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posted by martyb on Tuesday January 05 2021, @07:53PM   Printer-friendly
from the so-it-has-come-to-this dept.

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."

'We Are Not Abandoning Resuscitation': LA County Healthcare Leader Speaks Out After Memo Raises Concerns:

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.


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  • (Score: 4, Informative) by HiThere on Tuesday January 05 2021, @09:18PM (2 children)

    by HiThere (866) Subscriber Badge on Tuesday January 05 2021, @09:18PM (#1095217) Journal

    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]

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  • (Score: 2) by RS3 on Tuesday January 05 2021, @10:05PM (1 child)

    by RS3 (6367) on Tuesday January 05 2021, @10:05PM (#1095253)

    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):

    many of these reports come from hospitals that were experiencing a major surge in patient volumes and were forced to use suboptimal equipment and staffing models that varied considerably from typical practice

    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

      by hendrikboom (1125) Subscriber Badge on Wednesday January 06 2021, @01:00PM (#1095595) Homepage Journal

      Perhaps because it took a while to discover that severe inflammation was causing even more problems.