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MEDiCA - Medical Emergency Dispatch Centres Analysis

Final Activity Report Summary - MEDICA (MEDiCA - Medical Emergency Dispatch Centres Analysis)

The aim of the research has been to analyse communication in operations centres handling incoming telephone requests for assistance. It has therefore concerned communication in emergency situations. These are situations in which efficacious communication may sometimes make the difference between life and death. Hence derives the importance of conducting detailed examination of all the relevant elements of communication in these settings.

The operators at emergency medical call centres do not have immediate access to the scene of the accident. They can understand what has happened (the gravity of the event) and where it has happened (the exact place to which emergency vehicles must be sent) only through the description provided by the caller. The emergency operators must therefore be particularly skilled at conducting telephone conversations oriented to controlling the emotional stress often characteristic of emergency calls and making clear their typical vagueness ('I need an ambulance here now').

The research first examined what happens at an operations centre when a request for emergency assistance is received. As said in the project description, the purpose was to answer a series of questions like: What happens when a member of the public rings an emergency telephone number? Who takes the call? What information is needed to intervene efficaciously?

The analysis described a series of 5-part routines with which emergency calls are structured: (1) opening and identification, (2) request for assistance, (3) questioning by the operator to obtain the information necessary for intervention, (4) response to the request for assistance, (5) closure.

The research report described in detail how the emergency centre operator must guide the caller step by step through questions eliciting the information necessary to respond to the emergency. This yielded a description dense with communicative practices in the social construction of the event 'emergency'. The research then analysed how the operations centre decided what action to take following a request for emergency assistance. Inquiry centred on: How are the resources to deal with the emergency alerted? How are these resources distributed? Who organizes the work? What role is performed by technology in handling the emergency?

At the operations centre studied there was a complex social organisation of work involving a variety of professional figures each with a set of institutional tasks to perform. But the research also uncovered an important array of submerged practices, not described by the manuals and protocols nor articulated in the operator's discourse, but which enable the cooperative joint management of emergencies.

The coordination of actions is one of the main characteristics of emergency work, not only between the rescue team and the event on the ground but also among the components of the rescue team (dispatch centre included). The operations centre is the core of this system of coordination. The research report described an informal and situated kind of labour division, highly flexible and free-floating, oriented to handling the constantly-arising contingencies of an emergency. Even more importantly, the research showed that this flexible organisation of work enabled the operators to deal with emergencies within the on-going flow of routine and programmed events and activities.