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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

#151

Post by tomjen3 »

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…

The only solution is to vacinate at much, much higher rates than they are doing now. I don't know what is holding it up, but I imagine that setting an agressive deadline, say 2 weeks, for everybody to be offered a vaccine will get things moving, so long as the penalty is sufficiently harsh. Maybe holding politicians individually responsible for each dead as manslaughter?

Basically I am tired of politicans doing jack shit and expect the rest of us to dance to their tunes.

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

#152

Post by vkou »

baskire wrote: post #48
throw473388 wrote: post #19

Earlier quoted context omitted.

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

There hasn't been a liberal belief that obesity is some optimal state of being, but it is a polite society belief that crapping on an obese person is rude.

Most people aren't stupid. If they aren't in shape, they know it. They generally appreciate not being mocked about it by random strangers.

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

#153

Post by robbiep »

tylerhou wrote: post #132
baskire wrote: post #54

Earlier quoted context omitted.

Here’s a good summary of some findings. “ Among the 2,634 patients for whom outcomes were known, the overall death rate was 21%, but it rose to 88% for those who received mechanical ventilation, the Northwell Health COVID-19 Research Consortium reported.” “ Ventilators are typically used only when patients are extremely ill, so experts believe that between 40% and 50% of patients die after going on ventilation, regar…

1. This is from April. 2. The cited study only measures outcomes and does not claim that ventilators worsen patient outcomes. Covid patients who are hospitalized have a higher rate of death [citation needed]. Does that mean hospitals kill Covid patients? [1] https://jamanetwork.com/journals/jama/fullarticle/2765184

There is some weird sort of logic with 2.

For example, when I worked in Cairns (cape York Australia, which serves a massive area with a large indigenous population), aboriginals have a belief that people going to the hospital go there to die (because people who have been sick enough to go to hospital... die). So yes, hospitals kill covid patients, because patients sick enough to need to go to hospital are sick enough to die. I know you’re kind of writing in jest and looking for sources but the fact remains that admittance to ICU (when I did my ICU term, at least in Australia and at least when I did it - my brother is an ICU trainee and I raised this number with him and he said it’s lower than that now, here) carries an all source mortality risk of 30%. 30% of those who are wheeled through the doors go out in a bag.

To relate this to COVID, generally ventilators don’t cause an increase in mortality just because you are on one. This was a surprising finding during the early days. It is also contrary to what we find in influenza patients, where it is usually life saving when a patient gets too tired to breathe in their own but still has enough good lung function to be able to respire with their lungs (the alternative being ECMO, or artificial blood gas exchange). I’m on mobile and it’s late so am not at liberty to pull up the research but I recall the consensus being that there was a contradiction: patients who were sedated and ventilated were being so done on the basis of a rapid deterioration in o2 sats; but generally we’re still alert and potentially orientated. It was quickly found that prone positioning (putting a patient on their front to get more gas exchange to the apexes of their lungs) could keep then unventilated and they did better - a lesson learned pretty quickly as regions of Italy and the UK ran out of ventilators

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

#154

Post by cactus2093 »

covid21 wrote: post #122

Is there a site that shows statistics (over time) of hospital capacity over time in LA? It sounds to me like one of the typical articles that tries to induce panic without actually providing much information or context. Whenever I see such articles here in Germany, I go to the official statistics for ICUs, and inevitably it always turns out to be bullshit. Some of the things that are hyped to be a consequence of Covi…

So you won’t be satisfied until people are literally dropping dead in front of you, huh?

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

#155

Post by vkou »

ixacto wrote: post #133
kepler1 wrote: post #74

The medical system is stretched to breaking. Vaccine distribution is completely disorganized, despite months of possible preparation time. A ridiculous patchwork of federal, state, county authorities can't get it together to enforce rules and can only ask for voluntary cooperation in a true crisis. I think we will look back on this as one of the great weaknesses of decentralized, democratic, random-walk governance, f…

More people will die from covid. But the principals of free speech and assembly should not be sacrificed for something that will be and mostly gone in 6-9months. Yes people have died and that is horrible, but a dictatorship like china is not the answer. Tbh I'm more afraid of the governments authoritarianism than covid. *Disclaimer: yes I wear a mask indoors in public places and outdoors when not able to be 6 feet fr…

You are posing a false dichotomy. Free speech is not at odds with competent governance.

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

#156

Post by cactus2093 »

I still cannot comprehend why we had to let it go this far. Why have all measures in California been completely voluntary this whole time? I can get a ticket if I jaywalk or leave my car parked somewhere for too long, but if I walk into a Walmart with no mask on and start yelling at everyone in the store potentially exposing dozens of people to covid I’ll just get politely escorted out with no penalties.

Something so ridiculously simple we could have started with is just ticketing for not wearing a mask in public. If we needed to ratchet it up further, ticketing gatherings with people outside the same household, which is obviously more difficult to enforce but just start with the ones that happen in public. Maybe do a “see something, say something” campaign to encourage people to report private gatherings they see in their neighborhoods and police come and break up gatherings and give tickets.

What we’ve been doing instead with all these ever-changing vague optional guidelines is just so stupid. Either leave everything open, or actually enforce the so-called “orders”.

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

#157

Post by jsnell »

taxicabjesus wrote: post #80
jsnell wrote: post #27

Earlier quoted context omitted.

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…

> (There are other ways we can then cross validate that.) Tell me more, I'm interested. > by positing that the virus became more deadly. I posit that inappropriate treatments make the virus more deadly than it has to be.

Sure, here's a few ways to cross-validate:

If we had a high prevalence of Covid before there was any testing, we'd expect that the moment testing started, we'd see a high prevalence everywhere. We didn't. Most places saw only a small proportion of tests come back positive to start with, which then increased over time. (When looking at this kind of testing that's been done using antibody tests, it's good to remember that even a 99% specific test will mostly be returning false positives when the prevalence is very low).

We can re-test historical samples of various kinds for Covid. That has been done, and while they can find individual cases from a month or two before the first confirmed "live" case, there's no sign of it being widely spread.

We can also deduce the transmission patterns of the virus from the phylogenetic tree. If the virus had been widely circulating outside of China in 2019, sequencing would have show variants that are common in the west branch off from the Chinese ones earlier than they did.

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

#158

Post by multjoy »

warent wrote: post #42
andi999 wrote: post #26

Earlier quoted context omitted.

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.

“Injuries clearly incompatible with life”.

While an EMS may not be able to sign the death certificate, they are quite able to say in cases of major trauma or obvious rigor that the patient is exceedingly dead.

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

#159

Post by multjoy »

brodie wrote: post #23
throw473388 wrote: post #19

Earlier quoted context omitted.

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.

On a more serious, thought out note: It is kind of interesting seeing the rise of home pulse oximeter products (due to the pandemic).

They are so cheap now that there really is no reason to not have one in the bathroom cabinet.

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

#160

Post by multjoy »

saberdancer wrote: post #100
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…

CFR is 0.5%-1%.

with treatment.
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