Dispatchers Give--as Well as Send--Help : Emergency: Despite liability fears, they are now often trained to offer potentially lifesaving guidance over the phone.

The emergency 911 call began with an anxious Santa Ana man blurting into the telephone, “We have a woman here who is having a baby that’s already on its way.”

Fire Department dispatcher Maureen Ehart immediately began instructing the caller in the fine art of delivering a baby--quickly. Then came another bit of news.

“She has the (bathroom) door locked, and she won’t let anyone in there,” the caller told Ehart.

Finally, as the woman was giving birth, she unlocked the door. As paramedics arrived, Ehart, guided by an emergency manual, was helping to deliver a healthy baby girl.

For medical emergencies from choking to chest pains, seizures to gunshot wounds, nearly every Orange County city now has dispatchers trained to give emergency medical guidance over the phone. Five years ago, that wasn’t true.

“It used to be (dispatchers) would say help is on the way and hang up,” said Terry P. Mathers, the communications manager for North Net Fire Communications, which handles emergencies in Anaheim, Buena Park, Garden Grove, Fullerton and Orange.

Laguna Beach is the latest city to join the trend, with Costa Mesa planning to switch over this year. At the same time, a bill introduced in the state Legislature last month would make it easier for cities throughout the state to offer help over the phone without fear of a liability lawsuit.

What has happened in Orange County over the last several years is a new way of handling emergency calls. Dispatchers--reading from manuals developed by the Orange County Fire Department or by a Salt Lake City medical consulting firm--instruct people in life support or first aid.

“People are coming to expect it now,” added Dennis Kidd, a shift supervisor and dispatcher with Central Net Fire Communications. Kidd, giving instructions for mouth-to-mouth resuscitation in 1988, helped save 1-year-old Travis Scott, who had been found unconscious at the bottom of his grandmother’s Jacuzzi in Huntington Beach.

Although there are no tallies of the number of people saved since cities began providing emergency help over the phone, dispatchers and fire departments provide anecdotal evidence of successes.

Lori Boursier with the Orange County Fire Department recently told a Placentia woman how to perform mouth-to-mouth resuscitation on Frank Davis, the woman’s 61-year-old husband, who had gone into cardiac arrest.

“She was afraid to look at him. She was afraid to go near him,” Boursier said. In a practiced monotone, Boursier told the caller, “This is your husband. You’ve got to do this. We’re going to do this.”

As Boursier led the woman through cardiopulmonary resuscitation, her husband began breathing. Paramedics shuttled him via helicopter to Placentia-Linda Community Hospital.

“You have to just go ahead and do your job,” Boursier said. “You tell them what to do, but sometimes they are so upset that they don’t know if they’re doing what they are supposed to do.”

Dispatchers and fire officials say giving help over the phone has been a boon to emergency services.

“911 was the first godsend to public safety. Now this is the second,” said Richard Toro, the Orange County Fire Department’s senior communications supervisor.

But the practice also has sparked concerns about liability.

Last July, a 911 emergency dispatcher in Northern California refused to give a mother CPR instructions for her drowning 1-year-old baby. That county did not allow dispatchers to give medical advice over the phone because of the potential for liability lawsuits. As the mother pleaded with the dispatcher for help, the baby died.

Spurred by that case, the California State Firefighters Assn. submitted a bill three weeks ago in the state Senate that would grant limited immunity from civil lawsuits to dispatchers who give emergency medical help over the phone.

The bill’s backers hope its passage will prompt fire departments across the state to allow dispatchers to give potentially lifesaving instructions. Currently, only a handful of California cities and counties allow their dispatchers to do so, said Don Barkas, a Santa Barbara County emergency services dispatcher who is lobbying for the bill.

To qualify for the program, dispatchers must take at least 40 hours of training. And Orange County dispatchers said they are careful not to deviate from their manuals, despite the adrenaline surge and time pressure in emergencies.

“There are no problems associated with the program if it is followed like instructed. You just can’t go wrong,” said Dale Kinney, senior communications supervisor for the Costa Mesa Fire Department, whose 23 full- and part-time dispatchers will begin providing emergency medical dispatching pending approval of the city budget this fall.

Costa Mesa’s current policy does not allow dispatchers to give emergency medical information unless the dispatcher has training in a particular procedure, such as CPR or the Heimlich maneuver, Kinney said.

But Kinney said public expectations are changing.

“In this day and age, people pick up the phone and they expect you to have the answers,” Kinney said.

Dispatchers in Brea and La Habra currently do not give emergency instructions. Those cities have only two dispatchers working at once for both the police and fire departments, which is insufficient manpower to allow them to give instructions, communications supervisors said.

Brea officials also fear liability problems, said communications supervisor Shelley McKerren. But eventually, she said, Brea officials hope to train dispatchers to use the county-approved manual.

In La Habra, communications supervisor Isabel Mario said the city is small enough that emergency response times are short.

In San Clemente, dispatchers provide certain medical instructions, such as CPR, but also transfer calls to the Orange County Fire Department, where dispatchers are trained to use the emergency manuals, said Jack Stubbs, San Clemente Fire Department spokesman.

Laguna Beach switched to the new system only six months ago. Dispatch supervisor Sgt. Danell Adams called it “a timesaver” for paramedics. “It helps cut down on preparation time when paramedics know what to prepare for,” she said.

When starting medical aid, “time is of the essence,” said Jane Cameron, a supervisor and dispatcher with Central Net Fire Communications, which handles calls from Huntington Beach, Fountain Valley, Westminster and Newport Beach. “The quicker we can start that, the better the chance of survival,” she explained.

For the dispatchers, the new role poses challenges. Some callers are not close enough to a victim to provide help. Other callers may be too hysterical to listen. And some do not follow instructions.

“Human error is going to happen. And some of it we don’t know about,” said Diane M. Boyles, the lead fire dispatcher with North Net Fire Communications.

But dispatchers say that with the added stress can come incredible rewards.

Boyles recalled a call two years ago from a Fullerton woman who was suffering from a blood clot.

As Sharon Collins lapsed in and out of consciousness for several minutes during the call, Boyles stayed on the line to help her until paramedics arrived.

A year after the call, Collins thanked Boyles with a letter that the veteran dispatcher still keeps in her purse.

“I was so glad to wake up and hear you were still talking to me,” Collins wrote. “You were the first member of a team that brought me through a very tough experience.”

“When you get those thank-yous . . . you think, ‘Wow! I made a difference in someone’s life. I saved it,’ ” Boyles said.