OnStar discusses how they are equipped to save lives
Paul Stiegler, OnStar's medical director, spent more than three decades as a top-rated ER physician
By Jamie LaReau
Detroit Free Press
DETROIT — On any given day, OnStar advisers must be ready to call a tow truck or provide turn-by-turn directions. Or save a life or deliver a baby.
Take two years ago. Bryan Anta, 33, answered an OnStar emergency call from a man rushing his pregnant wife to the hospital when the baby started coming.
Anta had the father fully recline the front seat and coached him through delivering a son. That was the easy part.
Next, came tying off the umbilical cord. That's crucial; otherwise blood could drain too quickly into either the baby or the mother, causing serious complications. The emergency protocol suggests use a string or a shoelace.
"The father didn't have either," Ante recalled.
As Ante's adrenaline raged, he mentally climbed in that car and looked around. He had an epiphany: "Almost every one has a cellphone charger, so he can use that cord to tie off the umbilical cord."
When it worked, said Anta, "Everyone on the (OnStar) floor cheered."
Handling medical emergencies
Anta, who will be on duty this busy holiday travel week, credits the success of that day to OnStar's staff doctor's training.
That's right, OnStar has its own staff doctor. Paul Stiegler, 66, spent more than three decades as a top-rated emergency room physician. For the past eight years, he has been OnStar's medical director. In that role, he likes to say he has a potential patient base in the millions.
"I'm responsible for anything done medically to a patient" through OnStar, said Stiegler. "There are protocols for everything you tell a patient, from taking an aspirin" to administrating cardiopulmonary resuscitation to delivering babies.
OnStar is General Motors' in-vehicle driver's assistance program that offers subscribers such services as automatic crash response, stolen vehicle help, remote door unlock, navigation, vehicle diagnostics and hands-free calling. It also handles an array of medical emergencies.
In the United States and Canada, for which Stiegler is responsible, OnStar has about 5.5 million subscribers. Subscribers pay $24.99 a month or $240.90 a year for the OnStar Safety and Security plan that includes emergency services.
Last year, OnStar emergency advisers handled about 115,000 calls in the U.S. and Canada, an OnStar spokeswoman said. On average, they help deliver at least two babies a year, Stiegler said.
"We know how to do more types of deliveries than most paramedics in the field would know, such as delivering a breach baby," said Stiegler.
All it takes is a subscriber pushing the red emergency OnStar button in their car. That's when Stiegler's training kicks in and a dispatcher has scripts to help a person through a wide array of medical crises.
Finding Dr. Right
Cathy Bishop, OnStar's emergency services senior manager, hired Stiegler in 2010.
"I was running a 911 center and I had run an emergency medical dispatch program there. When I came to OnStar, I realized we needed to implement something similar," Bishop said. "It was necessary to find an accredited physician to oversee the program because we’d be interacting with some 6,000 emergency centers across the U.S. and Canada."
Prior to hiring Stiegler, advisers did not give callers at the scene any pre-hospital arrival medical instructions.
"It gives you a whole different sense of being able to handle an emergency when you know you can do something," said Bishop.
Dr. Jeff Clawson developed the series of key questions, pre-arrival instructions and dispatch priorities used in the calls. Clawson, the medical director for the Salt Lake City Fire Department, recommended Stiegler for the OnStar job, said Bishop.
"Doing emergency medical dispatch from a private service is unheard of, so it was very critical that we do it right and achieve the highest quality possible in providing this service," Bishop said.
Saving a life
In 2013, OnStar became the first nonemergency service, private company to be recognized by International Academies of Emergency Dispatch as a Medical Accredited Center of Excellence.
Stiegler has 35 years' experience as an emergency room physician. He leans on that knowledge to train OnStar's emergency advisers on everything from talking someone through birth to saving someone who's choking. It's crucial training because what's done in the minutes before an ambulance arrive, can often be the difference between life and death, he said.
"We had a driver call whose passenger had a sudden cardiac arrest," Stiegler said. "We gave him instructions on how to place his hands on the chest and the rate to do compressions and we kept encouraging him" to keep the person alive until the ambulance arrived to take over.
OnStar follows established protocol from the International Academies of Emergency Dispatch in the medical instructions to gives. Beyond that, Stiegler's job is to make sure the nearly 110 OnStar emergency advisers in the U.S. and Canada know what to do if a patient's condition suddenly goes off script.
"How do you navigate that change?" Stiegler said. "That's what we work on every week. If someone is awake, it's predictable they could go unconscious, and what do you do then? It's not that they don't know what to do, it's learning how to navigate the protocol itself."
Effective role playing
Each month, Stiegler, who lives in Madison, Wisconsin, drives his 2013 Chevrolet Equinox SUV to a nearby park. There, he hits the red OnStar button and acts out various emergency medical scenarios with the dispatchers for training.
"They run through the script with me and I critique them," Stiegler said.
Some times his acting is so realistic, park visitors rap on his window, asking whether he needs help.
"I have to say, 'No, thank you, I'm training. It's fake,' " Stiegler said with a chuckle.
He also reviews the 12-15 OnStar emergency life-critical calls each week from the two OnStar call centers in U.S. and Canada: One is in Charlotte, North Carolina, and the other is in Oshawa, Ontario. He evaluates the advisers' performances, offering tips to improve.
The training helps OnStar's advisers to handle the unexpected.
One honk for yes
Take the summer of 2014. Anta was working his afternoon shift at OnStar's call center in Oshawa when he got a crisis call.
"Somebody was gasping for air and we couldn't tell what was going on other than someone was in urgent distress," said Anta.
Anta was able to figure out the caller, a woman, was in the midst of a severe asthma attack. Now, Anta had to figure out how to communicate with her, given she was unable to speak.
"We had to think outside the box, so I ended up communicating through her horn," said Anta. "I got her to honk once for yes, twice for no. So when I asked her if she saw the fire department coming, she honked once. We could then remotely unlock her doors so the responders could get to her."
Similarly, when Anta had a caller pass out midway through another emergency call, Anta envisioned himself at the scene, he said. He knew the vehicle was in a large parking lot among dozens of cars, potentially making it hard for the ambulance driver to spot it quickly. So Anta remotely set off the car alarm to draw the driver's attention to the car with the unconscious driver.
While Stiegler did not train Anta to specifically make some of the decisions he has made, the doctor did teach Anta and other advisers to mentally put themselves at the scene to creatively solve problems.
"When we get a call, we're transporting ourselves into the vehicle," said Anta. "We try to think of what the member is experiencing in the vehicle."
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