Third-Party 'Not Breathing' Report From a Moving Vehicle
At 22:14 a 19-year-old male calls 911 from a moving vehicle. He reports a man 'passed out on the grass, maybe not breathing' at 'the Vista Del Sol apartments on Elm, I think.' He cannot name a building or unit and will not stop - he says he is already late for work. He adds that another person is standing over the man yelling at him to get up, and 'sounding mad.' The caller is talking over you, breathing fast, and repeating 'just send somebody.' CAD confirms Vista Del Sol Apartments, 4400 Elm Avenue: three buildings, 24 units each, one shared parking lot, two driveways. The closest engine is committed on another medical call 1.8 miles away; the nearest ALS ambulance is 6 miles out; a PD unit is 0.6 mile away. His phone location plots on the 4400 block of Elm.
1. What must you get from this caller in the first 60 seconds, and what can you safely defer? Justify the split.
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Get now:
- Location refinement - which building, which side of the lot, near which driveway, what the patient is wearing, any landmark. Three buildings of 24 units means a crew searching blind can burn several minutes.
- Scene safety - is the standing person armed, does he have anything in his hands, is he hurting the patient, is anyone else around.
- Callback number and confirmation he will answer - he is a transient witness in a moving car and may hang up within a minute.
- Breathing status in plain words - 'is his chest moving,' 'is he making any sound.'
Defer: patient name, age, medical history, medications, insurance, caller's full identity and address, the full narrative of how he came upon the scene.
Why: the two facts that change the response are where and whether the scene is safe. Nothing else you could ask in the first minute changes what gets dispatched or how it approaches. Demographics are needed for the report, not the response, and can be captured later or by the crew on scene.
2. The caller keeps interrupting and says he is hanging up. What techniques do you use, and what do you do if he disconnects?
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He is not being difficult - he is a witness with somewhere to be, panicking because he thinks the clock is running. Match his urgency instead of fighting it.
- Acknowledge and direct in one breath: 'You're doing the right thing - I need one thing before you go: which building is he closest to?' One question, not three.
- Closed, concrete questions. 'Is he on the grass by the north driveway or the south one?' beats 'can you describe the location.'
- Use his momentum. Tell him help is already being sent, then ask the next question.
- Do not stack questions, do not correct him mid-sentence, do not read a script at him.
- Slow him with a structured task: 'Take one breath and read me the numbers on the nearest building.'
If he hangs up: enter everything captured, attempt one callback, and pass the partial information rather than holding the call open. Note in the narrative exactly what was and was not obtained - a documented gap is defensible, an invented detail is not.
3. Do you give pre-arrival CPR instructions to this caller? What do you dispatch, and in what order?
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No CPR instructions to him. Pre-arrival instructions assume a trained-by-phone helper who can put hands on the patient. He is driving away and is not going to return to a stranger's yard where an agitated person is standing. Giving him compressions instructions wastes the last seconds of the call.
Dispatch:
- PD first-out - an unidentified person standing over an unconscious subject and yelling is an unknown-threat scene; medical should not be first in alone.
- ALS ambulance for an unverified 'not breathing' report, coded as a possible cardiac arrest rather than downgraded because the information is secondhand.
- Closest fire/engine company for CPR and AED capability, since the ALS transport unit is 6 miles out and the engine can start care.
Why: the caller's uncertainty ('maybe not breathing') is a reason to send more capability, not less - a true arrest has a minutes-long window, and the first-arriving unit here will likely be fire, not the ambulance. Also brief responders that the reporting party is uncooperative and has left the scene so they do not spend time looking for him.