Swamped by COVID, L.A. tells paramedics not to take worst-case patients to hospitals

A new Los Angeles County directive orders ambulance crews not to take patients who can be pronounced dead at the scene to hospitals strained by a COVID-19 spike.

A second directive also restricts paramedics from giving oxygen to patients with an oxygen saturation higher than 90%.

“Hospitals are declaring internal disasters and having to open church gyms to serve as hospital units,” Supervisor Hilda Solis told CNN. She called the situation a “human disaster.”

Both directives were issued Monday by the county Emergency Medical Services Agency.

The first orders ambulance crews not to take adult patients who cannot be resuscitated after suffering cardiac arrest to hospitals. Paramedics can continue to try to revive patients in the field, but can only take them to a hospital if blood circulation is restored.

Medical experts say those patients have virtually no chance of survival even if hospitalized, the Los Angeles Times reported.

“We are not abandoning resuscitation,” Dr. Marianne Gausche-Hill, director of the county Emergency Medical Services Agency, told KCBS.

“We are absolutely doing best practice resuscitation and that is do it in the field, do it right away,” Gausche-Hill said, according to the station. “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.”

The second order, noting a need to conserve oxygen, directs paramedics to administer oxygen in the field only to patients with a blood saturation below 90%, with a handful of exceptions.

Los Angeles County remains the hardest-hit county in the United States for both COVID-19 cases and deaths, according to Johns Hopkins University.

The county has had more than 820,000 confirmed COVID-19 cases and more than 10,000 deaths, the university reported.

More than 85 million cases of COVID-19 have been confirmed worldwide with more than 1.8 million deaths as of Jan. 5, according to Johns Hopkins University. The United States has more than 20 million confirmed cases with more than 353,000 deaths.

This story was originally published January 5, 2021 at 8:26 AM with the headline "Swamped by COVID, L.A. tells paramedics not to take worst-case patients to hospitals."