The green light bulb glows over Kari Dawson’s desk, signaling she’s ready to take a call.
Dawson is a new addition to the Las Vegas Fire Department communications center, but her role is different from the rest of the call-takers whose voices fill the room.
“Las Vegas Fire and Rescue, this is Kari, I’m a registered nurse,” she says into her headset, pausing to listen to the man on the other end of the line. “I’m going to ask you some questions to make sure we get you the right kind of help.”
Dawson is one of eight registered nurses staffing the new nurse call line in Las Vegas, where some of the less severe medical calls are being sent. The pilot program kicked off last month.
A software program walks the nurse on duty through a protocol with a caller, prompting new questions based on the sick or injured person’s answers.
Dawson’s other two computer screens show the status of all the active 911 calls at the center, and the ride-sharing service Lyft’s website.
In cases in which patients need medical care but not necessarily an ambulance, the nurses can order a 21st-century alternative — a Lyft to pick the patients up and take them to a hospital or an urgent care facility.
Many of the people whose calls are sent to the nurse call line don’t have a primary care physician and might not be aware of the other options available in less acute medical situations, aside from taking an ambulance to the hospital, Dawson said.
The program means ambulances can be used less in cases where they’re not needed, Las Vegas Fire Department Assistant Fire Chief Sarah McCrea said.
The nurse will urge the patient to seek care immediately, in four hours, 12 hours, one to three days or at home.
“We use our knowledge of how to treat these things in the ER,” said Dawson, who also works as a pediatric emergency room nurse at Sunrise Hospital and Medical Center. “I can’t see what it looks like. If you walk into the ER, I can tell that’s definitely broken, it looks broken, it’s not broken. You have to rely on what they’re telling you.”
Hoping for a year
One nurse is on duty from 9 a.m. to 6 p.m. daily. The number of calls sent to the nurse line vary, but Dawson estimates they get an average of five or six a day.
There’s $300,000 in the Las Vegas Fire Department’s regular budget to operate the pilot program, including training and pay for the nurses, who work one day a week, McCrea said.
The program is expected to run for about a year, or until that money dries up. During that time, department officials will evaluate data to determine whether it’s meeting the goals — curbing unnecessary ambulance dispatches and hospital trips, McCrea said.
It would take Las Vegas City Council approval to make the program and its staffing permanent.
The communications center is increasingly busy, taking roughly 600,000 calls per year. About 400,000 of those are medical calls, characterized in declining order of severity as echo, delta, charlie, bravo, alpha and omega. The alphas and omegas are the calls that can be transferred to the nurse call line, McCrea said.
Certain thresholds are in place: Callers complaining of chest pain won’t be sent to the nurse call line. Callers with minor injuries might not be sent over if they have potentially more serious risk factors. And if the caller insists on an ambulance or is uncomfortable with a Lyft, the nurse on duty won’t try to deter them from an ambulance, Dawson said.
The nurses take calls only within the city of Las Vegas jurisdiction now. But because the program is new, some of the kinks are still being worked out. A Clark County call slips through to Dawson’s line. In the meantime, an ambulance was dispatched to the man.
“This is a labor of love right now,” McCrea said.
Checking in with callers
The nurses make follow-up calls the next day for anyone they don’t send an ambulance to. During a follow-up call on Tuesday, Dawson asked the patient if he had gotten any medical attention the day before, after he called 911.
He hadn’t yet, but said he planned to later that day. Dawson put another alert in the system, so the nurse working the next day would call to see if he sought medical care.
The software program also creates patient records, so if someone calls a second time, their medical information and last call record can be accessed.
The Regional Emergency Medical Services Authority in Washoe County allows residents to call its nurse health line directly. Las Vegas Fire Department Chief Willie McDonald envisions giving Las Vegas residents a direct line they can call to speak to a nurse in the future, if the call line here becomes permanent, he said.
“I think it’s a really innovative service, that’s also a better use of resources,” McDonald said.