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This story is part of a collaboration between the public radio and the local broadcast network ProPublica.
Conner had just come out of the shower and back to where his young son was taking a nap. Barbara heard Conner shout and went up the stairs to his house in Warwick, R.I.
Conner handed over to Alijah, who was 6 months old, who was limping.
Barbara tried to stay calm while carrying her grandson in the living room. She had watched medical shows on television where they were doing CPR on babies.
"He becomes purple!" Barbara shouted while her daughter, Jessica, spoke to a 911 operator. (We do not use surnames at the request of the family to protect their privacy.)
"Are we giving him mouth to mouth, what are we doing?" Jessica, the baby's aunt, asked the 911 taker at one point.
She has never had a good answer.
The 911 call taker – whose officials refused to identify himself – asked the same questions over and over again, wasting crucial time. She gave incorrect information. And she failed to recognize that the baby was in cardiac arrest, which meant that his heart had stopped and that he was not breathing anymore, according to three emergency medical experts who reviewed a recording of the 911 call obtained by Barbara and transmitted to the public radio.
The call this Friday morning in February 2018 lasted nearly four minutes, when the emergency medical services staff arrived. During the call, the 911 operator never explained to the family how to perform life-saving basic treatment: cardiopulmonary resuscitation or CPR.
By the time the baby arrived at the hospital, it was too late. Alijah was dead.
"I have listened to thousands of calls," said Dr. Jeff J. Clawson, medical director of the International Academies of Emergency Dispatch, a non-profit association located in Salt Lake City. "I would say this call is in the top 15 of the worst calls I've ever heard in my life, maybe in the top 10."
Of the most serious calls handled by the 911 emergency system, Rhode Island appears to have failed, according to experts in emergency medical troubleshooting.
The American Heart Association says that providing CPR instructions by phone for 911 emergency calls involving cardiac arrest is the standard of care. According to experts, knowing how to perform CPR in person is very different than instructing someone to do it over the phone. It sounds like the difference between knowing how to tie one's shoes and trying to explain it over the phone to someone who has never done it before.
But there are no national training requirements for 911 callers. And the country is a patchwork of different systems where performance varies widely.
On average, about one in ten people in the United States who experience cardiac arrest outside a hospital survives. But even in a small state like Rhode Island, experts say the survival rate could double or triple, saving hundreds of extra lives a year, thanks to earlier CPR.
The benefits are well documented. Seattle launched its program in the 1980s. "They quickly found that they were literally stealing lives among patients who were experiencing cardiac arrest at home and in the community," said Dr. Mickey Eisenberg, Medical Director of King County Emergency Medical Services.
At the request of groups such as the American Heart Association, Louisiana, Wisconsin and Kentucky passed laws last year requiring 911 callers and other emergency dispatchers to be trained in CPR by telephone.
For about half of Americans who do not know CPR and others reluctant to practice it, the advice they receive from a 911 operator can be crucial.
"I continue to see cases where I think we could have saved people, which drives me crazy," said Dr. Joseph R. Lauro, an emergency physician affiliated with Brown University. "It's something we can do – it's something that has been studied – it's something that's happening elsewhere – so why on earth are we not doing it?"
Public safety officials in Rhode Island have defended the way their system is set up, noting that call takers are certified in CPR and basic first aid. A spokeswoman for the Rhode Island Department of Public Safety said in an email that it was forbidden for officials to discuss details of the 911 call involving Alijah, citing the privacy laws of the company. # 39; State. The agency also refused to answer questions about the call taker, who was not identified in the registration.
The final autopsy report, which Barbara shared with The Public's radio, indicated that the baby had been propped up on the left side with a bottle in her cradle. "He was later found unresponsive on the back."
The report says that the cause of death is "an unexplained sudden death of an infant".
Doctors who reviewed the 911 call, Alijah's autopsy report and a patient care report prepared by the local fire department said that he was impossible to know if Alijah would have survived with earlier intervention.
Throughout the investigation into the death of Alijah, the baby's aunt, Jessica, said that no one had talked to them about the emergency response following their 911 call. nor had they told them that he had been mismanaged.
"I mean, there were a million more questions," Jessica said. "But no one ever said: You know, what did the 911 call look like, did they give you clear instructions?"
Barbara shook her head. "Not once," she says. "None of them."
***
Since the publication of the full version of this article last month, the Chief of Rhode Island State Police has committed to conducting a thorough review of the procedures and training provided to the 911 interlocutors.
Lynn Arditi is a health journalist on The Public Radio in Providence, Rhode Island. Email her to [email protected] and follow her on Twitter at @ LynnArditi.
Public Radio and ProPublica are spending the year reviewing the 911 Rhode Island Emergency System.
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