As of April 2nd today EMS medical teams unable revive a patient with a heart attack on the call they can not bring the patient to the ER.

NYS EMS is totally overwhelmed. The ERs are overflowing (I live around the corner from a hospital; the morgue is a refrigerator truck parked out in front; a fork lift is moving bodies).

We havent yet gotten to where Italy was, rationing care away from those over 65. But we will be there in a week or so. This is what ignoring science looks like, sadly.

These are horrific times, Joel. But you provide no information on this patient as to his/her condition or other conditions.

Before the pandemic, if the EMS can't revive the patient, would they continue CPR on the way to the ER or at some point call the death?

Returning to our current situation, as you say, the ERs are overwhelmed. Medics are exhausted and getting sick themselves. Tough decisions must be made in times of crisis. It's terrible, and I have no doubt the medics are hating it more than anyone.

MM, he is not reporting on a specific patient. He is talking about a new EMS guideline. Previously, EMTs would do CPR and transport to an ER.

Hospitals throughout the country are making (or have already made) guidelines for which people will get care and which won't during this pandemic. It just hasn't been publicized because it would upset so many people.

Right now, this is where we are. The person could be in their 40s, not neccessarily an elder. Taking the person to ER would mean staff trying to revive a person that can't be revived. The time they have put towards that person could have saved someone else. This happens in War it happens in pandemics. Only the strong live.

If people would do what they are told and stay put. We may have helped lower the curve by now. The attitude is "won't happen to me". The only time I go out is when I need food. I have a list and go in and come out. Not other people. They are browsing thru the stores. Taking whole families. I was in a convenience store with 6ft Xs on the floor. An employee coming on shift gets herself a soda and stands right next to me while I am paying. This why an announcement comes over the intercom saying to stay 6ft away from each other.

Does anyone know of any senior who was NOT revived by EMS and who still made it to ER and lived? Because I don't. I was a nurse for many years. The law was that they come to the ER anyway, where resusitation efforts continue. They aren't successful. If someone know an instance where it was any other way, then I would love to hear it. Understand that going to ER in NYC now means you WILL almost certain be exposed to Coronavirus, and as an elder will get it. This is, in these dire times, I believe, a very good rule. I would also tell seniors that now is the time to post your POLST if you have done one, on your refrigerator. This will let EMS know if you even WANT resuscitation. I personally do not, and would loathe putting them through taking me to ER for no reason. I am afraid we are entering close to the times of triage. And we will have to understand what that means. We have been two generations completely spoiled in our country. Those times are now gone for the foreseeable future.

When I had my CPR training, I remember being told that for someone who was in cardiac arrest due to a heart attack (which is caused by a lack of circulation) very often CPR didn't do any good anyway. CPR works much more efficiently for someone whose heart has stopped for other reasons (drowning, electrocution, etc). Not sure if this is still the case anymore, though...
If this is true, I feel terrible for the EMT's who respond...I've known many throughout my career, and they are in the business of saving lives, not standing around doing nothing. As well as the families of the person who passed.
Not easy times for anyone. Sometimes your choices are only bad or worse.

Joel, do you really think that EMS would be engaging in illegal activities or treatment?  These are dedicated people with high standards of devotion to care.   First responders are a special breed of people, like those in the medical and military professions.   

I honesty don't understand how anyone could consider their actions irresponsible.  These men and women often put their lives on the line to save others.     Have you ever done that?   And BTW, what's YOUR profession?

No one is "letting seniors die."   They're triaging, which has to be done in the situation that we're in now, just as triaging is part of military medical care.   These aren't normal times.   

If I wrote to Gov. Cuomo, it would be to complement him on the dedication, devotion and strength he's shown in trying to bring NY through a pandemic.

Joel, don't forget that after a certain amount of time, even with CPR, the individual may have suffered irreversible brain damage.

What's your better idea?

If you think this bad, did you know that hospitals are placing automatic DNR orders on people admitted with COVID-19? Can’t say all hospitals are doing but some are.

