Los Angeles, US: Ambulances are having to wait for up to eight hours at times just to admit new patients at hospitals that are now working at maximum capacity.
Covid cases in intensive care units have more than quadrupled since November.
Last Monday, the Emergency Medical Services Agency of LA County directed medics not to bring in people with close to no chance of survival inside the hospitals and to conserve their supply of oxygen when on the job.
Medical experts have now warned that the worst is yet to come.
Dr. Nichole Bosson, assistant medical director at the Los Angeles County Emergency Medical Services Agency said:
“A lot of what’s happening right now, even though people are talking about it, people are reporting about it, people aren’t really seeing it. And the reality is, things are worse than people think.
And I say that because I see how people are still congregating in groups and making decisions to have family gatherings or New Year’s parties. And these decisions are what continues to impact our health care system.”
During an interview on NPR’s All Things Considered, the doctor talked about what the new rules mean and what steps are being taken to deal with the issues at hand. What follows are the excerpts of the interview.
“I want to start with some of these new directives that we’ve been hearing about, like not bringing in patients who have little likelihood of survival. Can you put that in context for us? How extraordinary is that measure?”
“Well, actually, it is best practice to resuscitate patients in cardiac arrest in the field where they are found. That is our normal protocol in LA County. So the shift towards not transporting patients who do not have restoration of pulse is a relatively small change. These patients have very limited chance of survival. And so these are the patients that we’re asking the paramedics to call in to our base hospitals, discuss with the base physician and determine if further resuscitation is futile and therefore terminate resuscitation on scene. We are continuing to resuscitate patients in cardiac arrest, and we continue to transport all patients in whom our paramedics are able to resuscitate in the field.”
“How concerned should Angelenos be about the availability of oxygen right now? We are hearing from people like [LA County Public Health Director] Barbara Ferrer that January will likely be the worst month on record for LA. So I imagine oxygen supplies will only get stretched even more in the weeks to come.”
“We have made this move because of a limited supply of portable oxygen tanks. … Because the paramedics and EMTs are spending more time in the field with patients. They are transporting longer distances because of hospital closures. They are spending more time waiting to offload patients at hospitals. And these patients need oxygen. And so they’re using a lot of oxygen in these small portable tanks. And if we cannot get additional tanks and cannot fill the tanks, we risk to run out of oxygen for patients who need it. So this directive is meant to conserve oxygen in order to make sure that we continue to have enough oxygen to treat patients who really, really need the oxygen.”
“The waits for ambulances to offload patients at hospitals are getting longer. What is being done to address that situation?”
“We are implementing a surge response to develop ambulance receiving spaces at these hospitals. These are intended to be climate-controlled spaces where EMS can offload patients. And instead of having each individual unit, usually two paramedics or two EMTs, monitoring a single patient, they will be able to offload the patients and have a paramedic or EMT as appropriate staffing the area and monitoring several patients at a time. … And we have a medical officer on duty 24/7 to help consult in terms of identifying the most critical patients and getting them into the hospital as quickly as possible and determining which patients may be stable, say, to go to the waiting room and be triaged in through the walk-in process. And by this way, we’re trying to get more ambulances back into the field to respond to the critical emergencies and reduce the burden on the hospitals as well, because we know they don’t have the staff to monitor these patients.”
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