Brett Patterson

Brett Patterson

Best Practices

By Brett Patterson

Brett:During a short period of time, we received three “calls of concern” from hospital staff at different hospitals about directing callers to do CPR, including mouth-to-mouth. The most recent was this weekend with a 20-something drug overdose in a gas station bathroom. I use the, “We have an obligation to provide CPR instructions,” and they can always refuse M-T-M argument. Is this becoming an issue nationally? If so, are there any plans to address this in the protocol?

David A. Rivers

Chief of Operations

New Hampshire Department of Safety

Bureau of Emergency Communications

Concord, N.H., USA


This has always been an issue, although of minor concern.

The MPDS protects callers from HAZMAT and other dangerous scene safety issues, and the move to a Compressions first pathway has dramatically decreased M-T-M exposure. In v13.0, with approval from local medical control, there will be an option to do Compressions Only for patients with cardiac arrest of suspected cardiac origin (respiratory etiology will still be handled with the 30:2 pathway).

The reality is that the incidence of disease being transmitted via M-T-M is very low, and a call to 9-1-1 is, as seen by our courts, a call for help in which we are obligated to provide a standard of care, and CPR is the standard of care. To ask a caller if they want to do CPR, or to provide instructions outside of the standard of care, is simply inappropriate and borders on clinical negligence.

And while hospital and EMS workers are afforded protective equipment and are expected to use it, this is not practical or possible in the DLS environment. Most importantly, CPR saves lives.

Brett Patterson Academics & Standards Associate Medical Council of Standards Chair