PSAP Medical Protocol Coaching

Overview#

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 (SOP) and advances through each step based on caller confirmation, ensuring that life-saving instructions are delivered in the correct order without the AI inventing or improvising medical advice.

The state machine enforces critical step completion, supports mid-protocol transitions (such as switching from choking to CPR when a patient becomes unconscious), 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 seamlessly.

• 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: check responsiveness, call for help, position hands, begin compressions with cadence timing, deliver rescue breaths, and continue 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.

Last Reviewed: 2026-04-02