08/16/08 153 W - + 7 - 9 Hot Line for Chest Pain: A Dangerous Idea?

Found this in yesterday's Star-Tribune1, about a University of Minnesota Medical Center chest pain hot line. Not sure if you should call 911? Call the hot line and talk to a nurse. They're there 24/7. Launched on July 1, the concept is questioned by experts. Will it cause delays in treatment, diluting the "hard-won public health message" to dial 911 in such situations? Is it just a marketing tool? There are also a couple dozen reader comments at the above link. Is this a window into the future of emergency response? A sort of consultative, pre-response? Can't imagine this hasn't been tried before.

1Read the physical edition, no less, while enduring the cacophonous din of diners at a restaurant in Bloomington, MN. Nothing like a Saturday morning trip to Perkins to stimulate the senses. For added effect, be seated beside the restroom door.

It’s been tried. Kaiser did something like this when they were big in NC. I have heard of it in other places as well. I think it is an attempt to rein in costs associated with ED visits. Not even counting the masses without insurance these days, those that do may call their doctor, and they get the standard “Call 9-1-1”.

Nothing like the days of my youth when we called the doctor, got the answering service, waited for him to call back, and then tried any manner of treatment regimens (many OTC) before going to the ED.

I would think you are going to see more of this. I think the insurance companies are open to tryiung anything to keep costs down (and profits up).

Kind of reminds me of a program that the Dallas (TX) FD tried during the 80s with ‘nurse screeners’. Ask former Nurse Screener Billye Myrick how that all worked out.
DJ (Email) - 08/16/08 - 12:21

Although not a “hotline for Chest Pain,” here in Mecklenburg County MEDIC is now using something called an Omega level response which basically means they transfer a call to a Nurse Practitioner who goes through a series of questions based on the callers chief complaints. Apparently this process can take up to 10 minutes and is aimed at cutting down the number of “non-emergent” EMS calls that are responded to by local agencies. From my (limited) understanding of this, it is basically used for those people who are calling with complaints that would qualify as an Alpha (non-emergency) or below response (being the Omega level). At any point during the questioning, if the caller complains of specific “ALS” type complaints (Chest Pain, Difficulty Breathing, etc) the call is then handled by MEDIC and appropriate resources are dispatched.

Not sure how well this has been working out as it is still a new concept to us in Charlotte and I’ve only heard a few calls cancelled because they became an “Omega level” call. Although we did cancel a call the other day just to get the call again from MEDIC advising that they call had now been upgraded due to the patient complaining of Diff Breathing. One thing I do know is that we’ve been instructed not to interfere with the caller while they are on the phone with the Nurse Practitioner, we must cancel our response.

Interesting concept here for us, I’m still skeptical….
Luke - 08/16/08 - 20:09

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