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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 RS3 on Tuesday January 05 2021, @10:27PM (2 children)

    by RS3 (6367) on Tuesday January 05 2021, @10:27PM (#1095270)

    The oxygen "generators" (in spite of their name, they don't generate, they separate) come in several output flow ranges, and from what I've seen (spending huge time in hospitals with my dying parents), the standard ones that plug into standard wall outlet power can't quite produce enough oxygen for the highest requirement patients.

    That said, if you're out of O2, or don't have enough and need to ration it, you could use some from the wall O2 outlet they have in hospitals (or a tank), and add the oxygen "generator" output to get the needed flow.

    I'm not sure of the purity, but the medical requirements are, and the specs say, they're in the 90-95% range, so it's pretty good.

    IIRC, the bigger (and much noisier) units make 10 LPM. That's liters per minute for all of you outside of the US who would be in disbelief that the US uses metric units (when we feel like it! :) There are smaller units that do like 3 LPM, and 5 LPM.

    To put it all in perspective, if you've ever seen someone carting around an oxygen tank, say 0.6 M x 10 CM diameter, at 10 LPM that tank will empty in well under an hour. More like minutes.

    The larger green tanks you may see being used for welding, for example, are typically 80 cubic foot capacity, so roughly 2,300 liters. So at 10 LPM, you'd have ~3.8 hours of oxygen. So you can see it can be a lot of oxygen and tank carting, and the critically ill patients need more than 10 LPM.

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  • (Score: 3, Informative) by RS3 on Wednesday January 06 2021, @12:38AM (1 child)

    by RS3 (6367) on Wednesday January 06 2021, @12:38AM (#1095370)

    Correction: "generator" should say "concentrator", as in oxygen concentrator, which is a good description of what they do, and here's more for nerds like me: https://en.wikipedia.org/wiki/Oxygen_concentrator [wikipedia.org]

    • (Score: 0) by Anonymous Coward on Thursday January 07 2021, @12:21PM

      by Anonymous Coward on Thursday January 07 2021, @12:21PM (#1096420)

      Oooh - thanks for the correction and the link.