Nursing staff need to wait for several hours before sending the patient.
The ambulance passed one hospital to another hospital.
Some people who are worried about their health call 911 for help-just to hear that their condition is not enough for urgent transportation.
The consequences of the coronavirus surge caused by holiday parties and pandemic fatigue have become more dire every day. The pandemic has killed thousands of Southern California families, and the death toll is on the rise. The hospital that was violently attacked by the case is paralyzed.
Now, even the ambulance service is very tight.
Medical staff throughout Southern California are facing longer and longer waiting times to reduce the burden on hospital patients. In turn, when an ambulance is needed elsewhere, this can cause logistical complications. Sometimes, the response to the 91
Counties and cities respond to crises in different ways, such as moving ambulances to hospitals that are not as busy as other hospitals or increasing resources. In Los Angeles County, health officials stepped up a horrible, albeit already in place, nursing staff strategy: if you can’t recover the patient’s pulse on the spot, don’t go to the hospital.
Jeff Lucia, spokesperson for the Ambulance Service in Los Angeles and Orange County, said: “EMT and paramedics are frustrated.
However, if the situation worsens (officials expect to continue until at least January), health officials can further allocate emergency response services.
Health officials warned that doing so could lead to more tragedies.
Not only from the coronavirus.
Long waiting time
This is how long a Torrance ambulance waited for a patient at the Centinela Hospital Medical Center in Inglewood on Monday, January 4.
The medical staff used their to language to describe the time waiting for the patient to be admitted: wall hanging time.
Ten hours is a long time, nothing to do. However, the practice of the medical staff of Torrance’s private operator McCormick ambulance is getting better.
Torrance Assistant Fire Department Chief Alec Miller (Alec Miller) said: “They are notorious, and the wall hanging time is now 10 hours.”
However, Centinela is not alone.
Overcrowding causes long waiting times in hospitals throughout the region. Lucia said that in Los Angeles County, ambulances often idling for eight to twelve hours to treat patients.
Medical staff in Orange, San Bernardino, and Riverside counties sometimes have to wander for hours before admission.
Boredom is not the only side effect.
“We have a few times that McCormick was unable to provide an ambulance for our phone,” Miller said. “If one of their units ceases production, it will affect the entire system.”
Steve Tracy, a spokesperson for the San Bernardino County Fire Department, is more direct:
He said in an interview at the end of last year that if the ambulance is tied up, “it cannot respond to other emergencies.”
Moreover, this situation has become so bad, especially in Los Angeles County, it has become increasingly difficult to keep up with the call.
Lucia said: “No matter how many ambulances we wear, they are all tied up in the hospital and are not going to clean the next phone.”
However, these delays are not inevitable. There are solutions.
But this requires some creativity.
Looking for a solution
One such strategy is transfer.
This strategy is a way of balancing resources by letting an ambulance go to one hospital instead of another, even if it needs to travel farther than normal.
On any day in the past week, 70% to 90% of Los Angeles County hospitals were in a metastatic state because they were unable to accept patients requiring advanced life support. A few hospitals also declared an “internal disaster” and shut down various ambulances to reduce the pressure on the staff.
According to the OC Health Care Agency, one day earlier this week, 22 of the 25 emergency reception centers in Orange County reorganized emergency personnel due to slow turnover in the emergency room.
However, some health officials say that if every hospital needs to transfer new arrivals, the strategy will become impeccable.
This is why Orange County’s health agency banned hospitals this week from transferring ambulance capacity-the second time in two months. The county’s emergency medical services director, Dr. Carl Schultz, also temporarily suspended this practice in December.
Schultz said in an explanatory explanation in mid-December: “If no measures are taken, the ambulance will be quickly taken away from the hospital and the patient may be admitted.” “Although this (ban) will bring more to the hospital. A lot of pressure, but it will spread throughout the county.”
However, not all hospitals have experienced long delays of several hours.
For example, Miller, the assistant fire chief at two Torrance hospitals, said that both Torrance hospitals had normal waiting times early on Tuesday, averaging about 30 minutes.
But both the Providence Small Company at Mary Medical Center and Torrance Memorial Medical Center have reverted to the strategy they originally used at the beginning of the pandemic: they set up triage units outside the emergency room to treat patients if necessary.
In short, Los Angeles County officials are setting up triage tents outside seven hospitals this week to ease the trouble of queuing.
At the same time, California has started using its fire and rescue mutual aid system (often activated in response to wildfires) to help the state respond to COVID-19.
For example, deploying firefighters’ medical staff and EMT to the emergency room for 14 days of operation-providing much-needed backup for exhausted hospital staff. The University of California Irvine Medical Center and Barstow Community Hospital are among the facilities that receive additional bodies.
Some local agencies also assume responsibility for increasing resources.
