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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

#171

Post by GavinMcG »

saberdancer wrote: post #97
GavinMcG wrote: post #66

Earlier quoted context omitted.

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 co…

Transporting these patients (the ones whose pulse hasn't returned in the field) appears to worsen their chances.[0] States vary widely in what protocols they require, but normal procedure in a lot of places is to not transport if resuscitation in the field has been unsuccessful.

[0] https://www.cardiovascularbusiness.com/topics/electrophysiol...

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

#172

Post by ibejoeb »

sjg007 wrote: post #143
ibejoeb wrote: post #137

Earlier quoted context omitted.

For example, here are some excerpts from just one other LA Times article: > Many hospitals also say they’re too full to accept any more patients or ambulances > when paramedics are allowed to drop off patients at a hospital, the emergency room is often so crowded that there aren’t available staff members > Hospitals across the state are sending away ambulances, flying in nurses from out of state and not letting child…

So where are the hospital ships?

The one that was deployed is now being overhauled in drydock in Portland.[1]

But what's the point? I posted this article to criticize the LA Times' handling of the messaging. If you wouldn't mind taking a look at the original article from which those excerpts are drawn, I think you'll get it.

1: https://www.marinelog.com/shipyards/shipyard-news/vigor-wins...

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

#173

Post by dang »

throw473388 wrote: post #124
VBprogrammer wrote: post #120

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 #&#+$+

Please stop posting flamewar comments, and definitely please don't create accounts to post flamewar comments.

https://news.ycombinator.com/newsguidelines.html

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

#174

Post by dang »

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

Would you please stop posting ideological flamebait to HN? You've done it repeatedly, and it's not what this site is for. Taking threads on flamewar tangents is particularly destructive.

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Edit: actually it looks like this account is being used primarily for political and ideological battle. We ban that sort of account, and eventually people's main account as well if they keep doing it. I've banned this one. Please don't create accounts to break HN's guidelines with.

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

#175

Post by cosmiccatnap »

It's almost like things related to healthcare shouldn't be privatised because then their interests are directly related to profit as are their disinterest such as the lives of soon to be unemployed (see: deceased persons) revenue streams (see: human beings)

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

#176

Post by tehjoker »

tylerhou wrote: post #131
tehjoker wrote: post #60

Earlier quoted context omitted.

The problem was that for a healthy person, ventilation just moves your lung physiologically, but for very sick patients parts of their lungs are like inflamed tissue paper so the forced inflation could cause problems.

Ventilators are highly complicated pieces of medical grade machinery that cost upwards of $50,000. They are not just regular old pumps with tubes attached. "Forced ventilation" does not properly describe the delicate nature of their operation. If used properly by trained medical professionals, they are better than the alternative — no ventilation at all.

The perspective I share is one that comes from a doctor that works in the ICU (not me). I am not against ventilation, but there are attendant risks when treating COVID-19 specifically.

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

#177

Post by wdr1 »

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…

There's a lot of bad reporting happening in Los Angeles.

There were a lot of headlines recently about "0% ICU capacity", which led most readers to think there are no ICU beds when there have been about ~50 since mid-December.[1].

The issue is the County Health department set a target of keeping COVID cases to under 30% of an ICU, so when when it exceeds 30%, for each point above 30% they deduct 0.5% from capacity.

I'm not a doctor, so that could very well be an appropriate way to do it, but when it comes to newspapers communicating with the general public, it misinforms people. (And I'm really worried about when we do hit 0 ICU beds -- as we probably will -- that people will be confused and/or lose trust.)

[1] http://file.lacounty.gov/SDSInter/dhs/1070348_DHSCOVID-19Das...

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

#178

Post by saberdancer »

polytely wrote: post #145
saberdancer wrote: post #100

Earlier quoted context omitted.

CFR is 0.5%-1%.

While that is true it doesn't take into account what happens once hospitals reach capacity. Once all doctors are busy and beds are full the fatality rate of strokes, heart attacks, car accidents, cancer goes way up which is something that has to be avoided.

Yes, I agree. I was pointing out that death rate is higher than 0.2% that parent mentioned.

CFR of 0.5% to 1% with treatment for a (likely) seasonal virus is extremely high.

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

#179

Post by dang »

cactus2093 wrote: post #154
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?

This comment breaks the site guidelines badly. Would you mind reviewing them and sticking to the rules when posting here? Note these ones:

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

#180

Post by dang »

covid21 wrote: post #163
cactus2093 wrote: post #154

Earlier quoted context omitted.

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.

We've banned this account for repeatedly breaking the site guidelines. Could you please not create accounts to do that with? We're trying for a different kind of site here.

https://news.ycombinator.com/newsguidelines.html

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