PSAP Medical Protocol Coaching

Overview#

A child has swallowed a battery. The panicked parent on the line has never faced this before. The AI dispatcher hasn't either, but the Medical Protocol Coaching module has: it activates the appropriate SOP, walks step-by-step through the correct intervention sequence, and keeps the caller focused. If the child stops responding and needs CPR, the system transitions protocols mid-session without missing a beat.

The Medical Protocol Coaching module provides a structured state machine that guides emergency callers through verified medical procedures step by step during PSAP voice AI calls. When the AI identifies a medical emergency, it activates the appropriate Standard Operating Procedure and advances through each step based on caller confirmation, ensuring life-saving instructions are delivered in the correct order. The state machine enforces critical step completion, supports mid-protocol transitions, and generates dispatcher briefings summarising protocol progress for human responders.

Key Features#

Step-by-Step Protocol Execution: Each medical SOP is decomposed into ordered steps with explicit instructions, confirmation requirements, criticality flags, and cadence activation triggers. The AI presents one step at a time and waits for the caller to confirm completion before advancing to the next step.
Critical Step Enforcement: Steps marked as critical cannot be skipped. If the caller attempts to move past a critical step without confirmation, the AI repeats the instruction and explains why the step must be completed before proceeding.
Protocol Transitions: The state machine supports mid-protocol transitions when the patient's condition changes. For example, if a patient being treated for choking becomes unconscious, the system transitions from the choking SOP to the adult CPR SOP, preserving the session context and continuing without interruption.
CPR Cadence Activation: Steps that require chest compressions carry an activates_cadence flag. When the state machine reaches such a step, it signals the CPR Cadence Engine to begin delivering audible compression timing to the caller.
Dispatcher Briefing Generation: At any point during protocol execution, the system generates a structured dispatcher briefing from a template, summarising the active protocol, steps completed, steps remaining, and the patient's reported condition. This briefing is included when the call is transferred to a human dispatcher or shared with responding agencies.
Session State Tracking: The protocol state machine tracks current step index, step history, caller-confirmed steps, cadence activation status, and elapsed time. This state is persisted on the voice AI session and included in call transfer contexts.
34 Standard Operating Procedures: The SOP library contains 34 verified procedures across 9 categories: medical (CPR, choking, bleeding, overdose, burns), fire (structure fire), hazmat, crime (active shooter), traffic, mental health (suicide threat), weather, utilities, and maritime (person overboard). Each SOP includes trigger keywords, pre-instructions, ordered steps, cadence mode, dispatcher briefing templates, and escalation triggers.

Use Cases#

Cardiac Arrest Coaching: Guide a bystander through adult CPR, checking responsiveness, calling for help, positioning hands, beginning compressions with cadence timing, delivering rescue breaths, and continuing until responders arrive.
Choking Emergency: Walk a caller through the Heimlich maneuver with step-by-step instructions, transitioning to CPR if the patient becomes unconscious.
Severe Bleeding Management: Coach the caller through direct pressure application, tourniquet use, and shock prevention while monitoring for signs of deterioration.
Active Shooter Response: Provide structured guidance for run-hide-fight protocols with step-by-step instructions adapted to the caller's situation.
Dispatcher Handoff: When a human dispatcher takes over, they receive a structured briefing showing exactly which protocol steps have been completed and what remains, enabling seamless continuity of care.

Integration#

The Medical Protocol Coaching module connects to the SOP Library for procedure definitions, the CPR Cadence Engine for compression timing, the call summary service for protocol progress inclusion in summaries, and the incident continuity service for transfer context packaging. Protocol state is exposed to the voice AI through function tools that the AI model calls to start coaching, advance steps, and activate cadence.

Open Standards#

ILCOR/AHA/ERC Resuscitation Guidelines: The CPR coaching steps (100-120 compressions per minute, 30:2 compression-to-breath ratio, full chest recoil) implement the current International Liaison Committee on Resuscitation consensus guidelines as adopted by the American Heart Association and European Resuscitation Council.
PHECC Clinical Practice Guidelines (CPGs): Each EMS protocol card is tagged with a PHECC CPG identifier (e.g., PHECC_CPG_CARDIAC_ARREST, PHECC_CPG_PAEDIATRIC) aligning pre-arrival instruction content to the Pre-Hospital Emergency Care Council's published Clinical Practice Guidelines for Ireland.
APCO/NENA Medical Priority Dispatch System (MPDS) determinant structure: The protocol engine's severity scale (alpha through echo determinant codes) is structurally parallel to the MPDS/AMPDS dispatcher priority determinant taxonomy, and the dispatch copilot maps chief complaints to AMPDS protocol numbers.
NENA-STA-010.3 Emergency Incident Data Object (EIDO): Protocol state and dispatcher briefings generated at handoff are pushed to CAD-connected systems via the NENA EIDO connector, encoding incident type, narrative, and priority in the standardised EIDO JSON schema.
IETF RFC 5031 / RFC 6443 (Service URNs): Emergency call routing uses urn:service:sos.ambulance and related URN vocabulary to identify the service type, which determines which SOP category is activated at call ingestion.
NENA-STA-012 / IETF RFC 7852 (Additional Data Related to an Emergency Call): Protocol progress, completed steps, and patient condition are included in RFC 7852 Additional Data blocks attached to the call, enabling seamless handoff briefings to human dispatchers and responding agencies.
EN 17128:2020 (Advanced Mobile Location): The PSAP layer receives AML location data from the caller's handset, which feeds into protocol selection for location-sensitive procedures such as maritime and mountain rescue.

Last Reviewed: 2026-04-02 Last Updated: 2026-04-14