it. Many countries have registries and apps, and many defibrillators are never used because nobody knew they were there.

Two things about being the person who helps

Good Samaritan protections exist in most jurisdictions, and legal action against a bystander who acted in good faith is vanishingly rare.

The real risk is doing nothing.

And afterwards: helping in an emergency is distressing, whatever the outcome.

Most resuscitation attempts do not succeed, and that is not a failure of the person who tried.

Talk to someone. Many ambulance services offer bystander debriefing, and it is a normal thing to ask for.

The whole Part in one place

Check for danger before you approach.

Check for response. Shout for help.

Open the airway with head tilt and chin lift.

Look, listen and feel for normal breathing for up to 10 seconds — and treat gasping as absent.

Not breathing normally: call for an ambulance, get a defibrillator, and push hard and fast in the centre of the chest.

Breathing but unresponsive: recovery position.

Severe bleeding: firm direct pressure, and do not lift the dressing to look.

Chest pain: sit them up, aspirin 300 mg chewed, ambulance.

Stroke signs: note the time, no food or drink, no aspirin, ambulance.

Anaphylaxis: adrenaline into the thigh immediately, and keep them lying flat.

Asthma attack: sit them up, ten puffs through a spacer.

Burn: cool running water for 20 minutes, then cling film.

Poisoning: never induce vomiting, and call the poisons service.

Low glucose: 15 grams of fast sugar, then something longer-lasting.

Seizure: time it, protect the head, nothing in the mouth, recovery position afterwards.

Head injury on blood thinners: hospital, even if they feel fine.

And when you are not sure: call.

None of this requires equipment. Almost none of it requires training beyond reading it. And every item on that list has saved lives in the hands of ordinary people who happened to be there.

That is what this Part was for.

What the next Part covers

Part 24 closes the volume on the other side of medicine entirely — food, movement, sleep and ageing. Not what to do when things go wrong, but what actually keeps them going right.