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

latimes.com

91–100 of 184 posts

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

#91

Earlier quoted context omitted.

It is not the mainstream liberal position that obesity is not a health issue. Michele Obama is still one of the most popular figures in American politics; and her signature issue was fighting childhood obesity.

That is not really a problem, but acceptance is. Making your child obese should be treated as a child abuse. Obese people should be treaded the same way as smokers, not to get disability benefits.

I'm pretty sure people with smoking related COPD get disability benefits.

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

#92
post #59
post #47

Earlier quoted context omitted.

When have they ever run out of oxygen before?

Hospitals are running out of oxygen in a way: so much is going through the pipes that the upper floors have low pressure, and the oxygen pipes occasionally freeze from adiabatic expansion. In LA.

You'd think they would test systems like that at maximum consumption.

Mind you, electricity and water systems are also not designed for every outlet to be maxed out. Whomst among us hasn't caused a breaker to trip from having too much stuff on at the same time.

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

#93
post #72
post #48

Earlier quoted context omitted.

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

Yea I think you got the sides mixed up there. The only time I’ve heard a liberal defend obesity was in response to body shaming - which is a problem and doesn’t help the person get in shape.

How strong is the data that body shaming doesn't help people get in shape?

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

#94
post #27

Earlier quoted context omitted.

The commonly-used treatments for hypoxia are incredibly damaging. In the beginning "ventilation" was the go-to treatment to pump oxygen into patients' lungs. Doctors eventually realized invasive ventilation was a death sentence. Now they're trying to just use lots of oxygen, but that doesn't work either. A lot of people had COVID-19 before tests were available. What happened to make the disease so much more deadly? I…

A lot of people did not have Covid before the tests were available. You know how we can tell? Because we did not have a lot of people hospitalised or even die with an undiagnosed mystery pneumonia. (There are other ways we can then cross validate that.) You have somehow internalised a gross mistruth as a fact, have realized it is inconsistent with reality, and are now trying to patch up the inconsistencies by positin…

Actually, a lot of people DID have it before tests were available.

https://academic.oup.com/cid/advance-article/doi/10.1093/cid...

https://www.bloomberg.com/news/articles/2020-12-09/covid-19-...

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

#95

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…

I was waiting for a military style quarantine earlier on. I still think it should have happened - though it may not be effective since china lied about the numbers BIG TIME and they're cited as the big success story here

https://www.bbc.co.uk/news/world-asia-china-55481397

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

#96
I can't believe they're rationing oxygen. I administered welding oxygen to my girlfriend every day for about 6 weeks when she had Covid. It's cheap, easy, and perfectly safe.

I assumed that when things got bad someone would just suspend the regulation requiring medical certified oxygen.

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

#97
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…

In emergency medicine, you've got patients who are dead, and patients who are dead dead. Patients who are just dead might still be brought back. This isn't about them. Patients who are dead dead because they haven't responded to resuscitation efforts aren't going to be taken to the hospital, is all. And in a lot of places that's already the norm.

Isn't the instruction in fact to limit resuscitation efforts to in field? To take it to an extreme, if someone collapses and has a heart attack near a hospital, by this instruction they would have to revive the person (get a pulse/breathing) before transporting them to a hospital.

It sounds very different to what normal procedure would be. I am assuming that usually they try to get the pulse back but that they can continue to do that while in the ambulance (at least that's how it works in the movies). This change would limit that.

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

#98
post #70
post #38

Earlier quoted context omitted.

A former EMT I know told me their policy was always to transport DOA patients and to tell the caller that the person died on the way to the hospital, even if they were already dead. I'm not sure if it's the same everywhere but the idea was that it's kinder to whoever found the person.

Maybe insurance covers the call then. Here if it is DOA medical insurance won't pay.

Is there any nuance to that policy? What if someone dies between the call and the ambulance arriving? What if the person making the call doesn't have the experience to know when someone is beyond saving?

On the face of it, it appears to penalise those who can't afford to get it wrong which feels morally bankrupt.

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

#99
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…

In emergency medicine, you've got patients who are dead, and patients who are dead dead. Patients who are just dead might still be brought back. This isn't about them. Patients who are dead dead because they haven't responded to resuscitation efforts aren't going to be taken to the hospital, is all. And in a lot of places that's already the norm.

I feel like there's a quote from "Princess Bride" in there but I guess now is not the time.

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

#100

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…

CFR is 0.5%-1%.
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