The emotional content and cooperation score in emergency medical dispatching

A common belief regarding scripted-protocol-driven emergency medical dispatch is that the caller is "too hysterical" or "too uncooperative" to allow a structured interrogation or to receive and act upon dispatch life support instructions.

To examine the emotional content and cooperation scores (ECCSs) of callers in more than 6,000 cases from two communication centers and to investigate the relationships between ECCS and caller party, incident nature, time of day, and geographical location.

The ECCS has five levels: 5, uncontrollable, hysterical; 4, uncooperative, not listening, yelling; 3, moderately upset but cooperative; 2; anxious but cooperative; and 1, normal conversational speech. The authors tabulated the ECCS as recorded during case review for a random sample of each center's ongoing quality assurance programs. Statistical tests were used to identify the presence of relationships between ECCS and caller party, arrest/nonarrest situations, time of day, and geographical location.

Regardless of the caller party, the type of call, the time of day, or the geographical location, the mean ECCS of emergency callers is extremely low, indicating that most emergency callers are, in fact, very calm. The average ECCS computed from more than 3,000 cases from British Columbia was 1.05; the average score from almost 3,500 cases from New York State was 1.21.

While relationships between ECCS and the different parameters were noted, the differences were so small as to be of little or no use as additional information to assist with complaint triage. The low overall ECCS shows that the typical caller who requests emergency medical assistance is calm enough to be interrogated in a scripted and structured fashion, and is cooperative enough to be responsive to dispatch life support instructions.