The Los Angeles County Emergency Medical Services Agency (EMS) told ambulance crews not to transport patients with low chances of survival to hospitals and to try and conserve oxygen if possible, according to directives issued Monday.
With L.A. hospitals at capacity, many facilities no longer have space to take in patients who do not have a chance of survival, according to CNN. If EMS workers are unsuccessful in resuscitating a patient whose heart has stopped while in the field, the agency says the patient should not be taken to a hospital, according to the memo.“Effective immediately, due to the severe impact of the Covid-19 pandemic on EMS and 9-1-1 Receiving Hospitals, adult patients (18 years of age or older) in blunt traumatic and non traumatic out-of-hospital cardiac arrest (OHCA) should not be transported [if]return of spontaneous circulation (ROSC) is not achieved in the field,” the agency said.
EMS workers are ordered to try and resuscitate a patient for at least 20 minutes. If the patient is stabilized, guidelines say they can be taken to a hospital. If EMS workers are unable to restore a pulse, paramedics are directed in the memo not to transport them to a hospital. To combat the shortage of space, officials have created temporary “ambulance receiving spaces” which are set up outside emergency room entrances. EMS workers can monitor patients until resources are available. Ambulance crews are also pressured to limit their use of oxygen tanks given the shortage due to the coronavirus pandemic. “Given the acute need to conserve oxygen, effective immediately, EMS should only administer supplemental oxygen to patients with oxygen saturation below 90%,” the memo said. Hospitals in the region “have reached a point of crisis and are having to make very tough decisions about patient care,” Dr. Christina Ghaly, the L.A. County director of health services said Monday at a briefing reported by the Los Angeles Times.