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NY issues do-not-resuscitate guideline for cardiac patients amid coronavirus
New York state just issued a drastic new guideline urging emergency-services workers not to bother trying to revive anyone without a pulse when they get to a scene, amid an overload of coronavirus patients. While paramedics were previously told to spend up to 20 minutes trying to revive people found in cardiac arrest, the change is “necessary during the COVID-19 response to protect the health and safety of EMS providers by limiting their exposure, conserve resources, and ensure optimal use of equipment to save the greatest number of lives,’’ according to a state Health Department memo issued last week. First-responders were outraged over the move.
“They’re not giving people a second chance to live anymore,’’ Oren Barzilay, head of the city union whose members include uniformed EMTs and paramedics, fumed of state officials. “Our job is to bring patients back to life. This guideline takes that away from us,” he said. Earlier this month, the Regional Emergency Services Council of New York, which oversees the city’s ambulance service, issued a new guideline that said cardiac-arrest patients whose hearts can’t be restarted at the scene should no longer be taken to the hospital for further life-saving attempts.
City hospitals have been inundated with dying coronavirus patients to the point where there are frequently no ICU beds. But under the regional council’s directive, emergency workers were still told to work on cardiac-arrest patients on scene for up to 20 minutes. The new state Health Department guideline wipes out the 20-minute effort. “Now you don’t get 20 minutes of CPR if you have no rhythm,” a veteran FDNY Emergency Medical Services worker told The Post, referring to cardiac-arrest patients who have no heart beat when paramedics arrive at the scene. “They simply let you die.” The paramedic acknowledged that only about three or four out of every 100 patients with no pulse — “a small percentage” — are actually brought back to life through CPR and other aggressive intervention such as drugs and hospitalization. But “for those 3 or 4 people, it’s a big deal,” the worker said.
The FDNY swiftly issued a letter Friday, the day after the state’s recommendation, telling city emergency-services workers that “the NYC 911 system will continue to maintain a higher level of care,” meaning attempted revivals at scenes would continue. The state Health Department insists that its new guideline has been in use “in many areas of the US as well as other locations throughout the world” — even pre-COVID-19. “These changes are based on standards widely agreed upon by the physician leaders of EMS Regional Medical Control Systems across NYS and the Medical Standards Committee of the State Emergency Medical Services Advisory Council,” a department rep told The Post in a statement.
https://nypost.com/2020/04/21/ny-issues-do-not-resuscitate-guideline-for-cardiac-patients/