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LA: Ambulance crews to not transport patients with little chance of survival

latimes.com

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Re: LA: Ambulance crews to not transport patients with little chance of survival

#41

Post by songgao »

This might be an unpopular opinion but this is a pretty awful headline and it makes it look way worse than what the EMS documents actually say. There’s a bold text [1] “shall not be transported if return of spontaneous circulation is not achieved in the field”. There’s a pretty big difference between abandoning patients with little chance of survival in general, and giving up after failure to achieve ROSC.

Perhaps at some point we’ll be at the place where EMS really have to give up without even attempting CPR, but we’re not there yet.

That’s not saying the situation is not bad — it’s terrifyingly bad. But a headline designed to make incorrect impression just doesn’t help.

[1] https://twitter.com/Pervaizistan/status/1346295476405084168

EDIT: link, to focus on the right tweet. typo.

Re: LA: Ambulance crews to not transport patients with little chance of survival

#42

Post by warent »

andi999 wrote: post #26
harikb wrote: post #14

> Patients who are not to be transported to hospitals include those whose hearts have stopped and, despite efforts at resuscitation, have no signs of breathing, movement, a pulse or blood pressure and would be declared dead at the scene.

Wait, so normally such patients are transported? For what? Billing purposes?

I've been thru EMT training. It boils down to EMTs not having formal medical education necessary to make a call as significant as pronouncing someone deceased. It's a blanket rule, so even in extreme circumstances like if you find someone beheaded, you just log it as a severe injury and transport the body to the hospital where a doctor pronounces them dead.

Re: LA: Ambulance crews to not transport patients with little chance of survival

#43

Post by gizmo686 »

andi999 wrote: post #26
harikb wrote: post #14

> Patients who are not to be transported to hospitals include those whose hearts have stopped and, despite efforts at resuscitation, have no signs of breathing, movement, a pulse or blood pressure and would be declared dead at the scene.

Wait, so normally such patients are transported? For what? Billing purposes?

Way outside my expertise, but you still need to remove the corpse, and the ambulance is already there.

Plus, it is not really a good look for paramedics to be leaving a dead person.

Re: LA: Ambulance crews to not transport patients with little chance of survival

#44

Post by danaliv »

danhak wrote: post #12
crx07 wrote: post #4

Earlier quoted context omitted.

What are they supposed to do? Sometimes dealing with reality involves some pretty uncomfortable choices to make, even when that essentially makes you the bad guy. The real issue here is that the economy was prematurely reopened before it was safe -- we have far more than enough money as a nation to have prevented this scenario from happening and chose a path of destruction out of sheer avarice instead.

There are many factors at play, but in L.A. I don't believe premature reopening is one of them. Bars, indoor dining and gyms have been shut down for pretty much the whole pandemic. Outdoor dining was banned (again) about a month ago. My take is that L.A.'s issues have more to do with housing density, high number of people living with roommates and high number of multigenerational households. Also perhaps some some ch…

I just moved to LA from New York State in December, and it seems to me that the number one problem here is noncompliance. So many people are just out and about like nothing unusual is going on. People aren’t wearing masks, or they are but not covering their nose. The number of house parties I’ve seen in the past month is shocking—and no one at these events has worn a mask. Outdoor places like beaches and trails are packed with unmasked people, which by itself isn’t necessarily a hazard, but then they aren’t maintaining a safe distance.

I’m not saying NY was perfect; not by a long shot. But here it’s like people aren’t even trying.

Re: LA: Ambulance crews to not transport patients with little chance of survival

#45

Post by tdeck »

highmastdon wrote: post #18
baggy_trough wrote: post #6

https://www.quora.com/What-is-the-current-treatment-for-Covi...

This is great. Of the effectiveness is a as good in the long run, we don’t even need a vaccine since it’s no longer a high risk disease. It’ll be a flu like vaccination where elderly and at-risk people can be using it

Everyone who can get the flu shot should be getting it. It's free in the US and takes a couple of minutes. It's not just for elderly or at-risk people, and even if you don't mind getting the flu spreading it can be dangerous.

