Coronavirus

Grim New Rules for NYC Paramedics: Don’t Bring Cardiac Arrests to ER for Revival

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What to Know

  • A regional EMT group has issued new guidelines almost unthinkable even days ago -- if someone's in cardiac arrest and you can't revive them in the field, don't bring them to the emergency room
  • The guidance from the Regional Emergency Medical Services Council of New York City applies to the city as well as Nassau and Suffolk counties. The group, known as REMSCO, is the state-designated coordinating authority for the region
  • The newly implemented order takes effect Thursday in an effort to control the surge of patients in hospitals due to the ongoing COVID-19 pandemic

As the coronavirus stretches New York City emergency rooms and paramedics to their limits, a regional EMT group has issued new guidelines almost unthinkable even days ago -- if someone's in cardiac arrest and you can't revive them in the field, don't bring them to the emergency room.

The newly implemented order that takes effect Thursday was implemented in an effort to control the surge of patients in hospitals due to the ongoing COVID-19 pandemic.

The guidance from the Regional Emergency Medical Services Council of New York City applies to the city as well as Nassau and Suffolk counties. The group, known as REMSCO, is the state-designated coordinating authority for the region.

Typically, if someone is in cardiac arrest, even if there's no blood flow, EMS units will perform CPR and other lifesaving measures while en route to the hospital. Now, with very limited exceptions, that's not to happen.

In response to the new mandate, the FDNY has issued an order to all its EMTs with additional guidelines. According to the order, which a senior FDNY official shared with NBC News, the mandate applies only to adult patients. If an adult patient has obvious signs of death like rigor or has a do not resuscitate order, EMTs will not try to revive the patient.

Despite the surge in coronavirus cases in the tri-state area, there are still other urgent cases that aren't limited to COVID-19. One family in New Jersey says they're struggling to find specialist care for their ill mother. NBC New York's Adam Harding reports.

In all other cases, EMS is told to limit the number of EMTs working on the person to only those necessary (to limit possible COVID-19 exposure); they must wear the proper N-95 mask, eyeshield, gloves, mask and gown. If, after 20 minutes of CPR, the defibrillator or the heart monitor shows a "no shock indicated" or a non-shockable rhythm and there is no blood circulation, CPR is to be terminated. At that point, the NYPD or medical examiner can be called to remove the body; the patient is not to be brought to the hospital.

The FDNY says the department will document each instance this occurs.

Emergency officials tell NBC News the measure will alleviate an influx of patients from going to the hospitals that have no hope of being saved. It also alleviates time the EMTs are out on a call where there is no hope for saving someone. However, the measures allow for a body to be taken care of with respect, according to emergency officials.

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