providers, including EMS ground and air medical services, heavy rescue services, trauma centers, and others. The committee believes evaluations should be conducted to determine whether emergency dispatchers should transmit that information selectively to local emergency providers to enable more efficient allocation of regional assets, or crash scene data should be integrated directly into EMS and hospital ED data systems.

Nonemergency Calls

The 9-1-1 emergency number is familiar to most Americans and is recognized as being highly responsive (NENA, 2001). Because the number is so widely recognized and remembered, however, it is often used in situations that are not true emergencies, such as property crimes no longer in progress, minor vehicle crashes resulting in no injuries, and some situations involving animal control. Use of the 9-1-1 system for questions or concerns that are nonemergent in nature may produce delays in the response provided for true emergencies, which can place victims in danger.

Because of increasing reports of inappropriate 9-1-1 use, some communities have established alternative phone lines for citizens with non-emergency concerns. In some cases, the phone lines devoted to less urgent calls are regular 7-digit telephone numbers. However, these numbers are more difficult for citizens to remember or to access easily. As a result, some communities have established 3-digit numbers—often 3-1-1—that can be used in nonemergency situations. Operators receiving such calls are able to make triage decisions and if necessary refer a call to a 9-1-1 call center; they can also refer calls to other appropriate government agencies. The hope is that this system will improve the processing of both emergency and nonemergency calls.

Because callers cannot always discern which number is most appropriate to call, 9-1-1 call takers and EMS dispatchers may need to exercise the option of transferring callers to a 3-1-1 system, a nonemergency transport service, or a local nurse advice line if they determine that the caller’s problem does not require immediate EMS attention. This strategy may help keep the 9-1-1 system open and preserve ambulance capacity for serious or life-threatening calls. However, evaluations are needed to assess the feasibility, impact, and risks of this approach.


Once a PSAP has been notified that help is needed, the dispatcher can summon an array of equipment and personnel to respond: a fire or rescue vehicle bringing first responders (Key et al., 2003), an ambulance carrying EMTs or paramedics, or an air ambulance bringing additional EMS per-

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