Calling 999 for an ambulance is for pupils who are experiencing life-threatening emergencies such as cardiac arrest, suspected sepsis, fits that are not stopping, chest pain, breathing difficulties, severe bleeding, severe allergic reactions, serious head injuries and their life is at risk. If the presentation of the pupil is less severe then you should use the NHS 111 service.
SWAST uses a triage tool called Medical Priority Dispatch System (MPDS), which establishes a universal standard for the call taker. The call takers are called Emergency Medical Dispatchers (EMDs). They take emergency 999 calls based on the signs and symptoms reported by the caller. Calls are prioritised so that patients with life threatening conditions receive the fastest and most appropriate response.
To further support clinical safety and the appropriate use of operational ambulance resources, SWAST now operates what is known as Clinical Navigation within the Emergency Operations Centre (EOC). Clinical Navigation is completed by Senior Clinicians, such as paramedics and nurses, who monitor incoming calls, review triage outcomes, and guide decision making. They help determine the safest and most appropriate response for each patient.
This could be either:
1. Ambulance response.
2. Further triage and assessment by an EOC clinician – including video assessment.
3. Referral to an external partner or alternative pathway (e.g. GP, community teams, self-conveyance to hospital or Minor Injury Unit).
Best practice when calling 999 is:
1.To be as close as possible to the patient.
2.Have all relevant information ready including patient’s name, date of birth, NHS number, address and number you are calling from.
3.Where possible, have a pen and paper with you to write down instructions from the 999-call taker.
4.Ensure that wherever possible when calling 999 you call from a Smart Mobile phone with data enabled so that a video assessment can be undertaken if indicated.
Once connected to the ambulance service, the EMD will immediately begin to gather information, following the steps below:
1.You will be asked two pre-triage questions, is the patient breathing? and is the patient awake? If the patient is not breathing, you will not be asked if the patient is awake. If the patient is not awake, you will be asked does their breathing sound noisy?
2.You will then be asked okay, tell me exactly what has happened? At this point the EMD will only want to know a brief summary of what is happening/has happened. i.e. “they have fallen and have sustained a head injury”, “they have breathing difficulties”.
3.You will then be asked to confirm the address of the emergency, including a contact telephone number in case you get cut off so the EMD can call you back. These may be requested a second time to confirm that they have been correctly recorded.
4.The call will then be triaged, based on the description of events described. For this to be done more effectively, the EMD will need to speak with someone who is with the patient.
5.The EMD will conduct a safe and effective assessment of the symptoms reported. As the clinical assessment progresses each answer determines the next question to be asked.
6.Instructions on how to manage the patient may be given by the EMD in response to the symptoms presented. These may include simple wound care, patient positioning, or CPR instructions.
7.You will then be informed of the outcome of the triage. This maybe an ambulance response, await further assessment by an EOC clinician or referral to an external partner. If an ambulance is being responded EMDs are unable to give an estimated time of arrival but will give worsening advice.
If an ambulance response is agreed please ensure a specific location is given to the EMD for where the patient is and ensure that there is someone there to meet the crew.
Remember:
•If, when asked is the patient breathing, you answer “no”, this could potentially be a life-threatening emergency, and an ambulance will be dispatched immediately, or even diverted from a lower priority emergency call.
•If deemed necessary, the EMD will ask you if someone is able to get a defibrillator. Many schools have defibrillators but if one is not immediately available, they may give you the location of the nearest Public Access Defibrillator.
•The EMD will talk you through what you can do to help, such as providing instructions on how to perform CPR. This requires a phone to be next to the patient and ideally on loudspeaker. You will be asked to shout out the chest compressions as you give them, so the EMD knows what is happening. If there is more than one person able to perform CPR, please remember to swap as it will be very tiring.
•Do not stop resuscitation when the ambulance crew arrive, as they will require time to gather and assemble their equipment. They will let you know when they are ready to take over.
•Where possible, if an immediate priority ambulance has been agreed it is important for someone to meet and direct the ambulance crew, as this may assist them in getting to the patient quicker.
•If the outcome of an ambulance attendance is conveyance to hospital, please ensure that the patient is accompanied and information is available in respect of: any current medications; allergies; contact details for parents/carers/guardians (if not with patient); any safeguarding information e.g. child on protection plan, social worker details if known.
Additional Guidance for Education Settings: Calling 999 for an Ambulance
This guidance is intended to support education establishments by outlining what to expect when calling 999 for an ambulance. In an emergency, it can be stressful and difficult to know what information will be required. The points below are shared to help make the process as clear and straightforward as possible.
When calling 999, you will be asked questions to help the emergency services understand what is happening and send the right help as quickly as possible. Having clear location details is particularly important. Education settings may wish to consider downloading what3words (what3words /// The simplest way to talk about location), which provides a precise location and can help ensure an ambulance arrives at the correct entrance or area of the site.
Cardiac Arrest and Defibrillators
If a child is in cardiac arrest, the call handler will ask whether a defibrillator is available. While many schools now have defibrillators, not all are registered on The Circuit, the national defibrillator database used by 999 services. If a defibrillator is not registered, it may not be visible to emergency call handlers when they are supporting you.
Schools can check whether their defibrillator is registered by visiting DefibFinder (www.defibfinder.co.uk). If it is not listed, it can be added free of charge to The Circuit (www.thecircuit.uk), ensuring it is visible to emergency services and can be used quickly in an emergency.
Severe Bleeding
In cases of significant blood loss, a person can deteriorate rapidly. Bleed control kits are designed to help control bleeding and preserve life until trained medical responders arrive. These kits include clear instructions that can be followed by staff under the guidance of a 999 call handler.
Where schools have a bleed kit, it is recommended that it is registered on the UK Bleed Control Kit Map (www.bleedmap.uk). If a bleed kit is not available on site, the call handler will be able to advise where the nearest registered kit is located.
This guidance is intended to support your preparedness and confidence in an emergency. calling 999 promptly and following the call handler’s instructions will always remain the most important steps.