‘Things Are Worse Than People Think’: LA County Official On New Directives For EMS

Los Angeles County paramedics examine a prospective COVID-19 patient sitting on the sidewalk prior to carrying him to a medical facility in Hawthorne, Calif., on Dec. 29, 2020.

Apu Gomes/AFP by means of Getty Images

toggle caption

hide caption

Apu Gomes/AFP through Getty Images

In an interview with All Things Considered, Bosson discusses what Mondays orders indicate and what is being done to resolve the issues. Here are excerpts.

And rather of having each specific system, generally 2 paramedics or two EMTs, monitoring a single patient, they will be able to offload the clients and have a paramedic or EMT as suitable, staffing the location and keeping track of a number of clients at a time. … And we have a medical officer on responsibility 24/7 to assist consult in terms of recognizing the most critical clients and getting them into the healthcare facility as quickly as possible and determining which clients may be stable, say, to go to the waiting room and be triaged in through the walk-in procedure.

The waits for ambulances to offload patients at health centers are getting longer. What is being done to attend to that scenario?

The shift towards not transferring clients who do not have remediation of pulse is a fairly small change. And so these are the clients that were asking the paramedics to call in to our base medical facilities, talk about with the base doctor and figure out if more resuscitation is futile and therefore end resuscitation on scene. We are continuing to resuscitate clients in cardiac arrest, and we continue to transfer all clients in whom our paramedics are able to resuscitate in the field.

And instead of having each specific system, normally 2 paramedics or two EMTs, keeping an eye on a single patient, they will be able to offload the clients and have a paramedic or EMT as appropriate, staffing the location and keeping track of numerous patients at a time. … And we have a medical officer on task 24/7 to help consult in terms of determining the most critical patients and getting them into the healthcare facility as rapidly as possible and determining which clients may be stable, state, to go to the waiting room and be triaged in through the walk-in procedure. And by this method, were attempting to get more ambulances back into the field to respond to the vital emergency situations and lower the problem on the healthcare facilities as well, because we understand they do not have the staff to keep track of these clients.

And so these are the clients that were asking the paramedics to call in to our base medical facilities, discuss with the base physician and identify if more resuscitation is useless and for that reason terminate resuscitation on scene. We are continuing to resuscitate patients in cardiac arrest, and we continue to transport all clients in whom our paramedics are able to resuscitate in the field.

How worried should Angelenos be about the availability of oxygen right now? I think of oxygen supplies will only get stretched even more in the weeks to come.

I wish to begin with some of these brand-new directives that weve been becoming aware of, like not generating patients who have little probability of survival. Can you put that in context for us? How amazing is that procedure?

In Los Angeles, ambulances are awaiting hours– up to 8, in some cases– to confess brand-new patients at overloaded medical facilities. The variety of coronavirus patients in ICUs has more than quadrupled considering that the start of November.

On Monday, LA Countys Emergency Medical Services Agency directed EMTs not to bring people who have long shot of survival in to medical facilities and to conserve oxygen out in the field.

And with the vacations just behind us, public health officials warn that the circumstance could become worse for emergency situation services.

They are spending more time waiting to unload clients at medical facilities. And these patients require oxygen. And if we can not get extra tanks and can not fill the tanks, we run the risk of to run out of oxygen for patients who need it.

” A lot of whats happening today, although people are discussing it, people are reporting about it, individuals arent actually seeing it. And the truth is, things are even worse than individuals think,” states Dr. Nichole Bosson, assistant medical director at the Los Angeles County Emergency Medical Services Agency. “And I state that due to the fact that I see how people are still gathering together in groups and making decisions to have household events or New Years celebrations. And these decisions are what continues to affect our healthcare system.”