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Communication and Diagnostic Work in Medical Emergency Calls in Italy

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Abstract

This study analyses a series of emergency calls related to the same event: an accident in a factory. The aim of the analysis is to show how a lack of information hinders operator’s diagnostic work. The paper shows the effects of communication problems on operator’s decision making, that is, how the operator’s diagnostic work is actively resisted by callers, and therefore, how disaligment in relation to the activity at hand influences operator’s decision making and the actual organisation of the rescue activities. I argue that CSCW technologies need to enable negotiation of potentially conflicting social practices and organizational protocols around diagnostic work and should not just support remote collaboration between professionals, but also with the public.

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Notes

  1. Basic Life Support (BLS) is a specific level of prehospital medical care provided by trained responders, including emergency medical technicians, in the absence of advanced medical care. http://en.wikipedia.org/wiki/Basic_life_support

    In this case, the expression seems used to indicate reanimations manoeuvres.

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Acknowledgments

I would like to thank all the personnel in the 118 control room in Trento for their cooperation during the data collection, Maria Grazia Delaiti, who let me use her brilliant set of recorded data. I thank also Giolo Fele and Monika Buscher for their comments on the first draft of this paper and the very useful comments of the anonymous reviewers.

Author information

Authors and Affiliations

  1. Social Research and Intervention Centre, NGO, CP 131, 06100, Perugia, Italy

    Isabella Paoletti

Authors
  1. Isabella Paoletti
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Corresponding author

Correspondence to Isabella Paoletti.

Additional information

For the Communication Science Department, University of Bologna, Italy

Appendix 1

Appendix 1

List of the calls concerning the accident in the factory

Below the list of conversations though which the event was managed, with the indication of the caller, and the main topic of conversation. Notice that the great majority are telephone calls in and out the center of coordination, there are also a few radio communication and a couple of recording of operators ‘comments over the event.

11:38:36: call

Caller1 from the factory

Asks for an ambulance

11:39:02 call

Operator1 to ambulance station

Dispatches the ambulance

11:40:17 call

Caller1 from the factory

Asks for an ambulance

11:40:31 call

Factory porter office

Asks for an ambulance

11:44:43 call

Operator1 to the factory porter

Asks for information

Radio

Ambulance driver (no recording)

Communicates code 4

11:49:56 call

Operator1 to the fire brigade

Asks their intervention to remove a machinery

11:51:09 call

The ambulance station

Communicate code 4

Ansa

Asks for information

10 11:51:09 call

Ambulance driver

Asks for a doctor to certify the death

Operator1 to GP

No answer

11:49:57 call

Operator1 local police station

Asks for their intervention

via radio

Operator to ambulance

Informs that she is dispatching the helicopter

11.52.03 call

Operator1 to the helicopter station

Dispatches the helicopter

11:53:00 call

Operator1 to ambulance station

Ask the cellular number of the ambulances

11:54:08 call

Fire brigade

Asks for information

11:54:41

Comments among the two operators

One asks the other to dispatch the helicopter

12:04:43

Journalist of a local newspaper

Asks information

via radio

Doctor of the helicopter team

Communicates the code 4

12:09:51 call

Operator 2 to necroscopy doctor

Asks information on the procedures

12;13:41 call

Ansa

Asks for information

12:16:45

Comments among operators

“The patient was breathing a minute ago”

12:30:45 call

Doctor of the helicopter team

Protests to be sent to rescue a dead person

12:36:00 call

Operator2 to ambulance station

Asks for clarification

12:55:55 call

Operator1 to ambulance station

Comment on the decision to send the helicopter

13:53:48 call

Doctor of the helicopter team

Protests and request of explanation

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Paoletti, I. Communication and Diagnostic Work in Medical Emergency Calls in Italy. Comput Supported Coop Work 18, 229–250 (2009). https://doi.org/10.1007/s10606-009-9091-1

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