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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: 0) by Anonymous Coward on Tuesday January 05 2021, @10:14PM (4 children)

    by Anonymous Coward on Tuesday January 05 2021, @10:14PM (#1095262)

    "Any EMT will tell you that mouth to mouth and heart pumping almost never works out out. Despite how it's portrayed on TV shows, It's nothing more than an show for friends and family so they can feel better about doing something."

    Painfully wrong. It keeps oxygenating the blood to give the patient time until they can defib, intubate, whatever. It is a stop gap measure, and yes sadly most people still die because CPR isn't magic.

    "Any doctor will also tell you that if you end up on ventilator, you're going to die."

    Sweaty balls on a camel you are nuts. Oh look, survival rate in the 70% range for COVID.

    So far, Venderbilt has been able to keep COVID-19 patients on ventilators in existing ICUs with experienced intensive care teams, Rice says. And the mortality rate "is in the id-to-high 20%..."

    https://www.npr.org/sections/health-shots/2020/05/15/856768020/new-evidence-suggests-covid-19-patients-on-ventilators-usually-survive [npr.org]

    Maybe we should repeal 230 even with the dystopian information censorship it will create. Then we can prosecute people like yourself that spread dangerous misinformation, or at least shut down any unapproved platforms. Wheee dystopia, the only way to deal with the evil, stupid, or evilly stupid people like yourself that won't do the most basic fact checking.

  • (Score: 2, Informative) by Anonymous Coward on Tuesday January 05 2021, @11:06PM (2 children)

    by Anonymous Coward on Tuesday January 05 2021, @11:06PM (#1095318)

    “The majority of patients and non-medical personnel have very unrealistic expectations about the success of CPR as well as the quality of life after patients are revived,”
    https://fr.reuters.com/article/us-health-cpr-expectations/cpr-survival-rates-are-lower-than-most-people-think-idUSKCN1G72SW [reuters.com]

    CPR survival rates are less than 10% for out of hospital events, less than 20% for in-hospital events. And survival doesn't even begin to touch on the long term neurological damage. In some cases "survival" is barely better than death.
    https://www.medscape.com/answers/1344081-122892/what-are-the-survival-rates-for-patients-with-cardiac-arrest-treated-with-cardiopulmonary-resuscitation-cpr [medscape.com]

    Covid-19 patients on ventilators usually survive? Survive what? Getting off ventiatlors? Or recovering and leaving hospital? That's some good cherry picking going on there. Everything is true if you conveniently ignore ugly truths.

    Survival rates of ventilation were studied at 66.6% which sounds pretty good. Until you read deeper. That's just the survival to "getting off the ventilator". Then it drops to 61.1% leaving ICU alive (after being taken off a ventilator), down to 49.1% leaving the hospital alive and finally only %30 1 year after leaving the hospital. So sure, odds are pretty good you'll survive the ventilator. Pretty much 2/3 good. Pop your champagne and have a toast. Unless you flip the coin wrong and die before leaving the hospital, or take the Vegas odds on surviving the first year after. The bottom line is mechanical ventilation f*cks you up and most likely will kill you. If not immediately, not too much longer later due to complications.
    https://pubmed.ncbi.nlm.nih.gov/8404197 [nih.gov]

    I would dig up some equally disturbing covid-19 ventilator stats, but to be honest there's a million media stories and research papers about covid-19 ventilator "facts" out there that all claim to be telling the truth and vary wildly different proportions. Pick your bias.

    • (Score: 0) by Anonymous Coward on Tuesday January 05 2021, @11:12PM (1 child)

      by Anonymous Coward on Tuesday January 05 2021, @11:12PM (#1095320)

      Nice links and data.

      Care to show it to the author of:

      Finally! They've publicly recolonized just how pointless some medical interventions can be. Any EMT will tell you that mouth to mouth and heart pumping almost never works out out. Despite how it's portrayed on TV shows, It's nothing more than an show for friends and family so they can feel better about doing something. Any doctor will also tell you that if you end up on ventilator, you're going to die. There's saving lives and then there's just theater to pretend we're saving lives. As a society we need to try harder to recognize the difference and make better use of the time we have.

      ??? Pretty please?

      • (Score: 0) by Anonymous Coward on Wednesday January 06 2021, @05:17AM

        by Anonymous Coward on Wednesday January 06 2021, @05:17AM (#1095492)

        omg, haha. I am the author

  • (Score: 5, Interesting) by Tork on Wednesday January 06 2021, @01:31AM

    by Tork (3914) Subscriber Badge on Wednesday January 06 2021, @01:31AM (#1095391)

    Painfully wrong. It keeps oxygenating the blood to give the patient time until they can defib, intubate, whatever. It is a stop gap measure, and yes sadly most people still die because CPR isn't magic.

    Correct.

    But even if you weren't I wanted to mention that when you take a CPR class what they emphasize most, even above the actual breathing and compressions, is that you summon help, get those EMTs en route to you right away. By the time you've started CPR you've already kicked things into motion that have a huge say in the survival of the person you're assisting. The reason for this is when someone falls ill it's typical for an American to pretend not to notice or just play dumb. When someone shouts "Help this person!" that's when they'll leap to action.. and that's precisely what CPR courses teach you to do... take charge cos nothing will happen until someone does. EMT arrival time is a much larger factor in the victims' survival than say skill at giving compressions.

    The expectation of a miracle really isn't all that unrealistic when framed in a practical context. The real problem here is yet another anonymous dipshit thinking the accuracy of their data source has any relation at all to the validity of whatever agenda they're trying to push. It's like railing against gun control saying "You actually can't die from a bullet in your body!" because sometimes when treating a gunshot wound they don't actually remove it.

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