Henry Mayo medical director on ambulance transports, overwhelmed ERs countywide

Henry Mayo Newhall Hospital.

Amid reports of the nightmarish circumstances in overrun Southern California hospitals, Henry Mayo Newhall Hospital officials said Tuesday while resources are thin, the hospital hasn’t been impacted by a recent order that prevents ambulance crews from transporting patients with slim chances for survival. 

The intensive care units in Los Angeles County and the rest of the Southern California region have remained at 0% capacity for weeks on end during the recent COVID-19 surge, in which L.A. County has seen more than 14,000 new cases per day for the past week.  

It’s a dire situation in many areas: Hospitals are setting up for care in parking lots, ambulances are waiting several hours to offload new patients and those with non-life-threatening emergencies are waiting several more hours in the emergency waiting rooms. 

The Santa Clarita Valley hospital, which issued a “code triage” last month due to staffing shortages amid a large number of COVID patients, is feeling the effects of the COVID-19 surge but “not nearly to the degree as others in the general area, such as in the San Fernando Valley,” according to Dr. Bud Lawrence, medical director of Henry Mayo’s Emergency Department.

“Yes, occasionally paramedic ambulances or non-paramedic ambulances may have to wait with a patient on their gurney to get a bed to put that patient into, but that is happening everywhere,” he said. “Unfortunately, Los Angeles is, essentially, the COVID epicenter of the world right now.” 

As of Tuesday afternoon, the average wait time at Henry Mayo marked “300 minutes” on its website, a number that is fluid, according to Lawrence. 

A Jan. 4 memo issued by L.A. County EMS Medical Director Marianne Gausche-Hill now orders ambulance workers not to transport adult people to hospitals if their heart stops beating and those who cannot be resuscitated at the scene, such as victims of heart attacks, shootings and stabbings. The order became effective “due to the severe impact of the COVID-19 pandemic on EMS and 9-1-1 receiving hospitals,” reads the directive.   

Henry Mayo does not have control over the directive and only controls “what’s brought to us,” but Lawrence said he understands why the county has issued the directive. 

“They’re basically saying that if we cannot get the heart beating again, we’re not going to transport the patient to the emergency room, which, I know can be very disconcerting to the family members or people that are on the scene … but in reality, what the county is saying is that some of these efforts may be futile in these very specific, certain situations, and they don’t warrant transportation to the hospital.” 

This directive comes at a time when resources for hospitals are stretched thin. And those resources most likely will get thinner over the next two weeks with the holiday surge in COVID-19 numbers expected to continue, according to Lawrence. 

“We have our resources stretched so very thin and we have to be very deliberate about how we utilize those resources,” he said. “We’re going to see a real thinning of our resources, not only hospital beds but nurses, respiratory therapists and things like ventilators and certain medications — and there are difficult decisions that have to be made, and this is one of them.” 

What hospitals are seeing still represents the cases resulting from the Thanksgiving holiday, according to Dr. Christina Ghaly, director of health services for the county, during a Monday briefing. 

“We do not believe that we are yet seeing the cases that stemmed from the Christmas holiday,” she said. “This, sadly, and the cases from the recent New Year’s holiday, is still before us, and hospitals across the region are doing everything they can to prepare.”

County Supervisor Kathryn Barger, whose 5th District includes the SCV, wrote a letter to Gov. Gavin Newsom Tuesday, requesting additional nurses and respiratory care practitioners from the Army National Guard. 

“All counties in this state are experiencing this same surge, which is why an injection of additional staff to the entire system from the National Guard is necessary,” she wrote. 

On Tuesday, the county reported a new high in COVID-19 hospitalizations with a total of 7,898 currently admitted, of which 21% are in the ICU. The figure is an increase of more than 200 patients since Monday, according to the county Public Health Department. 

Lawrence reiterated that residents should continue wearing masks, washing their hands and get tested for COVID-19 when presenting even mild symptoms that are cold- or flu-like. 

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