Katie Hall
Austin American-Statesman
AUSTIN-TRAVIS COUNTY, Texas — For two years, Austin-Travis County EMS had been discussing ways to best direct people who call 911.
Not everyone who calls 911 needs to go to the hospital immediately. In some cases, a caller might not even need an ambulance. Austin-Travis County EMS leaders had been thinking of putting a trial system in place, through which medical professionals could advise callers about their best course of action.
Then a deadly and highly contagious virus swept through the world, and suddenly, having such a system was crucial.
The COVID Clinical Consultation Line is what emerged as EMS leaders decided how people in Travis County and the medics who serve them could best navigate the new normal the virus created.
“We put very experienced clinicians in the call center, so that when the 911 call came in . . . we would discuss with those patients what their symptoms were,” Division Chief Ed Piker said. “It gave us the opportunity to triage these patients over the phone and determine what the appropriate navigation for that patient would be.”
People who call 911 are sent to the hotline when they have symptoms consistent with COVID-19, the illness caused by the coronavirus. Dispatchers first send an ambulance out, then talk with callers to determine whether the medics need to go inside. If so, then they decide what level of personal protective equipment medics need to wear. Dispatchers and medics then can determine together whether the caller needs to go to the hospital.
Sometimes the patient’s issue is as simple as a necessary prescription refill or can be addressed through telemedicine, officials said. In other cases, the issue can be better addressed by a different county agency, such as Integral Care, or by a physician’s assistant who has their own response unit.
The goal is to prevent the illness’ spread from patient to health care worker whenever possible, Piker said.
“It alleviates what could be a substantial burden on the healthcare system, especially at a time when something like an infectious agent is running around the community,” he said. “It truly does help the health care system and citizens as a whole by not moving infectious people around the city unnecessarily.”
Cmdr. Neda LaFuente, one of several people who takes the hotline calls, stressed that those operating the hot line are quick to send a team whenever someone might be at risk.
“If I’m suspicious at all of a patient being in an emergency situation, I do not hesitate to have a paramedic come to that patient’s side,” LaFuente said.
Hotline dispatchers not only ask about symptoms, they also ask callers about their age, their health conditions, whether they live with others and whether they are able to care for themselves.
Piker said several agencies outside Austin have inquired about their process and are interested in implementing it.
“We’ve had other cities that are concerned about the same thing, as they see an uptick in the number of calls in their jurisdictions,” Piker said. “Government agencies have reached out from the East Coast to the West Coast — other states, cities, as well as places in the state of Texas — and asked what we’re doing and for copies of our protocols.”
The hotline has so far received 4,600 calls. Of those, 450 of them were classified as “COVID alerts” — people who have symptoms consistent with COVID-19 and need to go to the hospital.
The line is staffed by field medics, like LaFuente. She was an Austin-Travis County field commander, who supervised a district of ambulances and crews, before she was asked to join the consultation line.
“I knew that when the pandemic began, my job might change a little bit,” she said. “I was kind of ready for something to happen.”
LaFuente said the job has given her a deeper respect for emergency dispatchers, who have to assess as much as they can about a patient without being able to see them or take their vitals.
“There are so many times where I just want to say, ‘Hold on, I’ll be there in a second,’ ” she said. “That’s my instinct.”
LaFuente said she relays everything she learns to the medics and tells them exactly how much personal protective gear to wear before they go inside.
“Then, I have them go in and actually do an assessment and call me over speakerphone — over a secure channel,” she said. “And then we can discuss and we can collaborate together.”
Piker said these can also be ongoing conversations with a patient that take place over multiple calls.
“They can always call us back, and we can go back to their house in minutes to take care of them,” he said. “But the goal is just to appropriately navigate them.”
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