Calling 911

[squeezebox]

Live and learn.
it was a hard day for me. I was tired. misread some signage. should have backed up and reevaluated signage. once injured evaluate injury as serious or not. I did that and decided it was not life threatening. I did wait a while for some other hiker to come by. Should not have called 911 it was not a serious enough injury. That was my 1st experience stealth camping. I had food and water and shelter. I was okay to spend the night. I should have calmed down and just wait till morning. I could have tried to climb back out but I was very concerned about a possible broken collar bone.
Once again I've learned from you folks and learned from the experience.
Thanks!

[rickb]

I think we have all learned something from this thread, but I am not so sure you were 100% wrong to call 911.

By definition, a fall can be unsettling and disorienting.

Your shoulder hurt like hell and you were concerned about getting out of the woods-- who wouldn't be?

But with a call to 911, they had the capacity to ask other questions that you might not have considered in the situation. I would not have expected you to be in a total clear state of mind. Were I taking the call I would have probed about any possible head injury-- I have no expertise in all that, but I am smart enough to know a back country concussion is a big deal. And what about shock? Is that even a concern if you had broken one or more bones and decided to spend the night?

Probably not, who knows?

It seems like the Ranger who called you back might have recognized that kind of complication can happen. That could well be why he called back.

Of course if you hadn't called 911, the ranger would not have had that opportunity. Too be direct, I think you did the right thing in calling.

I think the problem with 911 call is that the response and expection is often binary-- nothing at all or everything they'd would do for John Kerry had he made the call.

In in the end, I think this is an example where everything went very right-- from you making the call, to the measured response (the follow up calls) to getting help from fellow hikers, to a better understanding of things.

I want to thank you for sharing the experience. it's good to think about these things in advance.

[rocketsocks]

I think we have all learned something from this thread, but I am not so sure you were 100% wrong to call 911.

By definition, a fall can be unsettling and disorienting.

Your shoulder hurt like hell and you were concerned about getting out of the woods-- who wouldn't be?

But with a call to 911, they had the capacity to ask other questions that you might not have considered in the situation. I would not have expected you to be in a total clear state of mind. Were I taking the call I would have probed about any possible head injury-- I have no expertise in all that, but I am smart enough to know a back country concussion is a big deal. And what about shock? Is that even a concern if you had broken one or more bones and decided to spend the night?

Probably not, who knows?

It seems like the Ranger who called you back might have recognized that kind of complication can happen. That could well be why he called back.

Of course if you hadn't called 911, the ranger would not have had that opportunity. Too be direct, I think you did the right thing in calling.

I think the problem with 911 call is that the response and expection is often binary-- nothing at all or everything they'd would do for John Kerry had he made the call.

In in the end, I think this is an example where everything went very right-- from you making the call, to the measured response (the follow up calls) to getting help from fellow hikers, to a better understanding of things.

I want to thank you for sharing the experience. it's good to think about these things in advance.

I agree...good post, good thread.

[billnchristy]

I agree that the call was not warranted, but were the half a dozen plus calls BACK that he received warranted? If they decided it wasn't an emergency, shouldn't that be the end?

As he put it, they almost harrassed him into an ambulance.

[Traveler]

I agree that the call was not warranted, but were the half a dozen plus calls BACK that he received warranted? If they decided it wasn't an emergency, shouldn't that be the end?

As he put it, they almost harrassed him into an ambulance.

Once people who perform SAR work are notified of someone having trouble, they tend to monitor the situation. In this instance since cell phone contact had been established, it was a good tool to use and was fairly easy check on the person trying to get out of the forest. As long as that person keeps moving, is alert, communicative, and isn't lost, there is little need to send people in to help. On the other hand, if during that process anything changed they would be able to respond quickly.

911 typically has questions that are asked, sometimes repeatedly like "do you need an ambulance", because many of those who use the number are disorientated and not able to think clearly. It appears both 911 and SAR personnel who were involved handled the circumstance well and in line with best practices.

[Starchild]

I agree that the call was not warranted, but were the half a dozen plus calls BACK that he received warranted? If they decided it wasn't an emergency, shouldn't that be the end?

As he put it, they almost harrassed him into an ambulance.

