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Managing Medical Emergency Calls

HEDMAN, KARL LU (2016)
Abstract
This dissertation is a conversation analytic examination of recurrent practices of interaction in medical
emergency calls. The study expands the analytical focus in past research on emergency calls between
emergency call operators and callers to pre-hospital emergency care interaction on the phone between
nurses, physicians and callers. The investigation is based on ethnographic fieldwork in a Swedish emergency
control centre. The data used for the study consists primarily of audio recordings of medical emergency calls.

Fundamental procedures in medical emergency calls examined in the dissertation are: (1) questioning; (2)
emotion management; (3) risk management and (4) instruction giving. Emergency call-takers... (More)
This dissertation is a conversation analytic examination of recurrent practices of interaction in medical
emergency calls. The study expands the analytical focus in past research on emergency calls between
emergency call operators and callers to pre-hospital emergency care interaction on the phone between
nurses, physicians and callers. The investigation is based on ethnographic fieldwork in a Swedish emergency
control centre. The data used for the study consists primarily of audio recordings of medical emergency calls.

Fundamental procedures in medical emergency calls examined in the dissertation are: (1) questioning; (2)
emotion management; (3) risk management and (4) instruction giving. Emergency call-takers ask questions to
elicit descriptions by callers of what is happening and to manage symptoms of patients to help keep them safe
until ambulance crews arrive. In the questioning practice about acutely ill or injured patients call-takers use
mainly yes-no questions and clarify problems by questioning callers making a distinction between defined and
undefined problems. The analysis reveals four core types of emotion management practices: (1) call-takers
keep themselves calm when managing callers’ social displays of emotions; (2) promising ambulance
assistance; (3) providing problem solving presentations including emergency response measures to concerns
of callers, and (4) emphasising the positive to create hope for callers. Call-takers use seven key procedures to
manage risk in medical emergency calls: (1) risk listening through active listening after actual and possible
risks; (2) risk questioning; (3) risk identification; (4) risk monitoring; (5) risk assessment; (6) making decisions
about elicited risk and (7) risk reduction. Instruction giving using directives and recommendations is
accomplished by call-takers in four main ways: (1) acute flow maintaining instruction giving when callers are
procedurally out of line; (2) measure oriented instructions for patient care and emergency response
management; (3) organisational response instructions and (4) summarising instruction giving. Callers routinely
acknowledge risk identifications and follow instructions delivered by call-takers to examine statuses and life
signs of patients such as breathing, movement and pulse, and perform basic first aid and emergency response
measures.

The findings generated from this study will be useful in emergency call-taker training in carrying out interactive
procedures in medical emergency calls and add to the larger research programmes on on-telephone
interaction between professionals and citizen callers. This is an essential book for pre-hospital emergency care
providers and institutional interaction researchers and students. (Less)
Please use this url to cite or link to this publication:
author
supervisor
opponent
  • Professor Cromdal, Jakob, Linköping University
organization
publishing date
type
Thesis
publication status
published
subject
keywords
Conversation Analysis, emergency call operator, emotion management, instruction giving, medical emergency calls, nurse, physician, questioning, risk management, Swedish
pages
283 pages
defense location
Edens hörsal, Pardisgatan 5H, Lund
defense date
2016-06-03 10:00
ISBN
978-91-7623-690-1
language
English
LU publication?
yes
id
09f80deb-8249-44cd-a1e5-99dd1cd8fa71
date added to LUP
2016-05-19 13:23:27
date last changed
2016-09-19 08:45:20
@misc{09f80deb-8249-44cd-a1e5-99dd1cd8fa71,
  abstract     = {This dissertation is a conversation analytic examination of recurrent practices of interaction in medical<br>
emergency calls. The study expands the analytical focus in past research on emergency calls between<br>
emergency call operators and callers to pre-hospital emergency care interaction on the phone between<br>
nurses, physicians and callers. The investigation is based on ethnographic fieldwork in a Swedish emergency<br>
control centre. The data used for the study consists primarily of audio recordings of medical emergency calls.<br/><br/>Fundamental procedures in medical emergency calls examined in the dissertation are: (1) questioning; (2)<br>
emotion management; (3) risk management and (4) instruction giving. Emergency call-takers ask questions to<br>
elicit descriptions by callers of what is happening and to manage symptoms of patients to help keep them safe<br>
until ambulance crews arrive. In the questioning practice about acutely ill or injured patients call-takers use<br>
mainly yes-no questions and clarify problems by questioning callers making a distinction between defined and<br>
undefined problems. The analysis reveals four core types of emotion management practices: (1) call-takers<br>
keep themselves calm when managing callers’ social displays of emotions; (2) promising ambulance<br>
assistance; (3) providing problem solving presentations including emergency response measures to concerns<br>
of callers, and (4) emphasising the positive to create hope for callers. Call-takers use seven key procedures to<br>
manage risk in medical emergency calls: (1) risk listening through active listening after actual and possible<br>
risks; (2) risk questioning; (3) risk identification; (4) risk monitoring; (5) risk assessment; (6) making decisions<br>
about elicited risk and (7) risk reduction. Instruction giving using directives and recommendations is<br>
accomplished by call-takers in four main ways: (1) acute flow maintaining instruction giving when callers are<br>
procedurally out of line; (2) measure oriented instructions for patient care and emergency response<br>
management; (3) organisational response instructions and (4) summarising instruction giving. Callers routinely<br>
acknowledge risk identifications and follow instructions delivered by call-takers to examine statuses and life<br>
signs of patients such as breathing, movement and pulse, and perform basic first aid and emergency response<br>
measures.<br/><br/>The findings generated from this study will be useful in emergency call-taker training in carrying out interactive<br>
procedures in medical emergency calls and add to the larger research programmes on on-telephone<br>
interaction between professionals and citizen callers. This is an essential book for pre-hospital emergency care<br>
providers and institutional interaction researchers and students.},
  author       = {HEDMAN, KARL},
  isbn         = {978-91-7623-690-1},
  keyword      = {Conversation Analysis,emergency call operator,emotion management,instruction giving,medical emergency calls,nurse,physician,questioning,risk management,Swedish},
  language     = {eng},
  pages        = {283},
  title        = {Managing Medical Emergency Calls},
  year         = {2016},
}