For most people living in Maine, their understanding of the Emergency Medical Services System is that when a call is placed to 911, help arrives a short time later. In some respects this is a good sign, because it illustrates that many people who live and work in Maine will never use an ambulance – although each year there are more than 250,000 calls to which EMS responds. However, what happens behind the scene when a call is made is the activation of an impressive and coordinated system of care that is known and understood by the providers.

The first and, perhaps most important, step in the EMS system is you, the person who sees or experiences an emergency and calls 911. Within the health care system, there are many steps involved in providing care, and each of these steps takes time. On a regular basis, hospitals and EMS services review these steps and make adjustments to reduce unnecessary delays. Ambulance services do the same thing by modifying their staffing structure and even ambulance locations. These changes can be life-saving, but only if the 911 call is placed in a timely manner.

It is well known, and frequently observed, that many people who are exhibiting the signs and symptoms of a heart attack, stroke or other emergency, hesitate to call 911. Part of the hesitation is likely due to our inherent independence and reluctance to involve others with our problems or to enter into the unknown realm of EMS.

So what happens when a 911 call is placed in Maine? The EMS system is activated, and care begins immediately – literally, with the person that answers the 911 call. Effective Jan. 1, 2007, all people who answer 911 calls are required to be certified emergency medical dispatchers. EMDs are trained to ask specific questions that help alert the responding EMS crews about the nature of the emergency, identify what additional resources may be needed, and provide instructions on how to begin treatment for specific emergencies, such as heart attacks.

In some communities, there will be EMS providers who respond before the ambulance arrives. The information that is collected and the care that is provided have been developed by experienced physicians who know what it is like to work in an emergency setting. The care that begins at the scene of an emergency is carefully designed and coordinated to work smoothly with the local hospital, and in cases where advanced care is needed, to work with other hospitals and specialists.

How this all happens is not a secret, it is by design. Incorporated into that design are partners in health care who are committed to providing high quality care to all patients. These are providers who understand the complexities and importance of timely treatment for ill and injured patients, and who work together in a system that may be transparent to patients and their families.

Maine’s EMS system is often used as a shining example of collaboration and cooperation because it is one of health care partners at all levels working together and constantly challenging themselves to do better.

However, this system cannot be activated until that all-important, potentially life-saving call is made – by you. Critical communication and coordination of care, which are needed to save lives and physical functioning, are delayed and sometimes lost forever if you drive yourself or a loved one to the hospital instead of calling 911 and activating EMS.

February is American Health Month, and we can all accomplish a great deal by knowing the signs and symptoms of a heart attack, which include: chest pain or discomfort, sweating, feeling week, lightheaded or faint, shortness of breath, pain or discomfort in the arms or shoulders, pain or discomfort in the jaw, neck, or back chest, and-or difficulty breathing.

At the first sign of a heart attack, pick up the phone and call 911. Regardless of the time or day – make the call, activate the system, and begin the care.

Jay Bradshaw is director of Maine Emergency Medical Services, Department of Public Safety, and a member of the In a Heartbeat executive committee. He can be reached at Jay.bradshaw@maine.gov