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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, Interesting) by RS3 on Tuesday January 05 2021, @08:53PM (6 children)
I've wondered the same thing. In fact, I simply wanted to help, in any way possible, and I can't find any job openings or volunteer openings or anything.
A local medical equipment company has been running an ad for an equipment tech. They do mostly ventilators- sell, rent, repair. I'm pretty sure I remember reading about critical shortages of ventilators, oh say last March, April, May, etc. Long story short- got phone interview, maybe July / August, and was rejected because "I'm overqualified". What? I even asked the guy- I thought ventilators were in shortage and great demand. No response. What? Was the news lying? Maybe, there were some shortages in a few places, but the news media blew it up as if it was nationwide? Maybe it was, but the situation got rectified quickly? Who know- the news rarely follows up on its own stories.
Last spring, not far from my area, a recently closed school was converted into a field hospital by the Army Core of Engineers. Huge effort and money spent. It was NEVER used (except by crickets).
A local hospital has an uptick in COVID patients. Most of their job openings require schooling, certs, experience (RNs, patient techs, etc.), but one position is basically a patient watcher. Yes, you just sit and watch the patient and call for help if they go nuts (not just COVID). They have a huge number of such openings. I called, and despite the huge need, they don't want to hire anyone on a temporary basis. "Too much investment in training." What??? "Open your eyes. Watch the patient. Press this button if there's a problem". Okay, you're trained now.
I'll drive vaccine delivery vans, whatever, but can't find any way to get in to help. I've asked doctors and other health care workers and officials I know and nobody knows anything. Not sure who to blame, but by now, we still don't have a plan? It's easy enough to blame the govt, and they certainly could do more. But I'm reminded of the Amish, and how they very quickly and cohesively come together to help each other and organize and move on whatever needs to be done. Why can't we do that? Maybe we need to start electing the Amish. Kidding, but I can't help but wonder if we could at least learn from their cooperative society.
(Score: 5, Insightful) by Grishnakh on Tuesday January 05 2021, @09:01PM (2 children)
Kidding, but I can't help but wonder if we could at least learn from their cooperative society
You don't need to look at religious nuts who refuse modern technology to see a good example of a cooperative society. You just need to look outside the US borders; Asian nations in particular are good at this. Western European nations also do a better job of this.
Basically, this is a cultural problem, and this pandemic has shown just how ill-equipped America's "fuck you, I got mine" society is to handle common threats like this. I don't see any way of fixing it before it collapses.
(Score: 0) by Anonymous Coward on Tuesday January 05 2021, @09:23PM
Oh Jeez, you're not better than Americans. Go take your "little brother" competition complex somewhere else.
(Score: 2, Interesting) by Anonymous Coward on Tuesday January 05 2021, @09:37PM
No need to mischaracterize the Amish that way. Visit some. Work with some. You'll find they have and use "modern technology". They shun being dependent on larger society- you know, the one you rightly railed against. If you got to know some you'll find they're not so "religious" as you think. They're just much better at being cohesive, like the Asians, Europeans, and many others. They get criticized for being too separatist, but I can't blame them.
America is, almost by definition and certainly its founding a collection of independent, sometimes fiercely so, people. Even our name illustrates it. When push comes to shove, we will cooperate. IMHO, the problem is too much BS happening. Why are there anti-maskers? Because there's so much general BS in the news media that nobody quite knows what to believe. Some believe masks work (I wear them), some think it's all lies. Find me a clean clear solid reliable news source. No question that the year leading up to election has greatly messed up everyone and everything in the news / media.
I think, hope at least, that most Americans will "do the right thing" when necessary.
(Score: 4, Informative) by HiThere on Tuesday January 05 2021, @09:18PM (2 children)
There was a huge shortage of ventilators. Then they found that most people that they put on a ventilator died there, so they started considering them REALLY last resort choices.
IIUC, there's still a shortage of ventilators, but funds are being used to buy other equipment that's less likely to result in dead patients. See e.g.: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0242651 [plos.org]
Javascript is what you use to allow unknown third parties to run software you have no idea about on your computer.
(Score: 2) by RS3 on Tuesday January 05 2021, @10:05PM (1 child)
Having some interest in and knowledge about medicine, I found those outcomes to make sense (sadly). IIUC, the ventilators were causing more lung tissue damage and exacerbating the whole deterioration process.
FYL (from your link):
Not sure what that means but it doesn't give me the warm fuzzies about our medical system.
Also, in UK they started using a steroid (dexamethasone) to treat COVID patients and had much better outcomes. Speculating, but AFAIK steroids are contraindicated in infectious diseases because they suppress the immune system. But in cases where severe inflammation is causing even more problems, they can be life-saving. Which makes sense to me, and when I heard of it I was surprised they didn't do that sooner.
BTW, thank you for that link. I'll read it in more detail.
(Score: 2) by hendrikboom on Wednesday January 06 2021, @01:00PM
Perhaps because it took a while to discover that severe inflammation was causing even more problems.