Somebody has to call, and early

The commonest delay is nobody deciding it is serious enough.

Reviews of workplace incidents repeatedly find a gap between the event and the emergency call, and the cause is usually deliberation rather than confusion. People wait to be sure, wait for somebody senior, or wait to see whether the person improves.

The organisational fix is permission. Staff need to have been told explicitly that calling an ambulance is never a mistake, that nobody will be criticised for a call that turned out to be unnecessary, and that they do not need authorisation.

Naming a caller in the moment is the technique that works. Instructions to somebody in particular, by name or by pointing, get acted on; an instruction to the room does not, and this is one of the better documented effects in emergency response.

The same applies to fetching equipment. Send a named person for the defibrillator rather than announcing that somebody should get it, and tell them to come back either way.

Where a site has an internal emergency number, it must not become a delay. An arrangement where staff call internal security who then call the ambulance adds a link, and it should be tested to see what it actually costs in minutes.

There is a further reason early calls matter that has nothing to do with the patient's condition. Ambulance dispatch takes time, and the operator can give instructions over the phone that begin treatment before anybody arrives. A call placed early buys guidance as well as transport.