Grim new guidance for EMS in NYC: Don't bring cardiac arrest patients to hospital for revival

[Recursion]

Source: The National Observer

With first responders and emergency rooms in New York City facing unprecedented demand due to the surge of severely ill COVID-19 patients, city officials have released grim new guidance ordering emergency medical services (EMS) to stop bringing cardiac arrest patients to the hospital if they don’t have a pulse on scene.

EMT’s can still perform life-saving procedures on patients suffering from cardiac arrest, but they are not permitted to transport them to the hospital if the patient cannot be saved in the field, according to the new guidance.

...

The Regional Emergency Medical Advisory Committee of New York (REMAC), which oversees emergency services in the region, announced the new directives in an April 2 press release.

In cases where patients can’t be revived on the scene, EMS workers are being advised to stop CPR and declare the person dead, rather than transporting them to the hospital for further attempts at resuscitation.

Read more: https://www.nationalobserver.com/2020/04/02/news/grim-new-guidance-ems-nyc-dont-bring-cardiac-arrest-patients-hospital-revival

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That's disconcerting

[gab13by13]

1. As Rachel pointed out to Cuomo last night,

why not take those cardiac patients to the Navy ship? Cuomo dodged that question like he had never thought of that. Maybe I took the sequence wrong. Cuomo has been doing a good job.

[truthisfreedom]

3. That sounds like exactly what should be done.

They should be driving to the navy hospital ship while attempting to revive and racing the patients up the gangway. There's only 3 patients on that ship!

[SheltieLover]

5. That was my 1st thought

Take them to the ship, but maybe ship won't accept anyone? Very few patients on ship. Maybe presence of ship is all fir show?

[MFM008]

16. Exactly!

All done so maggot could stand in front of all the flags
With the ship in background.
Why do you think he went in person....

[SheltieLover]

18. Yup!

MSM NEEDS TO COVER THIS RIGHT FKN NOW! (Sorry for yelling. 😊

[Squinch]

8. Apparently there are all kinds of restrictions on who the Navy ship will take.

And Cuomo has to be very careful not to piss Trump off by saying anything negative about that ship.

Cuomo just got permission last night to send CV 19 patients to the Javits center. That is another huge federal facility that has a dozen patients right now. So that was a good concession he got and I'm sure Cuomo didn't want to put that in jeopardy.

[Bernardo de La Paz]

20. Yup. 1000 bed hospital ship has 9 patients. Big photo op for tRump & typical no results. . . . nt

[Withywindle]

2. The ripple effect

The criminal mismanagement and negligence of this administration means that so many people will die because of this disease - who didn't even have it.

[sprinkleeninow]

4. Cardiac arrest is not a heart attack.

If defib or CPR is not administered within minutes, it's usually a terminal conclusion.

My husband was worked on for at least 15 minutes or more; they could not revive him, and so a transport to the hospital was not done. Then the funeral service came.

[MFM008]

19. They did the same

With my dad.
Couldnt revive him...

[we can do it]

23. Thank you. Very few are revived ever.

[DeminPennswoods]

6. There are also increasing numbers of people with DNR

requests in their advance health care directives. What might be helpful is for those people to have wrist bands or door stickers or be in an EMS database to alert EMS personnel that they do not want to be resusitated.

[donkeypoofed]

7. Why don't they just take them to that hospital ship?!

As of yesterday there were like, what, 10 patients there?!

The enormity of the stupid in this debacle is gobsmacking.

[Squinch]

10. Lots of federal restrictions on who can be treated by the ship. Lots of red tape no one has time to

deal with.

[Bernardo de La Paz]

21. There are 48 kinds of cases that are forbidden from being treated at the ship. Forty Eight excluded.

[gab13by13]

22. I was too hard on Cuomo,

I should have figured that Trump was the real reason that more people aren't be taken to the ship.

[Squinch]

9. My friend needs a surgery for cancer, and they're doing all kinds of tests now

to see how long they can put it off bc they worry about the care she'd get in a hospital right now. Meanwhile the cancer spreads.

And thus the cascade begins. I'm just trying to stay healthy for these next few months.

[Chemisse]

12. That has to be terrifying!

And chemotherapy poses great risks now as well.

As someone who has gone through the full gamut with breast cancer, my heart goes out to all those who are coping with this frightening disease now, when Covid-19 is consuming the nation.

(Note - I refuse to use words like 'battling' and 'survivor' in connection with cancer illness).

[Squinch]

13. She is very upbeat - because there is really no choice. We're waiting on the

decision today what will happen. And yes, either way it's frightening.

[Chemisse]

14. Good for her. I wish her luck in getting the treatment she needs. n/t

[Squinch]

15. Thank you, Chemisse! I'll let you know how it goes.

She is being upbeat so I can't express my fear for her to anyone. Thank you for your kind words and being a listening ear. (Or keyboard.)

[Chemisse]

17. Thanks, that would be nice.

Online community has become so important.

[Squinch]

32. So my friend got the news today that the cancer has not spread. They have taken

some measures and they think the surgery can wait 2 months, so they've scheduled her for her pre-op appointment then. Our peak here in NY should be within the next three weeks or so, so hopefully there will be a place she can go in 2 or 2 1/2 months to have the surgery.

Thank you again for your kindness.

[Chemisse]

34. That is great news!

She must feel so much better knowing that she is stable for now and there is a plan in place.

[luvtheGWN]

29. I'm with you, Chemisse.

I chose the words "dealing with" because that's just we had to do. And yes, I'm very concerned about everyone dealing with chemo, surgery etc. It was scary enough in normal times........

[Chemisse]

30. It's nice to hear of someone else

who doesn't appreciate the special lingo imposed on those who are being treated for cancer.

I suspect it began decades ago as a way of motivating people undergoing those early chemotherapies, which were so incredibly torturous and had such low expectations for good results. I've always felt I owed those early 'pioneers' a great debt.

[Chemisse]

11. How many people actually survive if taken to the hospital without a pulse?

From the article:

EMT’s can still perform life-saving procedures on patients suffering from cardiac arrest, but they are not permitted to transport them to the hospital if the patient cannot be saved in the field, according to the new guidance.

Resuscitation efforts must be limited to 20 minutes or less.

So if the patient can't be revived after 20 minutes of CPR, aren't the chances of ultimate survival almost nil anyway? Also, this directive can be overruled in individual cases by 'direct order from a medical control physician.'

So this seems sensible to me, although it places a heavy burden on EMS responders.

[we can do it]

24. Yes. Usually cpr stopped and pronounced dead.

[LastDemocratInSC]

31. If a person is "revived" after 10 to 15 to 20 minutes

The person is usually severely compromised due to lack of blood flow to the brain. Blind, incontinent, difficulty swallowing, too many things to enumerate.

[madville]

33. Almost none, this policy makes sense under the current conditions

Taking them to that hospital ship wouldn't magically save anyone that has already been in cardiac arrest for probably an hour at that point either, would just be a waste of vital EMS resources.

[Chemisse]

35. That is helpful to know.

And it should be included when being covered in the news so that people understand their loved ones are not being 'left to die.'

[Javaman]

25. okay. but what becomes of the body? nt

[getagrip_already]

26. Usually it remains on site. Ambulances don't take them to a funeral home

If funeral homes become overwhelmed, your options begin to diminish quickly. State or county coroners may take the body, but they usually only take them if they pose a public health threat or a criminal act is suspected.

[Coventina]

28. This is exactly what happened to my FIL.

He went into cardiac arrest at home and they refused to take him to the hospital.

Mortuary came and picked up his body.

He did not have a DNR registered, but he had told his wife that he was planning on getting one, so we were all OK with what happened.