In attempting to gain an answer to the question, “Is the patient awake (conscious)?” the emergency medical despatcher first asked “Is Yusuf awake?” When Yusuf’s mother replied “no”, the EMD went on to ask “Is he conscious?”

This seems a confusing way of approaching this very important question. If a person is asleep, then one cannot know if they are conscious without waking them. If the answer to the question “Is he awake?” is “no”, then the most obvious follow up to that would appear to be, “Can you wake him?”

Yusuf’s mother was by now panicking and erroneously replied “yes” to the question of whether Yusuf was conscious, though she had not tried to wake him. The EMD assumed that Yusuf was asleep but rousable, which in fact is unlikely to have been the case.

There were other difficulties with the call, such as the EMD’s failure to recognise that a description of scratches all over might actually refer to a rash, missing the description of pupils no longer visible, and not thinking about the possibility of meningitis. These have, I was told at inquest, been addressed by training, but I remain concerned that such a method of attempting to elicit whether the patient is conscious or unconscious might be used by other EMDs.