Riverside County is asking the American Medical Response Company, which has an emergency medical transportation contract, to provide more ambulances, said Shane Richter, spokesperson for the county’s emergency management department.
Fire Department spokesman Captain Jack Krabert said that Long Beach in Los Angeles County added four ambulances to its fleet around Christmas.
Two of these ambulances are specifically for patients showing coronavirus-related symptoms.
Long Beach also benefits from a more flexible form of computerized transfer.
Crabtree said that St. Mary’s Medical Center, operated by Dignity Health, has a computer network that connects to other hospitals in the Long Beach area to track available resources among peers.
Officials there will tell the medical staff which hospital to send each patient to.
Crabtree said the result is that when paramedics are busy, they effortlessly send patients to the hospital.
“Even though it seems that people are busy,” Crabtree said, “when the public still calls 911 and needs help, we want them to know that we are responding.”
Not answering certain calls
Overall, this is still the case throughout the region.
Even in Los Angeles County, the current national center of the pandemic.
Dr. Clayton Kazan, medical director of the Los Angeles County Fire Department, said that despite the overall increase in emergency calls (mainly due to coronavirus-related requirements), the response time at the scene has not been affected.
But response time usually refers to how long it takes for an ambulance to get from one location to the place where the 911 call is-not the logistical task of determining which medical staff to dispatch.
Therefore, health and public safety officials are beyond the scope of transferring and diverting tents, and can resolve long hospital waiting times by allocating emergency services.
Officials say a common way is to direct 911 callers to other less serious issues in the health system, such as emergency care, clinics or their medical providers.
Eric Sherwin, a spokesperson for the San Bernardino County Fire Department, said, for example, some people call 911 because they want to be tested for the coronavirus or do not have medicine.
Sherwin said that San Bernardino County is currently bringing 25 to 50 people to other places every day instead of calling an ambulance to take them to the emergency room.
Sherwin said the requirement for coronavirus testing is an example of “this policy is really helping us.”
However, San Bernardino County will still send emergency personnel to less urgent phones, but there is no direction.
For example, if someone calls 911 because their symptoms are consistent with COVID-19 or the flu, but do not seem to be hospitalized, the county will send emergency personnel to help.
Officials say the strategy adopted in November has also successfully reduced the pressure on medical staff who had previously leaned on the hospital wall for more than half a day.
Sherwin said the result is that medical staff have been able to make people experience a real emergency to the hospital as quickly as possible.
At the same time, LA County has gone further.
Health officials there have told medical staff in one of several recent instructions not to transfer residents of skilled nursing facilities or patients receiving hospice care to the hospital if they refuse to use ventilators and other life-saving treatments.
Another directive tells medical staff not to provide supplemental oxygen to patients unless the patient’s saturation drops below 90%, instead of the traditional 93%. The normal oxygen saturation level is about 95%.
One third instructed ambulances not to transport patients to the hospital if they had little chance of survival.
However, the instruction is not as drastic as it seems. In fact, the recovery policy remains unchanged.
The county health services director, Dr. Christina Ghaly, said on Tuesday: “The effort to restore blood circulation has not changed. It takes at least 20 minutes, (or) to provide medication and transport individuals in the wild.” “The only difference. Yes, for those who have died, there is no emergency department involved in managing the remains of the deceased.”
Officials said none of these new directives greatly deviated from typical standards of care.
However, if the coronavirus does not decrease, they may be the forerunner of stricter rationing.
Talk about prospects
Moreover, officials say that long waiting times for ambulances and rationed care can be catastrophic for people suffering from non-coronavirus emergencies (such as those who have had a heart attack or a serious car accident).
Bring heart attack and stroke survivors. Officials said they will still be taken to the hospital for treatment. However, it may take longer to get care.
In these cases, getting care quickly is essential for recovery.
Health officials say there are others who may have a treatable condition but are not getting enough care.As a result, these situations will become more severe and may even be fatal
Los Angeles County Public Health Director Barbara Ferrer said on Monday: “Our hospital’s high census of COVID-19 patients is frustrating. “Not only for those with COVID-19, but also for the county. For all those who need urgent care. Those who have suffered a stroke, heart attack, or trauma have more difficult access to medical care than it was a month ago. “
However, although medical staff and hospital leaders have made difficult choices in healthcare, strict rationing has not yet begun.
In fact, no hospital has announced an official crisis care standard, which will put them in a triage situation similar to natural disasters.
But some people worry that the area might get there soon.
Carmela Coyle, President and Chief Executive Officer of the California Hospital Association, said: “Doctors, nurses, respiratory therapists and others are excited about it, because in the next few weeks, the care of neighbors We will face a very difficult environment, our family and friends.”
Health officials say the only hope is to curb this growth. Otherwise, countless coronaviruses will die.
Including those who have never signed.
Staff writers Jeff Horman, Jeff Hunt, Nathaniel Percy and Ian Wheeler contributed to this story.