title: The lay public's expectations of prearrival instructions when dialing 9-1-1.
abstract: OBJECTIVE
  To determine whether the lay public expects public safety answering points (PSAPs) to provide prearrival instructions.
  
  
  METHODS
  Two thousand telephone numbers were randomly generated from all listed residential numbers in a county containing urban, suburban, and rural communities served by 26 enhanced 9-1-1 PSAPs. Only a minority of the PSAPs provided prearrival instructions. Research assistants made two attempts to contact an individual at each telephone number. A survey was administered to any person who answered the telephone provided the person was at least 18 years of age and gave verbal consent. The respondents were asked their age, level of education, and gender. They were also asked what number they would call for first aid or an ambulance and whether they would expect telephone instructions from the dispatcher if a close relative was choking, not breathing, bleeding, or giving birth.
  
  
  RESULTS
  One thousand twenty-four individuals were successfully contacted; and 524 (51%) were at least 18 years of age and agreed to participate. The respondents' mean age was 50 (standard deviation 19 years). Sixty-five percent of the respondents were female; and 90% had at least a high school diploma. Only 37% had previously called 9-1-1 (nine-one-one) for an emergency. Ninety-seven percent said they would dial either 9-1-1 (85%) or 9-11 (nine-eleven) (12%) in an emergency. Seventy-six percent (95% CI: 73%-80%) expected prearrival instructions for all four medical conditions. Specifically, prearrival instructions were expected by: 88% for choking (95% CI: 85%-90%), 87% for not breathing (95% CI: 84%-90%), 89% for bleeding (95% CI: 86%-91%), and 88% for childbirth (95% CI: 86%-91%). Ninety-nine of 117 respondents (81%) served by a PSAP that did not provide prearrival instructions expected to receive phone instructions for all four emergencies. Logistic regression revealed that knowing to dial 9-1-1 or 9-11 in an emergency was the only significant predictor of prearrival instruction expectation [p < 0.03, odds ratio 3.4 (95% CI: 1.16-9.78)]. Age, gender, service by a PSAP providing prearrival instructions, and level of education were not predictive.
  
  
  CONCLUSIONS
  The lay public expects prearrival instructions when calling 9-1-1, although they may not currently receive this service.
authors.affiliation: Department of Emergency Medicine, School of Medicine and Biomedical Sciences, State University of New York at Buffalo, USA. billittier@ed.ecmc.edu
authors.forename: A J
authors.initials: AJ
authors.lastname: Billittier
authors.forename: E B
authors.initials: EB
authors.lastname: Lerner
authors.forename: W
authors.initials: W
authors.lastname: Tucker
authors.forename: J
authors.initials: J
authors.lastname: Lee
mesh_terms: D000328:Adult; D001294:Attitude to Health; D003142:Communication; D004631:Emergency Medical Service Communication Systems; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009518:New York; D016017:Odds Ratio