What if 911 doesn't answer?

Philip J. Goscienski, M.D.

August 2012

When a medical emergency suddenly occurs it takes at least a few moments for a rescuer to process the situation before he or she springs into action. How long that requires depends on training and experience. Tragically, in about one instance in five there is no attempt to do anything. Some bystander will probably have the presence of mind to call 911 but what if there is no answer? That is rare but it does happen.

I have personally been placed on hold on two separate occasions after dialing 911. Fortunately for the victims the delay didn't have a tragic outcome. In those instances there was probably a flood of incoming calls from elsewhere, not unusual when an event occurs in a crowded area and dozens of cell phones emerge simultaneously from pockets and purses.

In most communities when someone places a 911 call on a land line the operator immediately knows the location but that is not always true of cell phones. Newer "smart" phones have GPS capability but old ones usually do not. In either case the caller should not end the call unless directed to do so by the 911 operator.

In some areas of the country emergency responders are on the scene in less than five minutes. Most communities are not so fortunate. The average response time has been reported to vary between 8 and 12 minutes. Considering that brain cells begin to die about 4 minutes after the heart has stopped it's obvious that bystanders cannot wait until help arrives even in the better served communities. If CPR can be started immediately the four-minute window can be extended much longer. In very rare but documented situations that has been more than one hour.

"Hands-only CPR" or "compressions-only CPR" is a relatively new but effective rescue method. It is based on the fact that when the heart stops suddenly (sudden cardiac arrest) there is still enough oxygen within the blood to support brain function if only it can be delivered. It eliminates the need for immediate mouth-to-mouth rescue breathing.

For those who may not have ever taken a course in CPR there are numerous online sites such as the University of Washington, http://depts.washington.edu/learncpr/index.html. That site also includes access to CPR apps for smart phones.

Many communities offer Sidewalk CPR Training that provides basic instruction and takes only a few minutes. A tiny investment can return years of life.

Philip J. Goscienski, M.D. is the author of Health Secrets of the Stone Age, Better Life Publishers 2005. Contact him at drphil@stoneagedoc.com.