CASE REPORT GUIDE
DEFINING CASE REPORTS
CASE REPORTS TELL STORIES
Case reports describe and interpret emergency calls, and you can think of them as accurate, detailed stories about the remote management of emergencies. Like stories, they describe a sequence of events related to human beings. Like fables, their value often comes from teaching readers learning points or lessons. And since they are basically narratives, case reports tend to be more accessible than other forms of research, which can be hard to understand for those outside the “ivory tower.” But unlike stories you might tell around a fire, case reports function as part of the evidence hierarchy in the growing science of emergency dispatching.
The Edwin Smith Papyrus, an ancient Egyptian manuscript dating back to around 1600 BC, contains what some consider to be the first medical case reports
WHY WRITE CASE REPORTS?
THEY’RE THE FIRST LINE OF EVIDENCE
Case reports are sometimes called the “first line of evidence” because they can give rise to new problems or questions in the field, which are then investigated in a more systematic way by others.
THEY’RE POWERFUL EDUCATIONAL TOOLS
Aside from being this “first line of evidence,” case reports share important insights about handling difficult or unusual emergency situations. In this way, writing a case report won’t only be for your benefit. It will be for the benefit of emergency dispatch professionals and the many communities they serve. Like a megaphone, a published case report amplifies your voice so that your message reaches a broad circle of people.
You can use the “case report megaphone” to share insights you’ve learned on the job. And by sharing what you’ve learned, you can improve the way others do the hard work of dispatching.
We recommend reading some of our published case reports to gain a feel for their style and structure. Here are a few interesting ones to check out:
HOW DO I START?
If you want early feedback, feel free to submit an idea or proposal for a case report rather than a completed draft. Just select your manuscript type to be ‘Case Report’ and communicate your idea in your uploaded manuscript file.
HOW TO WRITE AND PUBLISH A CASE REPORT
During school, you probably heard about the scientific method. If you haven’t, it’s only a name for a series of steps that describe a process for investigating the natural world. The method can vary from discipline to discipline, but usually it involves making an observation, formulating and testing a hypothesis, drawing conclusions, and communicating the results.
Think of these steps as a less demanding version of the scientific method. For this project, you won’t need to produce a testable hypothesis or design a study. However, like with most other research, you should start with observation, a word that can mean both the act of noticing or the more rigorous idea of recording data.
IDENTIFY AN INTERESTING CALL
What is meant by interesting here? From our experience, interesting calls tend to be the ones that strike readers as being either challenging or unusual.
Below is a list of examples that can be said to fall into one or both categories:
|Call Situation||Challenges||Unusual Features|
|A first-party caller diagnoses himself as suffering from Morgellons disease, a controversial disorder.||Selecting a protocol for unusual symptoms, handling a caller diagnosis.||Patient describes fibers protruding from skin.|
|A second-party caller gives an incomplete description of a patient’s fall, which results in the call being given a too-high priority.||Handling a caller who doesn’t know answers to protocol questions.|
|A second-party caller reports that his friend was bitten by his pet sting ray.||Exotic pet causes injury.|
|A second-party caller reports her newborn daughter’s vomit is green.||Patient’s vomit is bilious (green).|
|A first-party caller reports with a calm voice that he is having chest pain with no other symptoms. The dispatcher senses that something is off.||Accounting for intangibles or dispatcher’s gut feeling.||Patient has rare symptom presentation for aortic dissection.|
On the one hand, if you describe a challenging call, then your readers can benefit from the learning points or lessons learned from managing the situation. Did the dispatcher handle the call flawlessly? Or were there significant errors in management? In either case, readers can learn a lot from careful examination of good or bad decisions made.
Unusual calls, on the other hand, can be thought of as tests of a protocol system. Just as in software testing, where a user executes a program with the intent of discovering problems, a case report might examine a unique case to test whether a dispatch system is reliable. Therefore, a result saying the system passes increases faith in that system. Meanwhile a negative result, where for instance a protocol system does not adequately address a unique symptom presentation, can lead to a Proposal for Change Request and an enduring impact on the practice of emergency dispatch.
GATHER THE DATA
Data is only another word for information. A very useful piece of information to gather is an audio recording of the emergency call. Having this information allows you to review the call as many times as you need. Then while reviewing, you can make additional observations as you figure out what conclusions to draw. And as you do all this, it’s guaranteed that a faulty memory is not contributing any significant errors.
However, deep diving into your memory is an acceptable option if you don’t have access to a recording—just not a preferred one. After all, it’s not like your case report needs to depict every moment during the call. Your report only needs to present the most relevant moments, which are determined by what main ideas (usually learning points) you want to communicate to readers. If you can’t get access to an audio recording, then you should at least take a few minutes and write up the call to the best of your memory. By doing this, you will have something to work with before writing your report.
