Sunday, September 20, 2020


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Who Lives? Who Dies?

            The COVID-19 pandemic has brought out the best and worst in people.

            Day after day we hear and read about wonderful things that wonderful people are doing for others.  Sacrifices being made and folks going above and beyond to help others get through these trying times.

            But, there are plenty of examples of decisions and actions that leave us wondering what has become of our values.  Decisions that make us doubt the people making them.  Doubts that people shouldn't have at this critical time in history.

            The latest one, which happened just this week, is the order issued by the Bureau of Emergency Medical Service of New York.  The order directed emergency service workers not to attempt to revive anyone without a pulse when they arrive on a scene during the coronavirus pandemic. 

            The directive said the change was "necessary during the COVID-19 response to protect the health and safety of EMS providers by limiting their exposure, conserving resources, and ensuring optimal use of equipment to save the greatest number of lives.

            To their credit, New York City's Fire Department and other first responders were outraged and didn't adopt the new "no revival" directive from the state. 

            A previous directive instructed first responders to spend up to 20 minutes trying to revive people found in cardiac arrest before the state had issued the latest, drastic change.

            Less than 24 hours after the directive hit the news media, State Health Commissioner Dr. Howard Zucker "rescinded" the "do-not-resuscitate" order.  His reported response was, in part "This guidance, proposed by physician leaders of the EMS Regional Medical Control Systems and the State Advisory Council - in accordance with American Heart Association guidance and based on standards recommended by the American College of Emergency Physicians and adopted in multiple other states - was issued April 17, 2020 at the recommendation of the Bureau of Emergency Medical Services, and reflected ?nationally recognized minimum standards."

            He added, however it doesn't reflect New York's standards and for that reason it was ordered to be rescinded.

            Issuing the order, and reading the words "nationally recognized minimum standards" along with all of the quoted groups issuing guidance is unnerving. This is something that any appointed government official can declare.

            Throughout our nation we have highly trained emergency medical first responders who are in a much better position to make that call, when they arrive at the scene, than an appointed official sitting in the state capital - no matter how much data they have access to.

            The pandemic we are in presents all of our first responders with decisions they have to make, on the spot, and using their best knowledge and training.  It is bad enough that they may have to make decisions that you and I cannot fathom.

            We all just want what is best for the patient.  To be told that you shouldn't even try to save a life is appalling.

            Life or death of a patient should not be predetermined from an office using a narrative out of the book sitting on the desk in front of you.
            I trust our first responders.






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