911: Fire and Emergency Medical Services

What Happens when someone dials 911 for a fire or medical emergency call to 911

When a citizen recognizes a medical emergency and dials 9-1-1, they are immediately connected to an operator at the What-Comm Dispatch Center in Bellingham. The operator answers “911 What is your emergency?” As soon as the need for fire department or ambulance response is recognized, the operator will tell the caller “Please hold while I transfer you to Fire Dispatch.” The caller will hear a few clicks and another ring as the call is transferred. The original operator stays on the line until Fire Dispatch answers.

Common calls received are for fire emergencies including structure fires, brush fires, automobile accidents with injuries and smoke investigations. Common medical type calls are for emergencies including heart attack, respiratory difficulty, seizures and other illnesses.

Calls for law enforcement matters, are handled by the initial call receiving center. They will stay on the line, take information and dispatch appropriate units.

Calls for fire or medical emergencies are forwarded to Fire Dispatch before information is taken and emergency units are dispatched.

If it is a medical emergency, the dispatcher or call receiver may provide self-help instructions to the caller to assist them until professional help arrives.

Call taker at EMS/Fire Dispatch

When the phone operator at Fire Dispatch answers, they say, “What is the address of your emergency?” If the caller is calling from a “hard-line” telephone in Whatcom County, the address of the phone number is automatically displayed on the dispatcher console.  The latest cell phones, that provide GPS data, plot the callers location on a map screen in Fire Dispatch. Older cell phones provide the nearest cell tower location. The phone operator immediately verifies the address/location of all callers and types the information into a computer while the caller answers various questions about the emergency.

Radio Dispatcher at EMS/Fire Dispatch

A radio operator at the Fire Dispatch center receives the information typed by the phone operator and immediately page alerts the appropriate responders. The phone operator continues to ask the caller questions and may give the caller instructions on how to help the patient till responders arrive. The operator’s questions are prompted by Emergency Medical Dispatch (EMD) cards. EMD cards help to efficiently gather information necessary for identifying the exact nature of the emergency and they assist the phone operator in giving the caller proper aid instructions until help arrives.

Whenever a person calls 9-1-1, their message needs to be clear. They also need to stay on the phone until the person in the dispatch center has released them from the conversation.

Try to stay calm. State what kind of emergency it is – fire, car accident, heart attack, etc., then tell the dispatcher where the incident is.

Stay on the phone. The dispatcher may ask more questions may want you to stay on the line, or in the case of a structure fire – immediately hang up and leave the building. Emergency units already have been dispatched even while you are talking with the dispatcher. Children should be taught their home address and telephone number as soon as possible.

Alerts are sent out to First Responders & Paramedics

The responders receive the call for help on pagers that broadcasts the dispatcher’s voice message describing the address and nature of the emergency. The computer at the dispatch center is programmed to automatically send the closest First Responders and the closest Paramedics (in the event of a significant medical emergency) for medical emergencies, and the closest fire engines, tenders, ladder trucks and fire officers in the event of a fire, hazardous materials incident or rescue situation. The First Responders may be volunteer or paid staff from the local fire district. Often rural fire districts use volunteers to staff the functional positions of the department.

These volunteers have various levels of training ranging from basic first-aid to Emergency Medical Technician with defibrillator and airway management training. The volunteers must respond to the station from their homes before driving to the emergency site. The Paramedics are paid Firefighter/Paramedics from the Bellingham Fire Department who staff the ambulance site 24 hours a day and respond directly to the emergency site. Whatcom County Fire District #7 also staffs a part time paramedic unit.

Whatcom County emergency medical services are provided by:

  • Your local fire department or district
  • Whatcom Medic One paramedic units operated by the Bellingham Fire Department
  • Part time paramedic unit staffed by Whatcom County Fire District #7

The closest unit will be sent to ensure that help arrives as soon as possible. It also means that more than one fire unit may be sent to the scene.

When the fire department responds to a given location, it may be delayed in arriving if the address is not clearly seen from the street. Although it’s fairly easy spot a column of smoke from a house fire, it’s difficult to see someone’s heart attack from the street. In a medical emergency, firefighters may waste critical time having to knock on several doors to try and find a correct address. Make sure your address is clearly visible from the street. The numbers should be at least four inches in height on a contrasting background and be reflective.

Address problems are compounded in large condominium and apartment complexes. Arriving at a correct address, the engine company finds a huge residential facility with many buildings in the complex. Make sure large identification lettering or numbering is mounted on the side of the building. This is as important as the street address. It would be even better if someone could be standing near the street to direct the fire units to the appropriate apartment.

First Responders Arrive

In the event of a structure fire, the first arriving fire unit officer conducts a “size up”.  A size up is the gathering of as much initial information as possible-as quickly as possible-and initiating a rapid plan of action.  The size up also includes broadcasting over the radio to other responding units about the situation, what the first unit is going to do, and what they need to support their operation.

For a reported less serious medical emergency, the closest First Responders are typically dispatched on an ambulance, and frequently treat and transport the patient to the hospital if necessary.. In more significant medical emergencies, a Whatcom Medic One paramedic unit may be dispatched initially, or may be requested by the First Responders after they arrive on scene and determine the patient needs a higher level of medical care than they can provide.

All Bellingham Fire Department firefighters are also Emergency Medical Technicians (EMT’s).  Approximately one-third of these firefighters are also paramedics after receiving advanced life-support education/training including starting IV’s, advanced airway management techniques, cardiology and drug therapy. Currently, paramedics are assigned to 3 full time medic units.

Paramedics Arrive

When Paramedics arrive on scene they receive a more detailed report from First Responders about the condition of the patient and treatment steps that have been taken. The Paramedics bring their Advanced Life Support (ALS) equipment to the patient and begin their own assessment of the patient’s condition. They may take steps to stabilize the patient on scene or they may do a quick load and transport when it is clear that the patient is in critical condition requiring hospital level care. First Responders help with continued assessment and patient care. The patient is packaged for transport and moved to the ambulance. This may be difficult depending on the patient’s size and location.

Patient is loaded for transport

Once the patient reaches the ambulance, they are loaded inside and further prepared for transport. When critical patients are transported, First Responders often ride or drive the ambulance to the hospital to allow more assistance in the patient compartment. Supplies used by First Responders are replaced or exchanged with supplies from the Paramedic Unit before transport begins. The Paramedic gives the hospital an oral report by cell phone while in route. This allows the hospital to make room for the patient and to provide them time to call in special resources when necessary.

Ambulance Arrives at Emergency Department

When the ambulance reaches the hospital, the patient is offloaded and wheeled into the Emergency Department (ED) where nurses have a bed ready for the patient. Paramedics give another, more detailed report to the ED nurses and sometimes the ED doctor. Once the ED staff has control of the patient, the Paramedics write a detailed medical incident report that describes their findings and treatment of the patient. A copy of this report is left for the ED staff in order to aid in hospital diagnosis and treatment.