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Old 2021-01-05, 19:31   #1244
Dr Sardonicus
 
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Quote:
Originally Posted by Uncwilly View Post
So here is how bad it is in the Los Angeles area:
https://abc7.com/9358924/
A bit of digging turned up some actual directives. Grim stuff. EMS Transport of Patients in Traumatic and Nontraumatic Cardiac Arrest (image, can't copy text) and

HOSPITAL EMS SURGE ASSISTANCE PLAN: COVID-19 RESPONSE. (DRAFT)

Quote:
PURPOSE: To manage 9-1-1 ambulance resources during periods of prolonged ambulance patient offload delays at hospital emergency department (EDs) by coordinating resources through a regional EMS/Fire Department Response Framework: Hospital EMS Surge Assistance Plan.
<snip>
J. Patients arriving via ambulance shall be categorized as:

a. Morgue (black) – Patients arriving at the hospital in cardiac arrest shall be immediately assessed for prognosis and futility of effort. If futility is determined, resuscitation shall be terminated. Morgue patients shall be received by the hospital and captured in the hospital eMR. The decedent shall not be transferred to an ED treatment station but rather transported to the hospital morgue in order to release the ambulance crew back into service.

b. Immediate (red) – These are patients who exhibit severe respiratory, circulatory or neurological symptoms that would likely result in significant morbidity or mortality if not addressed within 1 hour. These patients require rapid assessment and medical intervention. Patients in this category shall be given priority to offload to an ED treatment station when available. In the absence of an available ED treatment station, these patients shall be offloaded in the ARS or assigned an ambulance parking space closest to the hospital EMS Triage Officer. In this situation, the ambulance back doors should remain open so patients may be directly observed. Immediate patients shall further be categorized to ensure that the most gravely ill is assigned a place closest to the ED ambulance entrance for transport into the ED as soon as directed by the hospital EMS Triage Officer or the AREP may notifiy the MAC and the EMS Agency MOD for possible rerouting.

c. Delayed (yellow) – These are patients who have a potentially serious medical or surgical condition but who are stable to wait until resources are not encumbered. These patients will typically require a gurney upon arrival at the hospital. Delayed patients shall be offloaded to stretcher or cots in the ARS. The Hospital EMS Triage Office shall ensure that delayed patients are captured in the hospital’s eMR. Hospital personnel or EMS Providers shall be assigned to monitor these patients. EMTs and/or paramedics may be assigned to monitor up to 4 patients.

d. Minor (green) – These are patients who are alert and oriented, able to sit in a chair, and medically stable. These patients shall be taken to the ED waiting room as per Directive #4 EMS Offload of ALS and BLS Patients to The Emergency Department Waiting Room dated 12-23-20. The Hospital EMS Triage Officer shall ensure these patients are captured in the hospital’s eMR.

Last fiddled with by Dr Sardonicus on 2021-01-05 at 20:00 Reason: Clarification (DRAFT)
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Old 2021-01-06, 13:30   #1245
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An update on this post:

I am pleased - very pleased, in fact - to inform one and all that my aunt and uncle are now feeling well, with temperatures back down to normal, after he (and most likely she) had been infected with COVID-19.
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Old 2021-01-06, 17:13   #1246
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Quote:
Originally Posted by Dr Sardonicus View Post
...I am pleased - very pleased, in fact - to inform one and all that my aunt and uncle are now feeling well, with temperatures back down to normal, after he (and most likely she) had been infected with COVID-19.
Excellent!

The county where I live in Indiana is now on a Red Advisory Level based on county metrics. I am not sure exactly what this is. It does not sound good.
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Old 2021-01-06, 17:38   #1247
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Originally Posted by storm5510 View Post
<snip>
The county where I live in Indiana is now on a Red Advisory Level based on county metrics. I am not sure exactly what this is. It does not sound good.
Your hearing is excellent!

The Indiana Department of Health's Color-coded County Maps page gives the skinny. The color coding uses two metrics. The Red zone is:

7-Day Positivity Rate (All Tests) 15% or greater


Weekly Cases Per 100,000 Residents 200 or more new cases
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Old 2021-01-06, 18:09   #1248
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Quote:
Originally Posted by Dr Sardonicus View Post
An update on this post:

I am pleased - very pleased, in fact - to inform one and all that my aunt and uncle are now feeling well, with temperatures back down to normal, after he (and most likely she) had been infected with COVID-19.
Wonderful news!
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Old 2021-01-06, 18:12   #1249
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I got a personal report from a healthcare worker in the Los Angeles area. Routinely they have to call the coroner's office after any death, so that the coroner's office can hear the basic facts and decide to investigate or not. This is required to be done by an RN or higher. This is normally a very quick process. In the last day or 2 there have been cases where the RN had to wait on hold for 20 minutes just to speak to someone. So, that is 20 extra minutes out of their time away from patients. In a larger hospital that could add up to a full time position equivalent.
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Old 2021-01-07, 00:52   #1250
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Quote:
Originally Posted by Uncwilly View Post
I got a personal report from a healthcare worker in the Los Angeles area. Routinely they have to call the coroner's office after any death, so that the coroner's office can hear the basic facts and decide to investigate or not. This is required to be done by an RN or higher. This is normally a very quick process. In the last day or 2 there have been cases where the RN had to wait on hold for 20 minutes just to speak to someone. So, that is 20 extra minutes out of their time away from patients. In a larger hospital that could add up to a full time position equivalent.
I read a short time ago first responders in L.A. County have been instructed not to bring in anyone whose survival chance are poor. As Uncwilly indicated above, this is about making the best use of their time.
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Old 2021-01-07, 01:00   #1251
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Quote:
Originally Posted by storm5510 View Post
I read a short time ago first responders in L.A. County have been instructed not to bring in anyone whose survival chance are poor.
You mean this?
Quote:
Originally Posted by Uncwilly View Post
So here is how bad it is in the Los Angeles area:
https://abc7.com/9358924/
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Old 2021-01-07, 01:28   #1252
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Quote:
Originally Posted by storm5510 View Post
I read a short time ago first responders in L.A. County have been instructed not to bring in anyone whose survival chance are poor. As Uncwilly indicated above, this is about making the best use of their time.
As posted here, a pdf image of the actual directive "EMS Transport of Patients in Traumatic and Nontraumatic Cardiac Arrest" may be seen here.
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Old 2021-01-07, 03:30   #1253
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Quote:
Originally Posted by Dr Sardonicus View Post
my aunt and uncle are now feeling well
Way to go! Good news!

Last fiddled with by LaurV on 2021-01-07 at 03:31
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Old 2021-01-20, 01:52   #1254
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https://www.npr.org/sections/coronavirus-live-updates/2021/01/19/958354466/cremation-limits-lifted-in-la-due-to-backlog-as-covid-19-deaths-skyrocket

Quote:
"The current rate of death is more than double that of pre-pandemic years, leading to hospitals, funeral homes, and crematoriums exceeding capacity without the ability to process the backlog of cases," officials said.
Quote:
As of Jan. 15, more than 2,700 bodies were being stored at hospitals and the coroner's office, according to the order. It adds that the county's 28 crematoriums have the "resources and capability" to perform more cremations than regulatory limits allow.
Quote:
The South Coast Air Quality Management District said in a press release Sunday that it is suspending certain permit conditions for crematoriums at the request of the county's medical-examiner coroner and public health department. Crematorium permits typically carry limits based on potential air quality impacts, but can be suspended during a state of emergency.
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