Read the post by rickb. His call was appropriate given that the OP states that:

but I was very concerned about a possible broken collar bone.

, but he did not like the way they offered to assist. That was the problem, it is common, people do not like to give up control. And fear of a big bill for a ambulance is unfortunately part of that equation for many areas that causes many to forgo early treatment.

But 911 is legally obligated to follow up on every call, to follow it to completion in a report that they are accountable for. If they just wrote him off in the woods as OK and didn't call back they would be held accountable. That is why it's important to call 911, and not direct to the rangers IMHO.

Starchild][/B]They are entitled to emergency services (as long as they can be contacted and can be safely and done). It's part of our society structure.

I know you want to believe that... but emergency service, and protection by fire and police are not an entitlement.

I believe you misinterpreted my quote to make it fit your point, but I ask you to explain your point. You are entitled to call for help (even a free call, even from a cell phone that has no carrier). They are legally obligated to assist to the degree then can and follow up. How are you using the word entitlement that makes emergency services not a entitlement in modern society?

[Lyle]

Folks seem to be implying that it was the 911 operator who determined that the situation was not an emergency and would not send help. In fact, it was Squeezebox who refused the emergency response. He recognized that the situation did not rise to that level, and he was correct. I'm positive that resources would have been sent if Squeezebox had accepted them. The 911 operator did not make the determination. I also am impressed with the extensive follow-up this system provided. That went above and beyond once a response was refused.

In Michigan, for emergency services purposes, if a caller states an emergency exists, then, officially, an emergency exists. Period. Different levels or response will be sent, but there will be a response. I imagine it's similar across the country. Too much liability to operate in any other way.

As LoneWolf says, most of the 911 "emergencies" are not really emergencies, just a quick, easy, foolproof way of getting immediate transport for medical attention. And a way to have insurance pay for the services - you can't get reimbursed for taking a cab or driving yourself. (not implying anything in Squeezeboxes situation, just a general observation)

Background: I am a recently retired Paramedic who worked full-time in the industry for over 30 years - working the road, teaching all levels of EMS courses, and even spent over a year in dispatch full-time. Couple of quick "war stories" to lillustrate true abuse of the system:

1 - Called at 3AM for a complaint of back pain. We were stationed in the local hospital basement. The address given was a house about two blocks away. When we arrived, the patient was not there. As we spoke with the man who answered the door, he pointed out the patient walking up the street towards us. The patient had no phone, so had walked to the Hospital lobby to use the pay phone to call 911. His reasoning was that he had Medicaid so the ambulance was "free" and he would get seen in the ER sooner if he came in by ambulance.

2 - Called in mid afternoon for a 12 year old with a foot injury. When we arrived at the home, there were three cars in the driveway. About 4 or 5 adults were present at the home. The 12 year old had stubbed her toe. There was no swelling, no redness, no bruising, no deformity. We transported the child 21 miles to the nearest hospital, with the parents following behind in their car. The ambulance was out of service for over an hour. The child was sent home about the same time we cleared the hospital.

The system is definitely abused, but we do not want to discourage folks calling - the other end of the spectrum also exists, folks do not call when they should. I always thought that this is one of the most important aspects of first aid training - learning to recognize an emergency and differentiating it from a non-emergency, always erring on the side of caution. I would stress this aspect a great deal in all the courses I taught. I wish all courses placed more emphasis on it.

Again, Squeezebox did the right thing by refusing an all-out response and self rescuing. He just was not aware of the limitations of what 911 can actually do for you. They are geared and intended for true emergency response, so practice "overkill" when called on for non-emergencies. Better to call and not need the cavalry then to not call and need it.

[Scrum]

This is one of the more informative threads I have seen on WB - definitely learning from it.

Question - what if I was in a similar situation:
(1) Took a fall and getting out would be difficult and painful, but not life threatening;
(2) No one else passing by on the trail to ask for help.
(3) I brought the telephone numbers for local SAR and/or the non-emergency number for the local PD.
(4) I try to call SAR/local PD non-emergency number (which I had the forethought to to look up and bring with me on the hike) to ask if some can hike in 2 hours to help me hike out so the experience is less painful and risky (not because I don't want to abandon the bag);
(5) NO cell phone coverage with my carrier - but there was priority coverage for 911 through another carrier.

