Dispatchers: How to Respond to Suspected Overdose Calls
When a citizen calls 911 in hysterics because their friend or loved one is potentially overdosing, they expect the dispatcher to be able to help. While the citizen and victim wait for first responders to arrive, the dispatcher’s response could prevent the overdose from becoming a fatality.
Opioid addiction in Kentucky continues to be a growing problem, and the rise of fentanyl and carfentanil mixed with heroin and other drugs has made the crisis deadlier. In response to this issue, the Department of Criminal Justice Training has launched a new class for dispatchers to aid in the fight to save lives.
911: Heroin in Kentucky was introduced recently during the Kentucky Emergency Services Conference in Louisville. The class, taught by DOCJT Training Instructor Sarah Powell, educated dispatchers about their role when handling suspected overdose calls.
“The more familiar you are with the process of something and why things happen the way they do, the faster you can process that situation and respond appropriately while preparing and protecting your responders and bystanders,” Powell said.
Powell expects to teach the course six times in 2018. The class was developed after it was specifically requested by the Kentucky Emergency Number Association/Association of Public-Safety Communications Officials Education Committee, she said.
Understanding the Problem
Powell opened the class with the history behind the opioid epidemic and how events like war and medical advertising have played a role in today’s problems. This was followed by an introduction to the different types of heroin, details about fentanyl and carfentanil, and some disturbing images of the consequences of these addictions.
“I started the class with the history of heroin and opiods, pointing out particular events that, by themselves, might not necessarily seem that significant,” Powell said. “But when you put all the pieces together, it shows how these contributing factors snowballed in size and velocity to the point where we are today. Then, showing the stats for today … emphasizes that this is a big issue at our agencies here in Kentucky.”
Powell played class members a video about a family wrecked by addiction. The mother of a popular, pretty teen with a sweet smile said in the video that she first noticed signs of her daughter’s addiction when all her spoons went missing. Her child had become addicted to heroin, and despite efforts to break its hold on her, the daughter eventually succumbed to a fatal overdose.
At the end of the video, Powell showed the class two images. One was of a disheveled, middle-aged man surrounded by filth with a hopeless expression. The image was juxtaposed with one of the teen, her blonde hair perfectly styled, eyes bright and full of life.
“When you think of a heroin addict, which person do you see?” Powell asked the class as they compared the images. “Is there a difference?”
The answer, of course, is no, Powell said. She then educated students about reward pathways in the brain, the cycle of addiction, the opioid overdose triad and what makes some people more susceptible to overdose than others.
“These can be ‘normal’ people with parents and children who fall into this trap, not just what you might picture in your head as the criminal drug addict,” she said.
How to Help
There are a multitude of questions dispatchers should ask when handling suspected overdose calls. Identifying the number of patients, what might have been taken and whether or not the person is breathing normally are among them. Dispatchers also should gather information about potential safety concerns for first responders, Powell said.
During the course, Powell discussed administration of naloxone if dispatchers determine that someone is actively overdosing. Powell explained what naloxone is and discussed the different ways it can be administered. She also provided class members with resources about adverse reactions and what not to do in an overdose situation – all information dispatchers can relay over the phone to desperate callers.
This also applies to when first responders are the ones who are exposed on duty.
“The dispatcher could recognize the signs and symptoms of exposure, dispatch assistance to the exposed responder and help walk them through treatment steps, since they may become anxious and disoriented,” Powell said.
A leading contributor to overdose deaths is fear on the part of 911 callers that they will get in trouble, said DOCJT Staff Attorney Shawn Herron. The class closed with Herron’s presentation about the law as it relates to heroin and overdoses. Herron reiterated an early statement from Powell that callers may have taken drugs themselves or are afraid they will be assigned blame for the drugs and paraphernalia in proximity to the victim.
Herron addressed 2016 amnesty legislation that protects callers who in “good faith” seek medical assistance for a person in distress. KRS 218A.133 protects those who call 911 for themselves or another in need of help if they remain with (or is) the person overdosing until the requested assistance is provided.
“As the first contact with most overdose cases, dispatch personnel should understand that what they know, and say, can make a difference to callers,” Herron said. “An understanding of Kentucky law and assuring callers that it is safe to stay with an overdose victim, cooperate and provide vital information to responders, is critical to ensuring that responders have a source of good information about the subject they are called to treat. They may very well save lives.”
“Hopefully some of this knowledge will help Kentucky dispatchers save lives, whether it be by treatment or by prevention,” she said. “Because this is a significant problem that is taxing our emergency response agencies currently. And there’s not going to be a miracle, overnight cure for our current state.”