COVID-19 Town Hall: Urban EMS Considerations in the COVID-19 Era

September 8, 2021

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  • As emergency care of the COVID-19 patient matured, death rates fell in spite of an increase in overall cases.  This underscores the importance of continually building upon lessons learned.
  • The idea that PPE usage is effective if used properly and consistently is supported by the ongoing data. Therefore, many EMS systems have begun to relax restrictions on “aerosol generating procedures” as long as clinicians don and doff their PPE appropriately.
  • Urban EMS services cannot be expected to know, let alone follow, dozens of different “protocols” for facility entry during this pandemic.  Coordination, at a system level, of EMS resources and response is essential.
  • While the overwhelming “tsunami” of anticipated EMS calls thankfully did not materialize, the preparatory steps—including treat-in-place protocols, alternative destination sites, and dispatch screening and triage modifications—should be examined for implementation in a post-COVID world in the context of quality medical oversight and increased CMS flexibilities for payment. 


NAEMSP President David K. Tan, MD, EMT-T, FAAEM, FAEMS


  • Marianne Gausche-Hill, FACEP, FFAP, FAEMS. Dr. Gausche-Hill is the Medical Director for Los Angeles County Emergency Medical Services (EMS) Agency, Professor of Clinical Emergency Medicine and Pediatrics at the David Geffen School of Medicine at UCLA and serves as Clinical Faculty at Harbor-UCLA Medical Center in Torrance, CA. The LA County EMS Agency receives over 700,000 911 calls a year, has over 70 receiving centers with multiple specialty centers including stroke, STEMI, Trauma, and pediatric. She is nationally and internationally known for her work as an EMS researcher and educator, and for her leadership in the field of EMS and pediatric emergency medicine. She is best known for her study of pre-hospital airway management for children published in JAMA 2000 and her work on the National Pediatric Readiness Project published in JAMA- Pediatrics in 2015. She has won numerous national awards for her leadership in emergency medicine, pediatric emergency medicine and EMS. Dr. Gausche-Hill currently serves as a senior editor for the textbook, Rosen’s Emergency Medicine: Concepts and Clinical Practice, and serves on the American Board of Emergency Medicine Board of Directors.
  • Drew Harrell, MD, FAEMS, Dr. Harrell is an Associate Professor of Emergency Medicine and EMS in the Division of EMS, Disaster, and Austere Medicine, Department of Emergency Medicine at the University of New Mexico School of Medicine. He is board-certified in both Emergency Medicine and Emergency Medical Services practice and has been a practicing EMS physician in New Mexico for over 10 years. He started in EMS in 1991 when he first took a Wilderness EMT class and, in a prior career, worked as both a nationally registered paramedic and wildland firefighter throughout the western US. He currently provides EMS Physician field response and medical direction through the UNM EMS Medical Direction Consortium program in Albuquerque for the multiple EMS partner agencies of the EMS Consortium. Drew currently serves as the operational EMS Medical Director for the following agencies: Grand Canyon National Park Emergency Services, Bernalillo County Sheriff’s Department,  the New Mexico State Police and State Search and Rescue, and the Albuquerque Police Dept. Special Operations Division TEMS team. Additionally, he provides operational TEMS medical support as a Reserve Deputy with the Bernalillo County Sheriff’s Department Special Weapons and Tactics Team and is also the educational program Medical Director for the US Air Force Pararescue paramedic training program through the UNM EMS Academy. His areas of interest include pre-hospital EMS practice and education, tactical and austere medical care, and EMS medical direction.
  • Lekshmi Kumar, MD, MPG, Dr. Kumar completed ER residency at Mayo Clinic Rochester MN, EMS fellowship at Emory and MPH at Rollins school of Public Health. She was an ER attending at Emory University Hospital and has been medical director for both ambulance and fire based systems for the past eight years. She is currently Medical Director for Grady EMS that is a hospital-based EMS system, a component of Grady Health System and provides 911 services to the City of Atlanta in addition to 16 counties across Georgia with an approximate annual call volume of 130,000 within the City of Atlanta.
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