Calm Before The Storm

Audrey Fraizer

Audrey Fraizer

Blast From The Past
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A familiar phrase describing peace and serenity—emotional control of a situation—before something unsettling tips the scales. In the emergency services world, the storms between the calm are many. The lull can take a sharp turn from difficulty
breathing to full-on sudden cardiac arrest, or a vehicle plunging off the road when the driver skids across a patch of black ice.

For example, a soon-to-be mom on her way to the hospital is experiencing this calm without realizing it. She is the passenger. It’s late evening. The father is driving and thumping the steering wheel in tune with a song playing over the radio. Unexpectedly, she goes into hard labor. The calm passes. The storm approaches. The baby is not going to wait.

A call to 911 from the roadside spreads the storm across the wires to an EMD. The caller is anxious, his voice loud. The mother’s voice is frantic, high-pitched. Her breathing is hard. This is an emergency. A baby is delivering in the front seat of their car.

No call is ever the same, but the EMD is ready to assist in the best way possible given any situation. She determines the location, on-scene phone number, and the medical emergency. She is polite but direct.

EMD—Okay. And she's in labor?
Caller—(shouting into the phone) Her water broke, and she’s complaining of contractions. This baby’s coming. We need an ambulance.
EMD—All right. I understand. You have done very well by calling 911. I am listening and ready to help. What is your name?
Caller—(sounding highly agitated) What? My name? Frank.
EMD—Thank you, Frank. Okay, how many weeks pregnant is she?
Caller—I don't know. (The mother holds up two fingers. She's two weeks overdue.)
EMD—The baby's not out yet, Frank?
Caller—No. Wait. Honey? (He pauses) She feels the baby’s head. Where is the ambulance?
EMD—Until the ambulance arrives, we can do this together. I need you to stay calm and listen carefully.

Using MPDS® Protocol 24 (Pregnancy/Childbirth/Miscarriage), the EMD codes the case 24-D-2: Head visible/out, and immediately sends it to the dispatcher. The EMD reassures the caller and, using ProQA®, provides exact childbirth and delivery PAIs. The EMD tells the caller how to position mom and prepare her for delivery.

Caller—I can’t do this. Is the ambulance close?
EMD—You can do this, Frank. It’s like I’m right here. I will tell you exactly what to do.

The caller follows PAIs. The baby delivers. The EMD hears the baby’s first cry in the background. The caller uses his shoelace to tie off the umbilical cord. He wraps the baby in a flannel travel blanket and places the baby on the mother’s chest. The EMD disconnects at the sound of the paramedic talking at the car door.

As stated in the accompanying article, it is very important for the EMD to “reach out” to the caller and give sincere understanding to their situation. Yes, this is an emergency. The EMD is with them, every step of the way, providing instructions and encouragement. She attempts a personal connection ("What is your name?"), reassures the caller ("You can do this,"), and provides the appropriate PAIs in a caring fashion.

The assistance is the highest quality possible before help arrives on scene. The caller might forget the song playing over the car’s radio that evening, but he will certainly remember the calm an EMD brought to his storm.