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Imagine having a cardiac arrest and being picked up by an ambulance that won’t take you to a hospital.

Or have a medical emergency and languish outside an ER for hours.

This is what Los Angeles County faces as the onslaught of COVID-19 devastates the community: one in five people tested for COVID-19 in the region tested positive

“Hospitals are declaring internal disasters and they have to open church gyms to function as hospital units,” said county supervisor Hilda Solis. “Our healthcare workers are physically and mentally exhausted and sick.” Solís called the situation a “human disaster.”

Motorists line up to take a coronavirus test in a parking lot at Dodger Stadium on Monday in Los Angeles.
Motorists line up to take a coronavirus test in a parking lot at Dodger Stadium on Monday in Los Angeles. (AP)

More than 7,600 people are hospitalized with COVID-19 in Los Angeles County alone. And 21 percent of them are in intensive care units, authorities said Monday.

And every 15 minutes, a person dies from Covid-19, said Los Angeles County Public Health Director Barbara Ferrer.

Now, Los Angeles County ambulance teams have been told not to bring patients with little chance of survival to hospitals.

“This order that was issued by county emergency medical services is really very specific to patients who have suffered cardiac arrest and cannot be revived in the field,” said Dr. Jeffrey Smith, director of operations for Cedars Medical Center. -Sinai. .

“Those patients each have a very low survival rate if they are transported to the hospital. Therefore, at this point, it is considered probably useless.”

Who is taken to a hospital and who is not

The Los Angeles County Emergency Medical Services Agency (EMS) issued a memorandum last week to ambulance workers.

“Effective immediately, due to the severe impact of the COVID-19 pandemic on emergency medical services and 9-1-1 recipient hospitals, adult patients (18 years of age or older) in traumatic out-of-hospital cardiac arrest and non-traumatic closed (OHCA) will not be transported [if] Return of Spontaneous Circulation (ROSC) is not achieved in the field, “the agency said.

If the patient has no signs of breathing or pulse, EMS will attempt to resuscitate the patient for at least 20 minutes, the memo said.

Administrative workers Leslie Castillo, far left, and Verónica Esparza register people at a COVID-19 testing site in Los Angeles.
Administrative workers Leslie Castillo, far left, and Verónica Esparza register people at a COVID-19 testing site in Los Angeles. (AP)

If the patient stabilizes during that time, he will be transferred to a hospital.

But if the patient is pronounced dead at the scene or the pulse cannot be restored, paramedics will not take the patient to the hospital.

Patients may or may not be helped with oxygen

The rise in COVID-19 has also caused a shortage of supplemental oxygen, meaning that some patients treated by EMS will not receive it.

“Given the acute need to conserve oxygen, effective immediately, EMS should only administer supplemental oxygen to patients with oxygen saturation below 90 percent,” Los Angeles County EMS said in its memo.

EMS said that an oxygen saturation of at least 90 percent is sufficient to maintain normal blood flow to organs and tissues.

Oxygen shortages in the county and San Joaquin Valley prompted the formation of an “oxygen task force” last week, Governor Gavin Newsom said.

The task force has been working with local and state partners to try to refill the oxygen tanks and get them to the most needy hospitals and facilities.

Holiday gatherings and essential fuel spread for work

As the most populous state in the country and home to about 1 in 9 Americans, it would make sense for California to have the most Covid-19 cases.

But it is the sheer size of hospitalized patients and the staggering rate of increase that is causing major problems.

As of Tuesday, more than 22,000 Covid-19 patients were hospitalized across the state, according to the California Department of Public Health. More than 27,000 people have died from Covid-19, including 368 new deaths reported Tuesday.

“Increases in cases are likely to continue over the next several weeks as a result of the holidays and year-end festivities and returning travelers,” Ferrer said.

“We are likely to experience the worst conditions in January in which we have faced the entire pandemic. And that is hard to imagine.”

Experts say other reasons also contribute, including pandemic fatigue, resistance to stay-at-home regulations, the large number of essential workers, and socioeconomic factors that affect the poorest and most minority households.

Ambulances wait for hours outside hospitals

Even when patients are lucky enough to make it to a hospital, they can languish outside for hours if there’s no more space.

“Emergency Medical Services are working very hard to divert ambulances or send them to hospitals that have the potential capacity to receive these patients,” said Smith, director of operations for Cedars-Sinai Medical Center.

“There are situations where patients have to wait in ambulances under the care of paramedics. We want to make sure that the time is as short as possible so that they can receive the necessary care.”

For EMT Jimmy Webb, the wait can take several hours.

“We are waiting at least two to four hours for a hospital, and now we have to drive even further … then wait another three hours,” Webb said. CNN affiliate KCAL.
Local officials have urged the public not to call 911 unless they “really need to,” said Dr. Marc Eckstein, chief of the Los Angeles Fire Department’s EMS bureau. CNN affiliate KABC.

“One of our biggest challenges right now is getting our ambulances out of the emergency department,” he said.

“When our paramedics and EMTs transport a patient to an emergency department, a transfer of care must take place. Patients who are unstable or cannot be safely transferred to the waiting room or to a chair need a bed in the emergency department to be transferred. And those beds are missing right now. “

And more ambulances waiting in hospitals means there are fewer ambulances to answer other 911 calls, leading to even more delays.

The situation may get worse, Eckstein said.

“I think this next four to six week period will be critical of our tax system,” he said.


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