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Los Angeles EMS workers told they shouldn’t transport those with ‘little chance of survival’

EMS workers in Los Angeles County are overwhelmed with calls for assistance. They have now been reportedly told not to transport patients with “little chance of survival” to local hospitals as intensive care units are overwhelmed with COVID patients. That includes those whose hearts and breathing have stopped and who can’t be resuscitated by paramedics. In some instances, patients are waiting more than six hours to get into a hospital for care.

The directive is from the Los Angeles County Emergency Medical Services Agency. It also mandates that ambulance workers “conserve the use of oxygen.”

“Effective immediately, due to the severe impact of the Covid-19 pandemic on EMS and 9-1-1 Receiving Hospitals, adult patients (18 years of age or older) in blunt traumatic and nontraumatic out-of-hospital cardiac arrest (OHCA) shall not be transported [if]return of spontaneous circulation (ROSC) is not achieved in the field,” the agency said in a memo issued to ambulance workers last week.

“Given the acute need to conserve oxygen, effective immediately, EMS should only administer supplemental oxygen to patients with oxygen saturation below 90%,” EMS said in a memo to ambulance crews Monday.

In Los Angeles, many intensive care units are at capacity as a purported wave of the virus surges across Southern California.

According to data provided by the county, more than 6,000 patients are currently being treated for coronavirus in Los Angeles. Available hospital beds at most ICUs are virtually nonexistent.

Los Angeles County Director of Public Health Barbara Ferrer is claiming that a person is dying of the virus every 15 minutes.

Because of all this, EMS workers were told to “perform resuscitation for at least 20 minutes” if a patient’s heart has stopped instead of taking them to a hospital. “If there are no signs of breathing or a pulse, EMS will continue to perform resuscitation for at least 20 minutes,” the memo said. If the patient is stabilized after the period of resuscitation, they would then be taken to a hospital. If the patient is declared dead at the scene or no pulse can be restored, paramedics will no longer transport the body to the hospital.

In addition, California Gov. Gavin Newsom on Monday formed a task force to “evaluate and upgrade outdated oxygen delivery systems” at six Los Angeles area hospitals.

A 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. The memo said a patient should be treated at the scene first and have a pulse during resuscitation before transporting them to the hospital.

The memo went viral online and many people have questioned whether first responders would deny taking stroke and heart attack patients to the hospital because of the coronavirus surge.

Gausche-Hill told CBS Los Angeles 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. We knew that already and we just don’t want to impact our hospitals.”

Treating heart attack and stroke patients at the scene instead of on the way to the hospitals can increase chances of survival, Gausche-Hill said. Many wonder if that is the case, why hasn’t that been the policy all along.

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