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

latimes.com

161–170 of 184 posts

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

#161

I'm disappointed that all the discussion seems to be operating at a non-quantitative level. ("If there's any chance, we have to try" against "If circulation can't be reestablished on scene, there's essentially no hope".) Presumably there are academic article that make an attempt at this.

People overestimate the efficacy of CPR because they see people in the movies come back to life after 4 chest compressions and a second of mouth-to-mouth. I wonder if that is the sort of thing driving the discussion

That's likely part of it. Unwitnessed cardiac arrests and those where no electrical activity is present in the heart are pretty rare to get back.

Cold temperature and submersion in water are two neat caveats though. They can be viable a lot longer, in part due to the Diving reflex.

https://en.wikipedia.org/wiki/Diving_reflex

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

#163

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?

What makes you think that? Quit the bullshit.

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

#164

Earlier quoted context omitted.

Why?

Assuming they're talking about the US, where being older rather than younger, being rural/exurban rather than urban/suburban, and being male rather than female are all indicators for both political conservatism and obesity, this is very likely to be the case. Hard to prove without some very peculiar polling, but it is statistically very likely.

[flagged]

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

#165
post #57
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…

> But a headline designed to make incorrect impression just doesn’t help. Yet this is basically all we get. Because it makes people click. It’s so hard to tell what’s real and what’s exaggerated these days. And if you try to make the case that something is exaggerated, you come off as a right wing nut job.

> It’s so hard to tell what’s real and what’s exaggerated these days.

You had to click through and read a few words in order to determine what was meant in the headline by 'little chance of survival.'

> And if you try to make the case that something is exaggerated, you come off as a right wing nut job.

In this case, you come off as perhaps just a little bit lazy?

edit: in the original complaining post about this topic, songgao links to a 4-post twitter thread that explains how EMS will handle things succinctly and nicely. The first post underneath is someone saying "So will they be left at home to die?"

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

#166
post #93

Earlier quoted context omitted.

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

If you're pushing a weird idea that on the face of it makes no sense, then the onus is probably on you to demonstrate that it works, not on other people to demonstrate that it doesn't.

Wait, which is the weird idea? That telling people they should lose weight doesn't make them lose weight, or that telling people that they're healthy and beautiful at their current weight helps?

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

#167

Earlier quoted context omitted.

I know your comment is coming from the right place here but it reads to me like "how strong is the evidence that straight conversion doesn't work for homosexually?". I think these is some merit to the arguement that we should treat obese people (in the interest of full disclosure I'm usually in the overweight category by BMI) in the same way we treat smokers. Reduce temptation, avoid glamourising unhealthy foods, rem…

Contries with lower obesity acceptance have much lower obesity rate. Compare US & UK to rest of the world. Comparing yourself to gays is just #&#+$+

I would bet that acceptance follows the rate, not vice versa.

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

#168

I'm disappointed that all the discussion seems to be operating at a non-quantitative level. ("If there's any chance, we have to try" against "If circulation can't be reestablished on scene, there's essentially no hope".) Presumably there are academic article that make an attempt at this.

People overestimate the efficacy of CPR because they see people in the movies come back to life after 4 chest compressions and a second of mouth-to-mouth. I wonder if that is the sort of thing driving the discussion

I've spent some time in hospitals and I don't overestimate the $20,000 for just a 0.3% of survival.

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

#169
post #133
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…

> But the principals of free speech and assembly should not be sacrificed

I can't exercise my right to free assembly in good conscience when a pandemic is going on. I can't walk into a business with my mask off, which is literally an infringement on my right to free speech. I'd rather finish off the pandemic quickly and have full rights back than live with half "rights".

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

#170

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…

Production capacity. The equipment to make the effective vaccines in high enough quantity simply doesn't exist yet. The easier to produce vaccines are either less effective (AstraZeneca) or haven't finished demonstrating how effective they are (Johnson & Johnson, CanSino, Gamelya, Sinovac, SinoPharm, and Novavax are still in trials). The risk with a less effective vaccine is that the virus could evolve resistance to whatever particular antibody types the vaccine tends to cause the body to produce, since there would be more vaccinated people who could get infected. Then we'd be back to square 1, trying to develop a new vaccine for the new variant. We REALLY want to avoid that.
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