Ambulance Crew Directive Reflects ‘Severity’ of LA Hospital Conditions

Ambulance Crew Directive Reflects ‘Severity’ of LA Hospital Conditions
After administering him with oxygen, Los Angeles County paramedics load a potential Covid-19 patient in an ambulance before transporting him to a hospital in Hawthorne, Calif., on Dec. 29, 2020. Photo by APU GOMES/AFP via Getty Images
Updated:

A directive to Los Angeles County emergency crews to avoid bringing adult patients into county hospitals who have little chance of resuscitation, or are proclaimed dead, reflects the seriousness of overstressed hospital conditions during the pandemic, says one expert.

Under the order, emergency medics are not to transport patients to hospitals if “reasonable efforts” to resuscitate have failed.

“That person could be declared dead in the field rather than being brought from the field in order to be reexamined by a physician and be declared dead at the hospital,” Aaron Kheriaty, director of medical ethics program at University of California—Irvine Health, told The Epoch Times.

“The directive itself is not something for the public to get alarmed about, but the directive is a sign of the severity of the situation in Los Angeles County that may be of concern to other patients who are brought to the hospital [and] encounter more delays in terms of evaluation and treatment than they otherwise would have under usual care-type circumstances.”

Decisions on resuscitations are usually made with calls to an administering hospital, so not much has changed for ambulance crews as the result of hospitals managing the surge of COVID-19 patients needing critical care, he said.

“This particular directive is really focused on the cases of individuals who are brought to the hospital as a kind of formality in ordinary circumstances so that the doctor can examine them and declare the patient dead,” Kheriaty said. “Maybe CPR would have continued at the hospital for a few more minutes depending on how long the transport took, but we know that the survivability in these circumstances is pretty vanishingly low.

“I don’t actually think this directive is going to result in any more people dying in the field than otherwise would have survived, but what it does suggest is that the patients who are a step up from that in a dire or less severe situation may arrive at the hospital to find that the hospital is very impacted and as a result of that, their care may be delayed longer than it otherwise would have been in ordinary circumstances, and that might lead to a worse outcome for those folks.”

The Los Angeles County Department of Public Health confirmed 258 new deaths and 11,841 new cases of COVID-19 on Jan. 6, the department stated in a press release. To date, public health identified 852,165 positive cases of COVID-19 across all areas of LA County and a total of 11,328 deaths.

“The rate of new cases this month is translating into a disastrous increase in the number of people with severe COVID-19 symptoms being sent to our local hospitals and, tragically, we are now seeing more than 200 deaths a day,” the health department said in a statement. “People who were otherwise leading healthy, productive lives are now passing away because of a chance encounter with the COVID-19 virus. This only ends when we each make the right decisions to protect each other.”

The public health department reports that there are 8,023 people with COVID-19 currently hospitalized, and 20 percent of these people are in the intensive care unit.

“On November 1, the three-day average number of people hospitalized with COVID-19 was 791. On January 4, the three-day average increased to 7,873. Hospitals are accepting more patients than they can discharge, and this is causing a huge strain on our emergency medical system,” it stated.