ER Visit During COVID? How Not to Freak Out
A leading EMS physician explains how ambulance crews are prioritizing care to keep everyone safe.
Folks living with chronic illness are prepared for just about anything when it comes to their health. You never know when an unexpected flare or odd symptoms may send you to the hospital on the quick. But right now, with reports of hospitals around the country being overcrowded with COVID-19 patients, it can be scary to think about what might happen if you need to call 911.
How can you be sure you’ll get the care you need, and that you won’t contract COVID in the process? We spoke to David K. Tan, M.D., president of the National Association of Emergency Medical Services (EMS) Physicians, about what emergency medical technicians (EMTs)—the first faces you see when you call an ambulance—are doing to ensure every patient is prioritized. He helped shed some light on the current state of emergency healthcare and what to expect from an ambulance ride (if for some reason you need one).
HealthCentral: What should people expect from an ambulance ride to the emergency room right now, if they need one for a non-COVID flare-up?
David Tan, M.D.: To speak broadly, people should rest assured that ambulance services and the physician medical directors who drive the decisions on who to transport and who not to transport are still committed to getting patients the care they need. That includes transporting them to the hospital.
But in places like Los Angeles, New York, and Chicago, the local health systems might be overburdened with an onslaught of patients right now. So if a patient is worried about having COVID, yet they don’t meet in-patient criteria—meaning they don’t have trouble breathing, their oxygen levels are good, and their vital signs are good— in locations where the hospitals are truly overrun, some medical directorsmay suggest that the patient not be transported.
But the protocols are never just: “Don’t transport the patient.” Instead, it’s: “Mr. Jones, we will be happy to transport you to the hospital. However, we don’t think you really need it because your vital signs are pretty good … Here’s what we’ll do: We will call you in exactly 24 hours and check in on you to make sure you’re OK. If you are feeling worse or don’t feel like you can wait to see your doctor, we will come back a second time and take you to the hospital. Or if even before 24 hours, you do develop trouble breathing, call 911 again. We’ll come back and take you immediately to the hospital.”
HC: What precautions are being taken by EMTs and other medical staff to keep non-COVID patients safe from exposure?
DT: Ambulances are being disinfected to a much higher degree than prior. Ambulances are always disinfected between patients anyway, even before COVID, but especially if a patient has signs or symptoms concerning COVID-19. This might include the use of special disinfecting wipes or special ultraviolet lights in combination with other cleaning solutions. The disinfecting process typically takes about 30 minutes, to include opening the doors of the ambulances, airing it out, and using the disinfectant wipes to wipe down every surface.
On top of that, the personnel themselves use gloves, gowns, eye protection, N95 masks, and they will typically put a mask on the patient to prevent any droplets or aerosols from contaminating the rest of the stretcher or the ambulance.
HC: Should people with chronic conditions worry about hospitals being overcrowded with COVID patients?
DT: There are certainly hospitals that have a higher caseload of COVID patients than others, by nature of where they may be and what kind of patients they treat. Having said that, hospitals, like ambulances, do everything they can to minimize the spread of COVID by having separate wards and even separate ICUs for patients with known or suspected COVID-19.
I would be lying to you if I said it was impossible to contract COVID [or any infection] from being at the hospital. It’s a problem that has existed since hospitals existed. But hospitals do everything possible to avoid cross-contamination and spreading that infection to those who don’t already have the disease.
HC: How can someone be sure they will get the care they need in a crowded and chaotic emergency room?
DT: From my bias as the president of the National Association of EMS Physicians—we represent the physician medical directors behind every EMT and paramedic—we repeat our commitment to providing excellent patient care and working with our colleagues in the ambulance to provide excellent patient care.The take-home message is that patients can rest assured that they won’t be abandoned, and if they need medical care, they will get it. There may certainly be anecdotal reports of horror stories, like there is in every profession, but by and large, especially given what has been happening the last year with COVID-19, there are a multitude of stories of EMS providers and clinicians going above and beyond to work extra shifts and make sure the call for help is answered 24/7.