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LA Paramedics Told Not To Transport Some Patients With Low Chance Of Survival:
The Los Angeles County Emergency Medical Services Agency issued a directive Monday that ambulance crews should only administer bottled oxygen to patients whose oxygen saturation levels fall below 90%.
In a separate memo from the county's EMS Agency, paramedic crews have been told not to transfer patients who experience cardiac arrest unless spontaneous circulation can be restored on the scene.
Both measures announced Monday, which were issued by the agency's medical director, Dr. Marianne Gausche-Hill, were taken in an attempt to get ahead of an expected surge to come following the winter holidays.
Many hospitals in the region "have reached a point of crisis and are having to make very tough decisions about patient care," Dr. Christina Ghaly, the LA County director of health services said at a briefing Monday.
[...] "We do not believe that we are yet seeing the cases that stemmed from the Christmas holiday," Ghaly added. "This, sadly, and the cases from the recent New Year's holiday, is still before us, and hospitals across the region are doing everything they can to prepare."
Los Angeles County hospitals are so inundated, officials said they're just trying to provide the best care they can for the people who need it.
The memo sent out on December 28 by the medical director of L.A. County's Emergency Medical Services agency, Dr. Marianne Gausche-Hill, addressed how first responders should treat stroke and heart attack patients, saying a patient should be treated at the scene first and have a pulse during resuscitation before transporting them to the hospital.
[...] The medical director of L.A. County's Emergency Services Agency, Dr. Marianne Gausche-Hill, assured CBS2 that officials continue to do all they can to save patients' lives at the scene and the hospital, as they always have.
"We are not abandoning resuscitation," Gausche-Hill said. "We are absolutely doing best practice resuscitation and that is do it in the field, do it right away... What we're asking is that — which is slightly different than before — is that we are emphasizing the fact that transporting these patients arrested leads to very poor outcomes.
(Score: 5, Insightful) by fadrian on Tuesday January 05 2021, @08:36PM (2 children)
Can someone explain to me why, after flattening the curve and buying time for *ten months*, nobody thought to use that time to expand hospitals, hire more hospital staff, mass-manufacture ventilators and oxygen tanks, and have 10x the capacity they'd need in the worst case?
Because in This Capitalist Society (TM), with its JIT mindset, excess inventory counts against you.
That is all.
(Score: 2) by RS3 on Tuesday January 05 2021, @09:02PM
You left out the excess of MBAs. :-} Half kidding.
To be fair, many things deteriorate in storage, often due to improper storage, including incompetence of the people in charge of the storage. I'm partially thinking about the hundreds (thousands?) of ventilators the govt. had stockpiled. When they were brought out last spring, many (most?) didn't work.
O2 tanks should last effectively forever in a warehouse. Maybe a bit dangerous to keep, but it's possible to store them safely when someone cares to.
And it's pretty easy to generate, concentrate, or centrifugally separate oxygen. But as you point out, existing generation infrastructure is likely running at near non-pandemic JIT capacity.
(Score: 2, Informative) by Anonymous Coward on Tuesday January 05 2021, @09:05PM
Right, because that's precisely how LA County runs things.
Total dedication to JIT management and ultra-lean processes at every step of government and quasi-government organisations.
Thanks, I needed that laugh.