Health

Oregon Issues Hospital Emergency Care Standards Amid COVID Surge

Oregon hospitals have new interim guidelines to help them determine which patients should receive life-saving care if the current surge in COVID-19 forces them to choose between people due to a lack of beds, staff, or critical medical equipment.

The guidelines will only enter into force if the hospital has exhausted all other treatment options for each patient, including transfers to other facilities, deferral of non-urgent surgeries and care, stockpiling, and repurposing of existing beds and facilities for critically ill patients.

The new policy takes effect when Oregon faces a wave of highly contagious but milder version of the omicronic COVID-19. The state has set new records for new cases of COVID-19 several times in the past week, and on Thursday, state health authorities said hospital admissions were up 12% from the previous day.

The Oregon Health Department said there are only 42 beds in adult intensive care units, and 95% of staffed non-intensive care adult beds are full. Gov. Keith Brown announced Friday that it will dispatch up to 500 members of the Oregon National Guard to hospital care, with the first 125 members arriving at some of the hardest-hit hospitals next week.

“Right now, we want to put the triage tool in the hands of clinicians who are likely to face very difficult decisions in the coming weeks as the Omicron option takes its toll and puts more patients in the hospital,” said Dana Hargunani, OHA. chief physician.

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“This stopgap tool is not perfect, but it ensures that clinicians can be confident that they are using Oregon’s solid values ​​of nondiscrimination and health equity when they have to make these painful decisions.”

The agency acknowledged that the surge in omicron cases “did not allow time for a robust, inclusive and fully inclusive community and the necessary involvement of doctors,” and that the interim standards were “imperfect.” A new committee, to be created this winter, will review the policy and make changes and additions as needed, according to the preface to the OHA guidelines.

The standards are based on standards developed in Arizona, Massachusetts and Washington during the COVID-19 pandemic. They replace previous ones, which were canceled after the Oregon Disability Rights Group filed a federal civil rights lawsuit, arguing that the rules discriminate against seniors, people with disabilities, and those with pre-existing serious medical conditions.

The guidelines instruct hospitals to rank patients by assessing the likelihood of their short-term survival without judging their overall quality of life or long-term survival prior to the current illness.

When there is a connection between two patients who need the same resources, the person already receiving care will continue to receive it unless their condition worsens. With two patients with similar conditions admitted at the same time, hospitals will use blind pranking to decide who gets care.

Unlike other states, Oregon’s standards do not prioritize any specific groups of people for life-saving assistance. Other states, for example, award more points to pregnant women, people under the age of 18, healthcare workers, or single parents, according to Oregon Public Broadcasting.

Previous standards allowed hospitals to exclude certain people from intensive care during a crisis, such as people with certain stages of cancer or other serious illnesses.

Hospitals in Oregon can create their own crisis management standards, but they must adhere to state regulations.


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