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LA County ambulances not to transport patients unlikely to survive: media

(Xinhua)    13:47, January 06, 2021

LOS ANGELES, Jan. 5 (Xinhua) -- As local hospitals are overwhelmed by COVID-19 patients, the Los Angeles County Emergency Medical Services (EMS) Agency has issued directives, saying ambulances should not transport patients to hospital if they have virtually no chance of surviving, CBS news channel reported Tuesday.

Patients likely with such treatment include those whose heartbeat and breathing have stopped and who couldn't be resuscitated by paramedics, said a memo signed by Marianne Gausche-Hill, the agency's medical director, and issued on Monday.

Due to the severe impact of the COVID-19 pandemic on EMS and 911 Receiving Hospitals, adult patients in blunt traumatic and nontraumatic out-of-hospital cardiac arrest shall not be transported if return of spontaneous circulation is not achieved in the field, read the memo posted online.

A patient should be treated at the scene first and has a pulse during resuscitation before he or she is transported to hospital, said the memo. That means if the patient does not regain a pulse or is declared dead, EMS workers should not move her or him to hospital.

Another document posted online showed that the local healthcare authority also issued a directive on Monday asking ambulance crews to administer less oxygen since supplies were strained because of the pandemic.

Gausche-Hill was quoted by CBS as saying that these memos did not mean the EMS crew would not continue to do all they can to save patients' lives at the scene or in hospital.

"We are not abandoning resuscitation," Gausche-Hill said. "What we're asking is that -- which is slightly different than before -- is that we are emphasizing the fact that transporting these patients arrested leads to very poor outcomes. We knew that already and we just don't want to impact our hospitals."

Treating patients with a heart attack or a stroke at the scene instead of on the way to hospital can increase the chances of survival, Gausche-Hill said.

While these measures triggered many questions by local residents about whether first responders would deny taking patients with a stroke or a heart attack to hospital because of the virus surge, many changes have been applied in the region on how to handle emergencies, according to the local ABC 7 news channel.

For example, the news channel said, people are being discouraged from calling 911 unless it is an absolute emergency, patients faced with no life-threatening emergency are waiting 12-18 hours in waiting rooms, ambulances are waiting for hours just to offload patients at hospital, and hospitals are setting up cots in parking lots to take in patients.

COVID-19 deaths in the Los Angeles County topped 11,000 on Tuesday as cases continued to rise across this most populous county in the United States, said the county's Department of Public Health in a daily release.

Public health officials noted that the county has seen more than 1,000 new COVID-19 deaths in less than a week. The department also confirmed 13,512 new cases of COVID-19 on Tuesday, pushing the total infections to 840,611.

Hospitals across the county are out of room following the Thanksgiving and New Year holiday seasons, with one in five residents testing positive for the coronavirus. According to the department, there are just 14 open ICU beds and 151 available hospital beds across the county as of Tuesday.

"Healthcare workers and hospitals continue to be taxed and overwhelmed with COVID-19 patients. The devastating impact of the pandemic is disrupting emergency medical care due to the sheer volume of COVID-19 patients and staffing limitations," said the department in the release. "These challenges will get worse if we don't slow COVID-19 spread."

"As a community, we must commit to stopping the spread of COVID-19 in its tracks so that we can save as many lives as possible," the county's public health director Barbara Ferrer said, adding that the roll-out of COVID-19 vaccines continued in the phases recommended by health authorities as supply allows.

(For the latest China news, Please follow People's Daily on Twitter and Facebook)(Web editor: Wen Ying, Liang Jun)

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