Re: LA: Ambulance crews to not transport patients with little chance of survival

#46

Post by flunhat »

trhway wrote: post #35
flunhat wrote: post #28

Earlier quoted context omitted.

I suspect the limiting factor is personnel, not beds (i.e. trained staff to manage covid patients), which can't be increased on short notice. But still -- we have incompetent state & federal leadership that basically knew what would happen yet still didn't do enough to prepare. > Instead hospitals were laying off people in the summer. Yup. One of the dark ironies of this whole mess has been that hospitals have been l…

>can't be increased on short notice. i think the 3-6 months that we had would have been enough to train any MD to care for a covid patient, at least for majority of cases and under supervision of existing high specialist. My understanding is that non-covid personnel had their workload significantly decreased, so they could have been trained for covid for the second wave.

You might be right -- at this point, with everything that's gone wrong at the govt level, I'm pretty willing to accept rank incompetence as an explanation.

Re: LA: Ambulance crews to not transport patients with little chance of survival

#47

Post by wbl »

songgao wrote: post #41

This might be an unpopular opinion but this is a pretty awful headline and it makes it look way worse than what the EMS documents actually say. There’s a bold text [1] “shall not be transported if return of spontaneous circulation is not achieved in the field”. There’s a pretty big difference between abandoning patients with little chance of survival in general, and giving up after failure to achieve ROSC. Perhaps at…

When have they ever run out of oxygen before?

Re: LA: Ambulance crews to not transport patients with little chance of survival

#48

Post by baskire »

throw473388 wrote: post #19
nnx wrote: post #5

Why are some proven simple yet _useful_ preventative measures not taken? Like, promoting self blood oxygen monitoring with those (cheap!) finger oxymeter devices for all at-risk persons... This would avoid lots of late emergency calls in critical condition due to silent hypoxia that developed in them for days/weeks...

Please, next time you will tell people to exercise and not to be morbidly obese. BTW read the article, it talks about already dead people with no pulse.

I’m curious if covid will finally change the liberal belief that being morbidly obese is ok and shouldn’t be viewed similar to smoking.

Our food policies have failed us. Like honestly allowing a single serving of food/drink to have multiple “servings” on their labels is crazy. A single hot-bun is 1 serving not 2.5

Re: LA: Ambulance crews to not transport patients with little chance of survival

#49

Post by CyanLite4 »

highmastdon wrote: post #22
remote_phone wrote: post #13

Regardless of politics, I think places like LA need to institute a full lockdown. No one leaves their house except to go to the grocery store and pharmacy. No one leaves more than 2 miles away from their residence. It should be enforced by the military. Essentially martial law. It’s not something I suggest lightly. But 6-8 weeks of complete lockdown and pay people to stay home. It’s the only way that California is go…

There’s enough evidence for medication and preventive supplements (Ivermectin, Vitamin D) that lockdowns aren’t necessary anymore. Other treatments have looked promising when applied early in the disease instead of after hospitalisation. According to combined research (c19study.com) over 800,000 lives could’ve been saved when treated earlier

The vaccine is more effective. But we have 35 million doses stuck in warehouses around the U.S. because we don’t have a credible distribution plan. No way we’d be able to mass distribute vitamins to the general population. Not to mention the reluctance due to anti-vaxx social media memes.

Re: LA: Ambulance crews to not transport patients with little chance of survival

#50

Post by shortandsweet »

bozhark wrote: post #33
andi999 wrote: post #26

Earlier quoted context omitted.

Wait, so normally such patients are transported? For what? Billing purposes?

Because people can be revived

Indeed. I forget the term but I've read that trauma patients hearts can stop during massive blood loss. And they are saved by another person actually pumping the trauma patients heart with the responding care givers hands.
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