Arizona institutes 'crisis standards' of care, i.e. the most sick will not receive scarce resources

[essentialsaltes]

TUCSON (KVOA) - Arizona is now under "Crisis Standards of Care'. Soon, healthcare workers may have to start following triage protocols.

Former Arizona Department of Health Services Director Will Humble said doctors will have to prioritize patients using a point system that follows a four-step process. A stark reality for some patients whose care is dependent on how they score.

"The closer you are to multi-organ system failure, the lower priority you'll be. That's counterintuitive I think," Humble said. "You might think that the ones in the worst shape are the ones that get the limited resource. But when you're in crisis standards of care, what it means is that the ones that are most likely to benefit from the treatment are most likely to get the treatment."

 

[dogs4thewin]

How do they know barring someone who is terminal who is most likely to benefit from treatment?

 

[essentialsaltes]

How do they know barring someone who is terminal who is most likely to benefit from treatment?

They don't know for certain, but it's a reasonable rule on average, so it will save more lives than flipping a coin.

 

[dogs4thewin]

They don't know for certain, but it's a reasonable rule on average, so it will save more lives than flipping a coin.

I saw that this is likely to happen later this month. I would think that that would ONLY mean if the cases do not change ( lower).

 

[hedrick]

I hope this is to be used only in case they really can’t treat everyone. It follows standard triage principles. But in the East we mostly avoided getting into that situation.

 

[Desk trauma]

I saw that this is likely to happen later this month. I would think that that would ONLY mean if the cases do not change ( lower).

This is what "spreading it quicker" looks like.

 

[dogs4thewin]

This is what "spreading it quicker" looks like.

so if the cases were to go down they will not have that problem I would also assume that they also take volunteers first.

 

[hedrick]

I saw that this is likely to happen later this month. I would think that that would ONLY mean if the cases do not change ( lower).

With a few weeks notice I'd think they could expand capacity. NJ got Federal help to set up temporary facilities. If things got really bad, most hospital patients would be handled in them. The hospitals would become big ICUs, and everyone else would go to a temporary facility. We also had our hospitals double capacity. We didn't say how: put people in the halls or cafeterias. They managed to do it. I'd think they might be able to get volunteer staff from other states, given a bit of notice. Again, NJ did that. We've been known to loan ventilators to other states that need them.

The IHME site shows that we had 3000 patients in ICU at the peak with 466 ICU beds.

 

[dogs4thewin]

With a few weeks notice I'd think they could expand capacity. NJ got Federal help to set up temporary facilities. If things got really bad, most hospital patients would be handled in them. We also had our hospitals double capacity. We didn't saw how: put people in the halls or cafeterias. They managed to do it. I'd think they might be able to get volunteer staff from other states, given a bit of notice. Again, NJ did that.

yeah I would think if they know this is coming they would try to avoid.

 

[TLK Valentine]

TUCSON (KVOA) - Arizona is now under "Crisis Standards of Care'. Soon, healthcare workers may have to start following triage protocols.

Former Arizona Department of Health Services Director Will Humble said doctors will have to prioritize patients using a point system that follows a four-step process. A stark reality for some patients whose care is dependent on how they score.

"The closer you are to multi-organ system failure, the lower priority you'll be. That's counterintuitive I think," Humble said. "You might think that the ones in the worst shape are the ones that get the limited resource. But when you're in crisis standards of care, what it means is that the ones that are most likely to benefit from the treatment are most likely to get the treatment."

I thought Obama was supposed to be the guy with the Death Panels?

 

[variant]

I thought that triage is already standard practice in emergencies.

 

[pitabread]

I thought that triage is already standard practice in emergencies.

The protocols they are taking about are different in this case, since they have to deliberately ration treatment. People who are severe cases (e.g. close to dying) may not be treated, since they would be taking resources away from people who could otherwise be saved.

Reportedly they aren't quite at that point yet, but if cases continue to rise, they could be very soon.

 

[wing2000]

I hope this is to be used only in case they really can’t treat everyone. It follows standard triage principles. But in the East we mostly avoided getting into that situation.

It remains to be seen if it will be needed in Arizona (i.e percentage of the cases from the last two weeks end up in the hospital). ICU capacity is at 91% as of Thursday. However, there are will be additional beds available as hospitals invoke their surge capacity.

• Ventilator use for suspected and confirmed COVID-19 patients was at 489 on Thrusday, the highest day so far. Overall, 53% of ventilators remained available Wednesday.
• ICU bed use for suspected and confirmed positive COVID-19 patients was 741 on Wednesday, the highest number so far. The number has been above 500 daily since June 15.

Arizona coronavirus update: 91,858 cases, 1,788 deaths

 

[JackRT]

The medical term for this is triage --- when medical resources are strained they are allocated to those who are most likely to benefit. When my father was wounded in the last days of WW1 he was brought to a field hospital after about 12 hours without treatment. He was left in a tent with about 5 or 6 other severely wounded soldiers. In the morning he was the only one left alive. It was then he was treated --- an amputation without anesthesia. Medical resources were strained to the limit.

 

[JackRT]

It is criminal that in a nation with the resources of the USA it should come down to this point. Contrary to the president the crisis is not "being handled" but is getting worse. Where does "the buck stop"? It stops, as it always has, on the desk in the Oval Office no matter what the Denier in Chief says.

 

[dogs4thewin]

It remains to be seen if it will be needed in Arizona (i.e percentage of the cases from the last two weeks end up in the hospital). ICU capacity is at 91% as of Thursday. However, there are will be additional beds available as hospitals invoke their surge capacity.

• Ventilator use for suspected and confirmed COVID-19 patients was at 489 on Thrusday, the highest day so far. Overall, 53% of ventilators remained available Wednesday.
• ICU bed use for suspected and confirmed positive COVID-19 patients was 741 on Wednesday, the highest number so far. The number has been above 500 daily since June 15.

Arizona coronavirus update: 91,858 cases, 1,788 deaths

It also would depend on how many "volunteers" as it were they had,

 

[Desk trauma]

It also would depend on how many "volunteers" as it were they had,

Not enough to matter, that's how many there will be.

 

[dogs4thewin]

Not enough to matter, that's how many there will be.

Enough to matter to some.

 

[Desk trauma]

Enough to matter to some.

And irrelevant for addressing the issue. People declining treatment, while noble, does nothing to change the hospitals being over capacity anymore than someone giving up their seat in a titanic life boat fixed that there were not enough to go around.

 

[dogs4thewin]

And irrelevant for addressing the issue. People declining treatment, while noble, does nothing to change the hospitals being over capacity anymore than someone giving up their seat in a titanic life boat fixed that there were not enough to go around.

but if there are say two people in need of a bed and there is one bed if one of those people says the other can have the bed then that means that in that particular case the other person gets to live and the doctors are not forced to make that particular decision does not mean it will change for everyone and that everyone who needs and wants a bed will be able to have one.