Under these circumstances should I:
A. Call 911 and explain the circumstances;
B. Suck it up and hike out on my own;
C. Set up my tent and wait for another hiker?

No, this is not a question from the new SAT exam, just an effort to learn and keep this interesting discussion going.

[Lyle]

When in doubt, call 911. They MAY have some resources they can contact, but don't count on it. As stated, they can monitor and contact other officials (Park/Forest Service Rangers, for instance).

Best bet would be to have a local friend know about your trip. If you need help, less than a full-blown rescue, perhaps they could arrange it for you or provide it themselves. Perhaps they can pick you up at an alternate, closer trail head then you planned on exiting, or hike in to meet you as you suggested. I don't know too many SAR members who would or could operate as an individual in either their official or unofficial capacity. Too much liability and they would not want to accept the responsibility if you injured yourself further.

It's an individual call.

[WalkingStick75]

In following this post it is interesting that everyone starts out with calling 911 when it should start with assessment of the situation and self rescue.

Even Squeezebox arrived to the conclusion that he jumped the gun at calling 911 but he recognized that SAR was not really necessary.

The biggest problem here is that the 911 center failed by not sending someone out, they do not have to send the entire SAR team. I worked for a couple years as a campground host in Alaska at a popular state park, more times than I can count 911 called the ranger to check on an ATV or a hiker in the park and in turn the ranger would contact me as the host to take the ATV and assess the situation. In a situation like this I could radio the ranger or satellite phone directly to 911 and advise if EMS was needed or not. I'm also a retired LEO from Michigan, in the county I worked we had some large state hunting areas, while it wasn't very common to have hurt or lost hunters it did happen and somebody would have been looking for a new job if they didn't respond even if it was to carry their pack and walk them out a 1/4 mile.

[rocketsocks]

I guess it depends on the level of preparedness one wants when going on a long distance hike. Do you want to research and have on your persons the numbers of every trail club, angel, shuttler up and down the trail who may be able to help in the event of a minor emergency? If I needed help and had internet working, and it was not an emergency, I post here on WB and see if someone was able to help me out, it really is a great resource.

[Bronk]

As Lone Wolf said, the vast majority of calls made to 911 are not true emergencies. An emergency is when life or property are in imminent danger. Squeezebox's situation didn't rise to that level, though there was a very real potential for it to escalate to that level. And I have to say I'm impressed that Squeezebox was able to admit his mistake...few people are willing to humble themselves like that. As to the complaints some have of 911 operators getting hung up on the address, it might help to understand that the computer systems that 911 operators use to track and dispatch calls are very dependent upon addressing...when they type an address into their computer that location tells them which police department, fire department and ambulance services serve that area...even a small rural 911 center may dispatch for more than a dozen different agencies. If you tell them what road you are on they need a reference point on that road, which would be the nearest intersecting road. Because these computer systems are address dependent, and the location of the emergency is the most important thing, they will most definitely be fixated upon that. If they can't get your location to go into their computer, they get hung up and it becomes more difficult for them to get the ball rolling. You can give them GPS, but they can't type a GPS into their addressing system the way they can a physical address or road intersection. They then have to look at maps to figure out exactly where you are, then determine which agencies provide service in that area, which may be tricky in some jurisdictions. Whereas with an address all of that information goes automatically through the computer system and resources can be dispatched with the touch of a button. Usually as soon as a location and nature of the emergency can be established that button is pressed. If you can't give them a location in a way that their computer system understands then you are wasting time.

[10-K]

You made a judgement call.

The thing about decisions is that we make good ones and bad ones. Unfortunately, there's no way to know 100% of the time in advance if we're making good ones. That's what makes it a decision.

I wouldn't worry about it - it's over.

[Harrison Bergeron]

What if it is coffee that I am out of?

Tough call! I guess I'd have to say that if you can't figure out how much real coffee to take with you, you should confine your hiking to the mall, where there is always a Starbucks handy.
It is actually possible to exist without coffee for several days in an emergency, so you should be able to reach a trailhead without calling 911. If you absolutely can't make it to the trailhead without coffee, I'm going to have to be a hardass about this and say tough! You should have planned better!

