NYT Source Article | Comments Courtesy of Matt Zavadsky

Outstanding article in Sunday’s New York Times.  Our new normal? 

Crisis Standards of Care? 

We will have a treasure trove of data to analyze…  Did withholding CPR on cases with low probably of survival change the overall picture of OOHCA survival?  Do patients treated and transported with 1 provider and a driver (as is allowed in some states now) make any difference in patient outcomes?  Did no transport protocols put in place to preserve hospital capacity result in any adverse patient outcomes?

Shout out to NAEMT’s Medical Director, Craig Manifold for contributing to this story, and tip of the hat to Bill Bullard for sharing it…

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Paramedics, Strained in the Hot Zone, Pull Back From CPR

Their mission is to save lives at any cost. But in New Jersey, the coronavirus has sickened so many emergency workers that some units are holding off on risky procedures like CPR.

May 10, 2020

By Rukmini Callimachi, Photographs by Ryan Christopher Jones

https://www.nytimes.com/2020/05/10/nyregion/paramedics-cpr-coronavirus.html

NEWARK — The calls for patients in cardiac arrest came in one after another.

A 39-year-old man, followed by a 65-year-old, whose neighbor called 911 after getting no response when he rang the doorbell. Then a 52-year-old woman’s heart stopped, as did that of a 90-year-old, who had collapsed on her bedroom floor.

The ambulances turned on their sirens and screamed through red lights. But what the paramedics did after rushing to the victims — or more precisely, what they did not do — is a window into how a deadly virus has reshaped emergency medicine. After confirming that the patients’ hearts had flatlined, they declared each of them dead at the scene, without attempting CPR.

Before coronavirus cases hit hard a few weeks ago, John McAleer, a paramedic who responded to the call for the 90-year-old woman, would have begun chest compressions. His partner would have started an IV to administer epinephrine, which acts as a stimulant. They might have used the defibrillator to try to shock her heart back to life.

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