‘You don’t think? But you can check’: Do emergency callers really express uncertainty when they say ‘I (don’t) think’?

Abstract

This paper focuses on the epistemic phrase ‘I (don’t) think’ when used by lay persons describing a medical emergency to call-takers triaging ambulance dispatch. Using conversation analysis, we analysed a collection of 100 cases of callers saying ‘I think’ or ‘I don’t think’ in emergency calls for cardiac arrest in Australia. Callers do not typically express uncertainty when they say ‘I (don’t) think’, but rather, use ‘I (don’t) think’ as an epistemic stance marker introducing their own perspective and indexing low epistemic status. However, call-takers often orient to ‘I (don’t) think’ as signalling uncertainty (about accuracy of patient assessment) and subsequently request verification. These requests can create unnecessary delays, as we show that callers who said ‘I (don’t) think’ rarely changed their initial assessment. We describe how these findings can be translated into practical recommendations for call-taker training, so as to improve emergency medical dispatch for time-critical situations.