If you live alone, have you ever wondered what to do if you feel a persistent discomfort late at night or in the evening, and you need to call 911? Sometimes, all it takes is one of your loved ones to make you seriously wonder.

Néomédia asked the Coopérative des techniciens ambulanciers de la Montérégie (CETAM) and the Sûreté du Québec to find out what happens in these cases. 

When it's easier

It's customary to ask the 911 caller if he or she can get the paramedics in. 

Of course, if the person doesn't live alone, the problem isn't the same, because someone will certainly be able to answer and open the door for the paramedics. We're talking here about patients who live alone.

It's not that simple

At CETAM, we spoke to HR communications and marketing coordinator Patrick Jasmin, who outlined a few situations and what paramedics can do.

At the Sûreté du Québec, we spoke to Communications Sergeant Valérie Beauchamp, herself a former paramedic.

According to Ms. Beauchamp, the first thing to consider is the classification made by the 911 operator. Various codes are used, from 0 to 7-8, she explains, 0 being the code for imminent danger. Operators are used to asking the right questions to sort things out. 

But situations can certainly evolve rapidly, and people become increasingly at risk.

Basic rules 

CETAM's Mr. Jasmin explains a few basics about breaking down doors:

"It is against the law to enter a residence if it is impossible to access, even if we are emergency responders. Under the Criminal Code, this could constitute breaking and entering.

So, without the patient's verbal authorization, we must contact the police to force access.

The following four situations allow us to contact the police in a forced access situation:

- We can't see the person;

- We can see the person, but access is impossible;

- Verbal contact is made, but access is impossible;

- Verbal contact is made, but the patient is uncooperative and access is impossible. 

Finally, says Mr. Jasmin, if we have a visual on the patient whose life is clearly threatened, we can force access, but the police will be dispatched without delay".

According to Ms. Beauchamp of the SQ, firefighters or police officers (depending on the city or municipality) often act as first responders, so in some cases, the police may arrive before or at the same time as the paramedics.

Apartment buildings

Neomedia question: if a caller doesn't answer the main bell in an apartment block, what do you do? Do you ring all available apartments until the door is opened? If no one opens, do you have to call the police to force the door open?

CETAM's answer: "In practice, common sense and the nature of the call guide actions in the moment. For example, we ask the dispatch center to contact the caller to see what's going on and whether the person can open the door. If there's no answer, we'll try ringing other tenants. We may try to find a janitor who has the keys. If a neighbor tells us that relatives are available, we can try to contact them for help. If we can't get into the building, we can call the police for help".

According to Ms. Beauchamp of the SQ, it's important to remember that "the rule of imminent danger" prevails at all times. If anyone has reasonable cause to fear for a person's life, an apartment door can be forced open, taking care to cause as little damage as possible," she adds. The SQ will then have to secure the premises, by calling in a locksmith for example. 

Private residence

Neomedia's question: if the caller from a private residence is unable to unlock the door because he or she may be unconscious or unable to move about, what do you do? Do you check available windows to see if there's someone in a bad way? If you see that someone is unwell in this way, can you force the door open?

"Common sense and the nature of the call will guide the choices (a person unable to open for us is often in communication with the dispatch center), but without waiting we'll call the police in a more urgent situation.

"If the call is non-urgent according to the information we've received, and we manage to communicate with the patient, we'll try to find alternative access: a cleared or open window, for example. In the case of a patient on whom we have a visual and whose life is clearly threatened, we could force access, but the police will already be on their way because we will have requested their assistance," adds the CETAM representative.

As both CETAM and SQ representatives explain, there are an extremely wide range of possibilities. In the event of imminent danger, ambulance personnel can force open the door without delay, having called the SQ. 

If a person's strength is failing, it may be a good idea to unlock the door before the paramedics arrive. if they can, or to ask a close relative to come to their home. But the human tendency is often to minimize danger, which isn't always the right solution.

The ideal can't always be achieved; and there will always be cases where help arrives too late; and it won't always be possible to determine whether callers could have been saved, had the paramedics intervened a few minutes earlier.