[BirdBrain]

Tough call! I guess I'd have to say that if you can't figure out how much real coffee to take with you, you should confine your hiking to the mall, where there is always a Starbucks handy.
It is actually possible to exist without coffee for several days in an emergency, so you should be able to reach a trailhead without calling 911. If you absolutely can't make it to the trailhead without coffee, I'm going to have to be a hardass about this and say tough! You should have planned better!

Thanks. I needed the blunt answer. I will try to be prepared and will suck it up if I burn through my coffee too fast. Just kidding. I doubt I would have the ability to remember the number for 911 if I ever ran out of coffee.

[rickb]

I think the best question to ask is not what we (think) we would do in the backcountry if we thought we might have broken a bone, but what we would do if our wife, daughter, or mother thought she had.

Hey honey, let me splint that up for you-- you will be fine. Nothing to worry about sweetie, you will be back with your softball team in no time-- who needs a Sam splint when I have carbon fiber tent poles-- they are actually better. Puncture-smuncuter, broken ribs always hurt-- lets get out of here, we will stop for ice cream on the way home. I understand you are a bit nauseous dear -- but don't worry I am too. 911? Screw that, they have more imortant stuff to deal with-- not to mention our insurance might not cover any assistance. Are we still in NH?

Or not. If it turns out you have two different standards for calling in help, well, that doesn't make sense at all.

[Slo-go'en]

It seems a lot of hikers have fallen down and broke something or other this year. Some make it out on their own and some don't. Unless you got a bone sticking out the side of your leg, it can be a tough call.

If you fall and land on your shoulder it's pretty easy to break the collar bone. It's also pretty easy to tell you did. I broke mine once (thankfully not on the trail. Stupid accident, but aren't they all?) and I figured the bone wasn't suppose to move when I pushed on it. I also felt a bit nauseous. The collar bone can't be set or cast, so they had me wear what amounted to back pack straps with out the back pack for 6 weeks. And charged me $200 for it (and another $700 for the ER visit and another $200 for a "Specialist" to look at the X rays and say, yea it's broken). I had plenty of backpacks I could have used to do the job if I had known that was all it took to fix it. And lots of Vitamin I.

So, if Squeezebox had broken his collar bone, the best thing to do would have been to put the pack back on - maybe after taking some of the heavy stuff out of it. The pack pulls back the bone and helps ensure the broken end doesn't puncture a lung, which if it does, your in big trouble. A friend of mine broke his collar bone after falling on wet ledge, 3.5 miles from the road. He was able to get help, but they had him carry his pack out for just that reason.

[Another Kevin]

This is one of the more informative threads I have seen on WB - definitely learning from it.

Question - what if I was in a similar situation:
(1) Took a fall and getting out would be difficult and painful, but not life threatening;
(2) No one else passing by on the trail to ask for help.
(3) I brought the telephone numbers for local SAR and/or the non-emergency number for the local PD.
(4) I try to call SAR/local PD non-emergency number (which I had the forethought to to look up and bring with me on the hike) to ask if some can hike in 2 hours to help me hike out so the experience is less painful and risky (not because I don't want to abandon the bag);
(5) NO cell phone coverage with my carrier - but there was priority coverage for 911 through another carrier.

Under these circumstances should I:
A. Call 911 and explain the circumstances;
B. Suck it up and hike out on my own;
C. Set up my tent and wait for another hiker?

No, this is not a question from the new SAT exam, just an effort to learn and keep this interesting discussion going.

If you can self-rescue, you do self-rescue.

That said, are you comfortable with evaluating ABCDE (Airway, Breathing, Circulation, Deformity, Environment)? The 'D' (Deformity) part there is key. If you can't walk out wtithout walking on a possible broken bone and you haven't got help, then an SAR activation may be warranted, to avoid doing yourself further permanent injury. You may also need extraction if the trail is difficult enough that you have a significant risk of a life-threatening fall if you try to travel in your current condition.

Can you get out without significant risk of permanent injury? Do so. If you can't - or think it's likely you can't - then call by all means.