And yes, I’d like to know your answer to CMs question. Do you have a better idea?
If we’ve got to pick and choose who lives, why should a senior be picked over a youngster? have you ever done CPR? Did you know that it’s quite traumatic and often results in broken ribs and severe bruising to the chest? Sorry not sorry but I can honestly say I am not in favor of reviving elders who already have a poor quality of life. Why prolong it and cause them further problems? And do you understand that reviving a senior in NYC and taking them to the hospital is likely a death sentence? They will catch COVID. Hell they could catch pneumonia or the flu on a normal day. We need to keep first responders OUT of the hospital too. We need to keep them safe. We need to keep COVID patients OUT of the hospital so that our health care workers are safe.

FWIW.....when my MIL was told she could get a lung transplant at the age of 68, I didn’t think it was fair. We would have loved for her to live until she was 100, to see her grandchildren graduate high school and get married. The only way to survive pulmonary fibrosis is if you get a lung transplant. When her partner said that the doctors said if she was approved for a transplant, she would go to the top of the waiting list....I didn’t think it was fair to the young people already on list. At 68 she’d lived a good life, she was retired, she has traveled. Spent time with her children and grandchildren. She died way too young but to this day, I cannot see how it would have been fair to let her cut in line and get a set of lungs while people much younger died because they didn’t get new lungs.

What I keep thinking about, honestly, here in NYC, with a highly privatized health care system, arguably one of the best...

Its NOT "socialized medicine" that has led to "death panels" and rationing of care.

It's a profit-driven system and a conservative government ignoring science that has led us here.

I grew up in a family with conservative Republican values. Medicare was going to be the end of western civilization. Then, in 1966, just after Medicare came into existence, grandma broke her hip and was able to go to rehab to learn to walk again. I didn't hear so much about "socialized medicine" after that.

I've been reading some of the reports BB and I know it is genuinely dreadful. More like a war zone than anything.

But - it's not the structure, it's the onrush. There's no system in the world could cope with it.

We've just had our second national round of applause 🙄 for the NHS. Of course I love the NHS - it's like Lord Nelson and cricket, instilled in you from birth - but honestly? It brings tears to the eyes in the same sort of way that the general's faithful old charger being led out to inspire the troops would do. You wouldn't necessarily want to ride the poor beast home.

That chap in Ohio seems to have cottoned on pretty quickly and done his state good service. But then he has nothing like the density of population to cope with, or the international travel connections.

CM, it's BB here and yes, it is a war zone. Since they've shut down construction projects, the only sounds are birdsong and ambulance sirens. I live across the street from a housing project and a hospital. All we are hearing are ambulance sirens.

Politics aside, a LOT of people in my State, in my City, in my borough and in my
neighborhood are going to die. Hoping no one in my family. Instructed DH not to have a heat attack and he assented.

Let's acknowledge the fact that most people who undergo CPR do NOT survive. It is like a hail mary pass in football that is a long shot even under the best of circumstances. Only 10-20 percent survive to hospital discharge and they usually have severe impairments that reduce their quality of life. If people really knew what CPR really involves - broken ribs, ventilators, brain damage - I am willing to bet most people would not want it. When my heart gives out, so long and thanks for all the fish.

Worried, what's coming into play in this pandemic is something that some people recognize and acknowledge and others don't: life is not fair, or equal in terms of treatment.   And whether we like it or not, that's the way it is.    You've addressed the issues nicely. 

That's not to say that we shouldn't take precautions.   But, unfortunately, that still doesn't protect us as much as it could b/c others will NOT take precautions but insist on noncompliance.

Barb wrote:  "It's a profit-driven system and a conservative government ignoring science that has led us here."   Thank you for putting this in perspective.    As to science, there were warnings long ago:

"The presence of a large reservoir of SARS-CoV-like viruses in horseshoe bats, together with the culture of eating exotic mammals in southern China, is a time bomb.    The possibility of the reemergence of SARS and other novel viruses from animals or laboratories and therefore the need for preparedness should not be ignored."   Oct., 2007

https://cmr.asm.org/content/20/4/660.full

I guess perhaps I should have said that even without socialized medicine (aka a single payer healthcare system) our health care system has gotten overwhelmed in short order.

Well, it truly depends on the situation. My mom would never ever wish to be resuscitated in any way shape or form and put it in writing. My MIL had strict instructions not to prolong her life. My dad did the same.

I don’t think too many elderly people who are eager to go through a painful process only to die soon after. They would rather die with dignity.

