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LA County Tells EMTs: Don't Bring Patients Who Are Declared Dead On The Scene To The Hospital

Paramedics load a patient into an ambulance before transporting him to a hospital in Los Angeles.
Paramedics load a patient into an ambulance before transporting him to a hospital in Los Angeles.
(Apu Gomes
AFP via Getty Images)
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As the flood of COVID-19 patients continues to overwhelm local hospitals, L.A. County's EMS Agency has issued a directive for ambulances: Stop transporting individuals whose hearts have stopped on the scene to a hospital.

The directive is effective immeidately and applies to adult patients in "blunt traumatic and nontraumatic out-of-hospital cardiac arrest" who did not respond to resuscitation.

It's always been the policy of the EMS agency that paramedics can declare a patient dead in the field. Usually, however, paramedics have the option to transport those patients to hospitals, so the hospital staff can make the formal death declaration and work with mortuaries and the deceased's family to make final arrangements.

Now, if the patient is declared dead at the scene, paramedics will work directly with the coroner's office to handle the body, instead of involving the hospital.

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The policy is a direct response to "the severe impact of the COVID-19 pandemic on EMS and 9-1-1 receiving hospitals," the directive says.

L.A. County Health Services Director Dr. Christina Ghaly told the Board of Supervisors on Tuesday that paramedics will still make every effort to save a patient.

"There's still CPR, there's a minimum of 20 minutes to get spontaneous circulation back, there's requirements to provide medications in the field, there's requirements to transport certain kinds of individuals, all of that is the same. The only thing that's different, is for someone who really has died, who doesn't have return of circulation after all of those valiant efforts -- [for that person] the emergency department [will not] be involved in the management of the deceased's body."

This comes as over-capacity hospitals in L.A. County are moving ICU beds into spaces like cafeterias, conference rooms and outdoor tents, and making plans to ration care.

You can read the full EMS Agency directive here.

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