---

Things that definitely warrant 911:

• Anaphylaxis
• Chest pain
• Coma, seizure or convulsion
• Confusion (patient disoriented as to person, place or time)
• Dizziness with sudden onset
• Hallucinations
• Drowning
• Drug overdose
• Dyspnoea (unexplained shortness of breath or painful breathing)
• Dysentery (bloody diarrhoea with shock)
• Heart attack (see chest pain)
• Heatstroke
• Paralysis
• Unexplained slurring of speech
• Sudden blindness
• Copious nosebleed that cannot be controlled with pressure and posture.
• Sudden weakness on one side of the body
• Serious burns (any third degree burn, any second degree burn on face, genitals, or encircling an extremity, any burn exceeding 15% body surface area)
• Arterial bleeding
• Shock
• Compound fracture
• Suspected spinal injury, head fracture or concussion
• Suspected leg fracture.
• Suspected arm fracture if evacuation will necessitate bearing all or part of body weight on hands
• Attempted suicide or suicidal threats or statements.
• Sudden severe fever with light sensitivity.
• Stiff neck with fever and headache.
• Fire out of control. (Even if you think you can put it out, call for backup!)
• Witnessed felony.
• HAZMAT spill
• Motor vehicle accident with injury
• Odor of gas
• Live electrical wires down

---

I suspect that the things Lone Wolf is complaining about - and the emergency services see far too often - are calls to 911 for the OBVIOUS non-emergencies:

• Transport to a doctor's appointment
• Get a prescription filled.
• Minor cuts or bruises, broken fingers or toes
• Patient with chronic pain who has run out of painkillers
• Drunk patient vomiting (but not unconscious)
• Child with foreign body in nose or ear
• Single episode of blood in urine not associated with trauma
• Localized allergic reaction
• Mild animal bite
• Chronic aches and pains
• Dental pain
• Ear infection
• Migraine
• Rash
• Minor sprains and strains
• Burning urination
• Vomiting or diarrhoea of short duration
• Cold or flu or mild stomach bug
• Get quicker attention in the ED
• Report a noisy party
• Report a power outage
• Report a stray dog
• Report a broken fire hydrant or burst water pipe
• Pay a traffic ticket
• Out of gas, flat tire, mechanical breakdown out of traffic
• Property damage when suspects have fled scene
• Motor vehicle accident
• Theft from vehicle
• Lost property
• Abandoned vehicle
• Harassing or obscene phone call
• Find out whether someone has been arrested
• Curious why an ambulance or police officer is at a neighbour's house
• Find out about weather conditions
• Find out about school or business closings

---

And the people who call for reasons on the second list tend to be serial offenders, so a small minority of the population account for a tremendous fraction of Lone Wolf's business.

But - when in doubt, call! 80% of patients with heart attacks, for instance, don't call - because they fear embarrassment or huge bills if they do.

[Another Kevin]

I've found exactly the opposite. The last time I had to call 911 was when I was kayaking in Wharton State Forest in NJ. The fire was a 1/4 mile from Mullica River Camp, a wilderness campground, with officially no car access allowed although emergency vehicles can make it there via sand roads. I called 911 and reported the forest fire. Here's the rough version of the conversation:

Me: "Hi, I'm in Wharton State Forest and there's a forest fire, I can give you GPS coordinates of where it is."

911 Operator: "What is the address of the fire?"

"I'm in a state forest, there aren't any addresses back here. It's off Mullica Road –a sand access–, about 1/4 mile north of Mullica River Camp, I can give you the exact GPS coordinates of the fire."

"What is the address or cross streets of the fire?"

"I'm in a state forest. There is nothing around here for 10+ miles except for trees, the only road is a dirt road – Mullica River Rd, about a 1/4 mile north of Mullica River Camp. I can give you GPS coordinates"

....it went literally on and on with her asking me about 6 or 7 times for the address as the fire grew in size.

"Near Mullica Road, between Batsto River Road and Quaker Bridge Road" might have got you past the question, by giving the ill-trained operator SOMETHING to enter into the computer. Not very precise, but once someone gets dispatched, they'll call back.

[WingedMonkey]

What you should have done is made more of an effort to look homeless and set up camp next to the trail.

Someone would have reported you on the ATC hotline.

Then you would have been escorted out of the woods.