Paramedics being told when and when not to transport patients, officials say that's nothing new

Is it new or something we just haven’t noticed before? Los Angeles County EMS Directive #6 sounds new and it certainly has been presented as a reaction to the incredible crush of patients being rushed by ambulance to our local hospitals.

Local officials, however, say it's not necessarily new.

The Medical Director of LA says this directive is reaffirming what has been general practice in the past. Dr. Marianne Gausche-Hill says her agency has always encouraged optimal resuscitation in the field.

The directive says that paramedics involved in cardiac arrest cases shall not transport those patients if a pulse is not achieved in 20 minutes of trying.

Says Gausche-Hill, "People’s’ best chance of survival is if they get a good pre-hospital resuscitation. And, after that if they don’t get a good pulse the liklihood of survival is exceedingly low." Far less than a 1% survival rate, she says.

Dr. Clayton Kazan, the LA County Fire Department’s chief physician agrees. Sharing training photos with us, he says paramedics are well trained on resuscitation.

Says Kazan, "Patients in cardiac arrest have the best outcomes if they’re resuscitated where they are instead of scooping them and transporting them in cardiac arrest. So, we’ve been trying to work up patients in the field for 10  years."

Roland Sprewell is the Chief of Public Affairs for LA County Fire. He understands the public may see this as something new, but in practice, he says it’s not really new.

He adds, "We’re and going to treat these patients with the same intensity and same vigor as we’ve always treated these patients in the field."

That goes for the private ambulance companies like Boris Krutonog’s Amwest Ambulance company. His paramedics have dealt with everything from freeway wrecks to now COVID-19 and whose job it is to deliver us to hospital emergency rooms.

Krutonog is also an actor who has appeared in The Hunt for Red October, Star Trek and many other dramas. The COVID-19 pandemic drama is front and center for him and his workers.

He says if he could write a script about it he’d start with the ending.

"Emergency rooms we know are overcrowded... not enough doctors and nurses to get to the happy ending of the good guys winning. We Will! The question is how?," Krutonog said.

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