Primary data can be:
- An audio recording of an emergency call
- A written account of the call done from memory or notes (if you don’t have access to a recording)
Secondary data can be:
- External sources that better inform you about a topic
- References that you present as evidence inside your case report
WRITE DOWN YOUR LEARNING POINTS
In high school, your English teacher probably taught you to begin your essays by writing down your thesis statement. Similarly, with a case report, it makes sense to begin with your most important ideas, which will be your learning points—these are lessons to be learned from a careful review of your call. Most likely, these lessons will be the most important conclusions you’ll draw when writing your case report. For this reason, writing down learning points should be the starting point of your analysis.
Your learning points will make composing the rest of your case report an easier process, too. Once you better understand these lessons to be learned, for instance, you can determine what details to focus when you report the key moments of a call. More specifically, if your learning points all concern, say, how a dispatcher should react to a caller giving certain obvious death descriptors (terms a caller uses that suggest an obvious death), then you should describe call intervals when those terms emerged. The other parts of the call, like when the dispatcher and caller are waiting for the ambulance to arrive, won’t be as necessary to present to the reader.
Learning Points from "An Unorthodox Delivery"
Be prepared to think laterally…and draw on your own experiences when empathizing with the caller;
We should never think we have heard it all before, in this business there will always be a call that will surprise us.
WRITE A DRAFT
At the start, it might seem difficult to take your ideas and translate them into a clear and coherent whole, but once you know what the components of a case report are and understand their functions, writing a draft becomes a lot easier.
The Introduction is the first of three sections of your case report. This section gives background information and explains or justifies the selection of the case. In other words, a good Introduction section orientsthe reader and establishes that the case is worth reading.
For a dispatch case report, you might consider orienting the reader through first describing the call center where the dispatcher handled the challenging or unusual call. This description can answer questions—assuming they are relevant—about the center such as:
- Where is it located?
- Which communities are served?
- What protocol system is used (if any)?
- What is the background of the call taker?
The answers to these questions establish a setting and give readers a sense of the dispatch center’s organization.
You should, however, make sure your background information serves a clear purpose. For instance, you don’t want to include every bit of information you know about a dispatch center—that’s a certainly going to irritate your readership. Therefore, it’s important to write down your learning points or main ideas before writing the Introduction. That way, you can know which details are going to be relevant, which is the information that supports, illustrates, or explains your most important ideas.
Additionally, you can’t assume somebody will want to read your work merely because it exists. For this reason, at some point in the Introduction you should also communicate why the case is worth reading about.
What does it mean to orient the reader?
Well, in any piece of writing, there is a gap between what the reader knows and what the writer knows. What is familiar to you is not necessarily going to be familiar to a stranger. To help close this divide, authors generally include background information to make the topic or situation more familiar to their audiences.
MANAGEMENT AND OUTCOME
The Management and Outcome comes after the Introduction. This section presents the case in chronological order, describing what is most relevant using specific language that avoids personal judgements or opinions.
You should consider this section of the case report as your “data.” A simple way to present your “data” is to write it up in the form of a transcript, a written version of an audio call that captures what was said verbatim. A transcript has an evidentiary quality—this is a fancy way of saying it resembles courtroom evidence—that can lend your writing an extra bit of authority.
When writing this section, don’t think you need to write up everything that transpired during the call. Just focus on the parts of the call you want to discuss, which should be the moments most relevant to your learning points or main ideas.
The Discussion is the last section of your case report. This section does not present any new information about the case and answers the question: What has been learned from a careful review of events?
Additionally, this section can–but doesn’t necessarily–compare your case with other literature on the topic and propose solutions to a problem that has been discovered.
Readers generally will find a case meaningful if it teaches them a lesson, or at least assists them to make sense of difficult situations. Therefore, during this part of the report, you can think of yourself as a teacher, someone whose purpose is to instruct professionals on how to properly handle a very challenging call. For instance, if the case reveals a mistake committed during a call’s management, such as in “Second-Party Caller Information for a Falls Case,” it becomes the role of the writer to teach how to avoid making similar errors. Or, if the case reveals an emergency dispatcher’s exemplary conduct, like with “An Unorthodox Delivery: ‘I’ve Never Done One of These Before,’” then the Discussion section should explain to readers how the emergency dispatcher achieved that high level of professionalism. And here is a piece of advice: Any learning points you give will be more effective if you support them with details, which you can take from your case’s description.
DO A SELF-ASSESSMENT OR (OPTIONALLY) ASK FOR FEEDBACK
If your first draft isn’t perfect, don’t worry too much. First drafts are rarely beyond revision. That’s why writing is often described as a process, and not as something instantaneous, because it can take many drafts or iterations to get things right.
To help improve your drafts, you can use our case report self-assessment form (see below). You can also ask someone else for feedback if you are comfortable sharing early drafts of your writing with others.
When you are ready, you can submit your case report to us. Don’t feel intimidated to share your case reports – we are willing to work with you to get your writing published.
CASE REPORT SELF-ASSESSMENT
Once you complete a draft of your case report, you can perform a self-assessment to hone your work and ensure it meets your goals. Click the button below to access a form to guide you through the assessment.