In June 2025, the York County 911 Center, York, PA, received a call from the wife of a 75-year-old male, described as not feeling well and having just fallen off the toilet. Upon initial Case Entry questioning by the Emergency Medical Dispatcher (EMD), the patient was described as “awake” and “breathing.” Within a few seconds of these responses, the caller rechecked the patient and changed her response to “He was a minute ago” (regarding consciousness), then, after a brief pause, said, “He’s unconscious at the moment.” Seconds later, when rechecking breathing at the EMD’s prompting, the caller stated, “I can’t tell, he’s on his stomach.”

This case not only demonstrates the effectiveness of a structured dispatch protocol— in this case, the MPDS—for managing difficult situations where DD-CPR is necessary, but it also demonstrates the dynamic nature of patients described by 911 (and other emergency line) callers as fallen for an unknown reason and deteriorating in real time,
in front of the 911 caller. By following the MPDS Protocol sequence—methodically obtaining a complete problem description from the 911 caller and confirming age, awake or not awake, and breathing or not breathing—the patient’s arrest was identified rapidly by the EMD, a correct emergency medical response was sent, and DD-CPR instructions were started promptly.

REFERENCES

1. Wei, Jeng*; Tung, David; Sue, Sung-How; Wu, Shing-Van; Chuang, Yi-Cheng; Chang, Chung-Yi. Cardiopulmonary Resuscitation in Prone Position: A Simplified Method for Outpatients. Journal of the Chinese Medical Association 69(5):p 202-206, May 2006. | DOI:10.1016/S1726-4901(09)70219-9
2. Gomes, D. and Bersot, C. (2012) Cardiopulmonary Resuscitation in the Prone Position. Open Journal of Anesthesiology, 2, 199-201. doi: 10.4236/ojanes.2012.25045.
3. Jacobsen, R. C., Beaver, B., Olola, C., Briggs, A. M., Scott, G., Patterson, B. A., Clawson, J. J. (2022). Prone Dispatch-Directed CPR in Out-of-Hospital Cardiac Arrest: Two Successful Cases. Prehospital Emergency Care, 27(2), 192–195. https://doi.org/10.1080/10903127.2022.2058130
4. Salcido, D. D., Stephenson, A. M., Condle, J. P., Callaway, C. W., & Menegazzi, J. J. (2010). Incidence of Rearrest After Return of Spontaneous Circulation in Out-of-Hospital Cardiac Arrest. Prehospital Emergency Care, 14(4), 413–418. https://doi.org/10.3109/10903127.2010.497902