In fact, I know of one elderly man whose daughter decided to try and prolong her father’s life. He suffered broken ribs and terrible discomfort. Guess how much longer he lived? One stinking hour! Cruel to do, if you ask me.

GA that’s absolutely right. Some either recognize it or they don’t. I guess I am lucky because one of the mantras of my generation was “life isn’t fair”. I grew up being told “life isn’t fair” and “life isn’t fair and then you die” regularly. We grew up hearing those words. It was an explanation for a lot of things. If I told my parents something wasn’t fair, they told me “Well life’s not fair”. So to this day.....it makes sense, life isn’t fair. And it’s not fair that it’s inevitably going to come to a point where doctors are picking and choosing who gets to live. I can’t imagine having to make THAT decision. Either way, it’s not fair. They shouldn’t have do choose.

I am curious.....do we know if any of the countries with socialized health care were better prepared and if they are handling the pandemic better than the US?

on the subject of CPR.....it got my uncles heart started again, after very heroic efforts by the paramedics and ER staff. But his brain was already dead. And the reason I mention this is because the end result was that he was placed on ventilator for 4-5 days. On the news they said that, I believe in NY, they are days away from running out of ventilators. So....this order issued in NY to not revive heart attack patients, I get it. It’s not fair but I get it. They need to save the ventilators for those who have a real chance at survival. When my uncle was placed on one, the hospital knew he really had no chance. He was without oxygen for so long that if he wasn’t brain dead, the brain damage would have been catastrophic. He would have been a vegetable. So for me, this order makes sense and I get it. We need to save our ventilators for those who need them most & who have a fighting chance.

Love those adages.

Life is not fair.
Hindsight is 20/20.

Those who complain NOW that something should have been done BEFORE weren't saying anything BEFORE NOW.

Another adage; Talk is cheap.

Grow old gracefully. We should also have Accept death gracefully.

Well, how did our kids coaches all turn into people who gave our kids ‘participation’ trophies? There was no such thing as that when we were growing up.

Anytime we got an award, we earned it. It meant more. Our kids expected it. They saw everybody get a trophy. So weird. That sent a mixed message.

I have all of these trophies that my kids could care less about. They don’t want to clutter their apartments with them. I have them stuck in a closet.

My kids were top level volleyball players but every single kid received a trophy. They did dance and gymnastics.

They competed on the team. Same thing, every kid got a trophy. They loved their activities but they took the trophies for granted.

This is a disaster. A tornado or an earthquake. Or maybe a battle like Pearl Harbor. There are more injured than medical staff or resources can treat. Triage must be performed and resources are used on the people most likely to survive. I pray for the people who must make those decisions.

Some people have accepted this reality. The 90 year old who refused a vent and told her doctors to use it on someone younger is one.

Some people need to "blame" someone for the disaster or the unlimited resources available to respond to it. So even though the CDC developed a test in record time, testing deficiencies caused the spread. One MSNBC correspondent stated "We squandered months. We knew this was coming from late January and only recently began taking it seriously and now it's an all hands on deck." The CDC knew it was coming in late January just like the rest of the world and 5 weeks later they had a test available. How many "months" are in 5 weeks?

Testing deficiencies did not cause the faster spread. The people returning from foreign travel who were told to self-isolate for 14 days and choose not to comply spread this disease. The man who was feeling ill when he landed in NYC from Italy and still flew to his FL home spread the disease. The college students who took spring break on the beach spread the disease. The father who chose to attend his daughter's recital on day 10 of self-isolation only to find out his day 8 test was positive spread the disease. Human nature has and will continue to spread this awful disease.

Playing the blame game in the middle of a battle is not the way to win the war. Everyone needs to be able to focus on waging the war and not taking time to defend themselves, particularly against total lies.

Since most members of the "news" are more interested in being combative and finding someone to blame for something, I suggest not watching all that much news. I would also suggest watching something like Good Morning America or Fox and Friends which has a very different tone (informational and polite even when challenging the interviewee) than many daily shows.

I am enjoying televisions and books more these days. Streaming Disney+ movies or seasons of good TV shows from Hulu - I hope to be still standing when it has past and I pray you will be too. But until then, my daily life will not be ruled by fear and anger - that's just not a life I'm interested in living.

