New EMT directive limits some hospital transports as NYC hospitals fill with COVID-19 patients

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NEW YORK — As New York City hospitals become more crowded with COVID-19 patients, a new directive for EMT workers shows the harsh reality of the coronavirus crisis and the strain on the health care system.

According to a memo from the Regional Emergency Medical Services Council of New York City (NYC REMAC), paramedics are being told not to transport cardiac arrest patients to the hospital if they can not restart their heart and revive them in the field.

The new guidelines are part of an attempt to alleviate the strain on hospitals and health care workers and comes as 23% of EMS workers out sick and fleets stretched thin amid record call volume.

As of Wednesday, New York City had a recorded 47,439 cases of COVID-19, with nearly 10,000 of those patients hospitalized. The coronavirus death toll in NYC has risen to nearly 1,400.

Thursday, an FDNY official sent the specific guidelines for adult cardiac arrest patients to PIX11:

  • If a DNR is presented or the patient meets criteria for obvious death (ex. rigor), do not initiate resuscitation.
  • In all other cases, resuscitation shall consist of the minimal number of providers necessary (to limit exposure), wearing proper PPE (N95, eyeshield, gloves and gown).
  • If after performing CPR for 20 minutes, the AED indicates “no shock indicated” or the ALS monitor shows a non-shockable rhythm and the patient has not achieved return of spontaneous circulation (ROSC), terminate resuscitation (CPR).
  • Each occurrence will be document by the department.

The guidelines are for cardiac arrest patients over the age of 18 only, according to the FNDY.

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