911 is still very young compared to other emergency services. Firefighting has been around in the US since the late 1600's and law enforcement is as old as laws themselves. 911, on the other hand, couldn't exist until we had telephones and enough of them to make it a useful service.
The idea of 911 is simple: when you need to call for help, there's an easy to remember three digit number that can never be used for anything else. It's universal across the entire US (and Canada since both countries use the same telephone switching system). It is not only universally used in every state and across 97% of the geographical United States, 911 is also universal regardless of the type of emergency. You call the same number for an ambulance that you do for a cop.
So easy, even a kindergartner can learn to call 911. Indeed, they all know the number when I visit their classes.
As simple as that sounds, you might be surprised to find out just how complicated 911 really is. It's a universal number, but it doesn't work the same everywhere. Here are some secrets of 911 and how they might affect you.
One Number, Many Call Centers
There isn't a central 911 call center for everyone. In fact, not every call center actually answers 911 calls directly.
A 911 call center is known as a Public Safety Answering Point (PSAP). According to the most recent FCC registry, there are 8,334 PSAPs in the United States. Of those, about 6,800 are known as primary PSAPs and more than 1,400 are known as secondary PSAPs.
A primary PSAP is where the phone rings when you call 911. These are the front doors of emergency services. In most cases, these are government agencies, usually law enforcement.
New York City has five primary PSAPs registered with the FCC. They're all in Brooklyn and all are registered to the NYPD. Each of the PSAPs answers 911 calls for a different borough. So, no matter where you are in NYC, when you call 911 it will be answered in Brooklyn.
A secondary PSAP is where a 911 call may be transferred. There are still emergency call takers and dispatchers in a secondary PSAP, they just aren't the first voices you'll hear when you call 911. Primary PSAPs often handle law enforcement duties and sometimes other types of emergencies. In many cases, secondary PSAPs handle fires or medical emergencies.
In Los Angeles County there are 26 primary PSAPs. If you are calling 911 for a fire in LA, once the call taker at the primary PSAP confirms where you are, you'll be transferred to a secondary PSAP at either the LA City Fire Department or LA County Fire Department.
Just because you're in one area, however, doesn't mean you can't call 911 for somewhere else. For example, if you're in Georgia and talking to a sick relative in Idaho, you can call 911 and explain the situation. Be clear what you need. The call taker in Georgia will help you get in contact with the PSAP in Idaho. It's not a common call for emergency call takers to handle, but it does happen.
Some 911 Call Takers are Specialized
Many callers are taken off guard by the transferring of 911 calls. The first time you call 911, you expect a single person to answer and once that person has finished getting all the information necessary, you'll hang up.
Instead, the first person to answer a 911 call is usually the call taker specialized in law enforcement call taking. This call taker will know exactly what to do if you are in a situation that requires immediate action to protect your safety. These are the call takers you want on the other end of the phone if you have an intruder in the house or you've been kidnapped.
If you need something other than law enforcement, once the call taker has established where you are he or she will transfer you to the appropriate call taker or PSAP. In many cases, the secondary PSAP isn't even in the same building as the primary.
The new call taker will ask questions pertaining to your actual emergency. If someone has collapsed in front of you and you're now calling 911, this is the call taker who will get all the information needed for the ambulance to start rolling. It's also the call taker who will tell you what to do for the patient, including how to do CPR if it's necessary.
Location, Location, Location.
If you call 911, you might be surprised how often call takers ask where you are. Each time a new voice comes on the line, you'll be asked for your location (at least an address and sometimes more specific) as well as the phone number from which you are calling. This might even be confirmed a second time by each voice. In a call that's only transferred one time, you will potentially be asked for your location and phone number four times.
Don't be discouraged by this. It's not like the call takers forgot what you said or weren't paying attention. The location of an emergency is the most important piece of information in any 911 call. No matter what happens after you tell them where you are -- let's say a meteor falls from the sky and takes out the phone line -- the call taker has what he or she needs to send somebody driving a vehicle with red lights on top to your emergency.
There's a common misconception that 911 computers always know where you are when you call. This function is known as Enhanced 911 (E911) and is available in most places around the country. It uses a national database for addresses, but the database is sometimes wrong. Plus, that only works with landlines (phones on a phone line plugged into the wall). Cell phones don't always relay your location to the PSAP.
Even if location information is available when you call 911 on your cell phone, not all PSAPs have the equipment to read it. Internet phones work another way entirely. The information is stored in the phone, so if you move a phone from one location to another, it might tell the PSAP the wrong address.
It's because of these technological problems that the call takers ask you so often for your location.
So Many Questions
I often hear frustration in the voices of my patients as they are telling me about their 911 experiences. One of the most common complaints comes from how many questions they had to answer. It's a perception thing. In the mind of the caller, they already know what the emergency is. They want to tell the call taker and would love it if the call taker would just listen.
The problem is: not everyone communicates the same. Some folks are better at getting their points across than others.
Call takers are trained to ask specific questions in a predetermined order, using the answers as a roadmap on which question to ask next. Ultimately as a result of asking the right questions and getting clear answers, the call taker will be able to send the right type of resources (fire engines, police, emergency medical services, whatever) and provide the right kind of instructions to the caller.
The first and most important tip for calling 911 is: Don't hang up. When the call taker is ready to disconnect the call, he or she will tell you. Stay as calm as can be and listen carefully to the questions. If the call taker doesn't think you heard correctly, he or she is likely to repeat the question. If you hear the same question more than once, take a breath and answer it as clearly as possible. Don't get frustrated. The more accurately the call taker gets the information the more quickly you will get help.
If They're Talking to Me, Who's Talking to the Ambulance?
One last thing to remember about PSAPs: These are not usually one person operations. In most places around the country, the folks who answer 911 calls are not the same folks who are talking to emergency responders.
When you call 911 and start answering questions, you will most likely hear computer keys clicking as you answer the questions. That's the call taker writing down everything you say. The dispatcher can read all those comments and will relay them to emergency responders. In some systems, responders will be able to read those call notes directly through computers in their emergency vehicles.
When I first started in this business, the dispatcher was a one-man shop. He took the calls over a phone propped on his shoulder. The information was written on a punch card, similar to what some businesses use for clocking employees in and out. He put the card in the punch clock to record the times. He sent the calls out over the radio and kept track by hand of where all the ambulances were and what they were doing.
Today we've come a long way. Now the center has dozens of people answering multiple lines. Everyone is wearing a headset and sitting at work stations with multiple computer screens. Information is shared instantly, sometimes over great distances. There is more training and much more accountability. Despite all that, the job is essentially the same as it was two decades ago -- and just as hard.