Another opinion here...
CPR works great on TV. It may work well on younger, healthy people. It does not work quite so well on older people particularly ones with other medical issues.
In order to do CPR correctly there is a VERY good chance several ribs will be broken, the sternum as well. IF the person recovers from the heart attack then there is recovering from broken ribs with the distinct possibility of pneumonia due to decreased lung function. And the great possibility of brain death due to lack of oxygen.

And if this is current policy then the policy is not strictly for seniors. It would be for anyone that is having a heart attack. Heart attacks are not strictly limited to seniors. A bit of info thanks Google..Most are middle age and older. Average age for first attack is 66 for men and 70 for women. Risk climbs after age 45 for men and 55 for women.

And this probably should have been my first comment:
I think the key here is..."if they are UNABLE to revive a patient..." if the paramedics can not revive a patient in the field there is a much lower chance of survival if and when they can revive the patient in the hospital.

When my father had his first heart attack at age 84, caused by a blocked artery, he coded twice in the ambulance on his way to the hospital and was twice revived. After the placement of two stents, he went home and lived 5 more years. There were no apparent negative impacts but then his vascular dementia was already advanced. CPR performed by someone with the proper training can save/prolong life _but_ it still is not effective 85+% of the time outside a hospital setting.

If they are unable to revive a patient on the call what chance does the patient even have of being saved if brought to the hospital? My cousin's husband was revived twice- one at home and once in the ambulance- and all it did was cause him to spend two weeks in the ICU before he died.

They have the naval ship docked in New York CIty to deal with people who have heart attacks, strokes, broken bones, that sort of thing. New York is still treating people with heart attacks. Don't worry.

TN,

I totally agree with you that placing blame on each other is not what anyone should be focusing on. The only thing anyone should be focusing on is working together to solve issues.

Thanks for reminding everyone of what is truly relevant. 💗

A few things are demonstravely clear ~ overall and everywhere: there are no Real or Special Protections, provisions, or help for seniors or any with underlying medical conditions ~ they 'say' are most vulnerable. 

For kids, no school, stay home (let carriers roam); for families, don't go to work, etc. For seniors, go anywhere you please at crack of dawn to shop empty shelves before anyone else.  I'm getting the message.  Is anyone else?

I an a RN and briefly heard about the EMS/heart attack controversy in NYC.
Chances are by the time the *someone* recognizes the person is in dire straits & activates EMS and that *someone* on the other end doesn’t know how to initiate Basic life support/CPR, that unfortunately means the person having the acute cardiac episode will be close to passing/if not dead by the time EMS gets there. Medical professionals are trained in triage and have experience to know when enough CPR is enough in a person that has a h/o, age, physical assessment, etc. That’s what they do.

That’s being realistic. It is what it is.

As someone said not to worry -treatment IS indeed still being provided to heart attack patients in NYC.

Bill Gates concluded 5 yrs ago that this (my) country could not efficiently handle a pandemic. Whose administration was that?

Point being there will be plenty of time to blame and dissect and exude negativity after this unprecedented event is over.

Let’s be positive because we WILL get through this.

I have my USA flag up because we’re all just citizens trying to stay healthy and in this case, stay alive!

Follow the CDC recommendations and stay home.
We’re losing 1000s a day to this virus.

Let’s support the system in place and stay positive.

It’s Spring. Look outside and hope you get to see the next one. I myself am optimistic (today). 3 days ago I was in panic mode but it’s a bumpy ride.

There is one more thing you (we all, that is) can do, and that's download the Red Cross app to your phone. Then, should you stumble across someone who appears to be having a heart attack, you can do the most crucial thing of all - be quick, and start CPR.

Obviously, in these challenging times, you will also have to make the decision about whether to risk infection yourself; because you cannot perform chest compressions (let alone mouth-to-mouth) on a person without exposing yourself to any virus s/he might be carrying.

But that will be totally academic if you don't know what to do anyway. So get the app. Practise the drill on a cushion. Hope you never have to do it for real.

I think this underlines the necessity that all of us need to be especially proactive in looking after our health needs beyond covid19 - adhere strictly to your medication and diet regimes and don't even think about trying anything even remotely risky lest an accident necessitate a trip to the ER.