Pre-arrival instructions to patients or bystanders may include: As of 1988, Emergency Medical Dispatch use of pre-arrival instructions has been the standard recommendation of the National Association of Emergency Management Service Physicians (NAEMSP).
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Systems such as MDPS, CBD and Dispatch Life Support incorporate such instructions into specific call complaints.
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Since then, numerous systems have replicated the intent of the initial program: identify the life threat and instruct the caller on appropriate and timely intervention to possibly save a life. In 1974, the first organized effort to provide pre-arrival instructions was implemented in Phoenix, Arizona. "Pre-arrival instruction" refers to specific instructions or guidance provided by 911 dispatchers or public safety, answering point call-takers to the individuals making the emergency call. When specific life-threatening medical emergencies are identified, the following actions, by both the caller and recipient, can be the difference between survival or death. The person responsible for answering that call is assigned the crucial task of rapidly identifying the nature of the emergency, severity, and necessary resources to deploy, all while keeping the caller calm enough to answer the right questions. Nearly any circumstance resulting in a call to 911 call, will involve a stressed or alarmed caller seeking help for himself or someone else.