If you live in LA County and need oxygen or hospital-supplied resuscitation, you may — or may NOT — receive it.
This is not fiction! This is real, folks, as per a new directive (EMS USE OF OXYGEN, DIRECTIVE #7) just issued by the Emergency Medical Services Agency, Los Angeles County.
"Given the acute need to conserve oxygen, effective immediately, EMS should only administer supplemental oxygen to patients with oxygen saturation below 90%. For patients with hypoxia (O2 saturation <90%), the minimum amount of oxygen necessary to maintain the oxygen saturation at or just above 90% shall be administered. An oxygen saturation of 90% is sufficient to maintain normal tissue perfusion in most patients." —
What's more, the LA Times reports that ambulance crews have not only been advised to cut back on their use of oxygen but "to not bring to hospitals patients who have virtually no chance of survival," EMS USE OF OXYGEN, DIRECTIVE #6.
"Effective immediately, due to the severe impact of the COVID 19 pandemic on EMS and 0-1-1 Receiving Hospitals, adult patients in blunt traumatic and nontraumatic out-of-hospital cardiac arrest (OHCA) shall not be transported if return of spontaneous circulation (ROSC) is not achieved in the field."
It seems the oxygen demands of COVID patients in respiratory distress require significantly higher levels of O2 input than the general patient population (60 to 80 liters of oxygen per minute vs. 6 liters per minute).
This has led to an oxygen crisis of mammoth proportions, leading local authorities to literally choose who will live and who will die.
But surely Gavin Newsom and the local representatives will find a rapid solution. Oh, wait. Nevermind.
In the meantime, Dr. Jeffrey Gunzenhauser, L.A. County's chief medical officer, says his team is doing everything it can to ease the crisis, from sending patients who only need observation home or to nursing facilities, to downgrading some critical patients to step downwards and postponing medically necessary surgeries for lack of beds (all measures we've seen before, in say, NYC for example).
And the US Army Corp of Engineers is deploying crews to LA to assess and update O2 delivery systems.
In the meantime, let's hope and pray that all who are left with the "life in their hands" decisions choose wisely.
