Healthcare workers outside COVID-19 testing tents at Elmhurst Hospital in Queens, New York, on March ... [+]
Topline: Some New York City hospitals are activating policies allowing doctors to not revive dying COVID-19 patients, the Washington Post reported Tuesday night, an idea that had been dismissed earlier by Deborah Birx, the White House’s coronavirus coordinator, as cases surge across the five boroughs and facilities are stretched thin.
- The policies, called “do not resuscitate,” or DNR for short, are medical orders not to perform CPR on a patient if their heart stops beating, or if they stop breathing, according to the Mount Sinai Health System.
- Some New York City doctors are being allowed to not resuscitate COVID-19 patients to reduce their exposure to the virus, the Post reported, but spokespeople for Montefiore, NYU Langone Health and New York-Presbyterian’s Brooklyn Methodist hospitals said no system-wide policies have been instated.
- Montefiore workers are reportedly no longer performing chest compressions on COVID-19 patients, due to the risk of exposure and the amount of protective gear needed, the Wall Street Journal reported Wednesday.
- An unnamed Queens hospital was reportedly bullying older COVID-19 patients into signing DNR and “do not intubate” orders, Gothamist reported March 25.
- The Journal reported Tuesday that NYU Langone’s head of emergency medicine advised doctors to “think more critically” about which patients should receive one of their limited number of ventilators, and that the institution would support doctors who “withhold futile intubations.”
- Birx, one of the main faces of the White House coronavirus task force, dismissed the idea of DNRs Thursday: “There is no situation in the United States right now that warrants that kind of discussion.”
Surprising fact: It can take up to 30 medical workers to resuscitate a crashing patient, according to a March 25, 2020, report by the Post. Resuscitation is seen as resource-intensive, as it requires not just many doctors, but a lot of protective gear and equipment.
Big number: Just under 17%. That’s the percentage of patients who are resuscitated and get well enough to leave the hospital, the Post reported—a number that doesn’t account for those with complex respiratory issues.
News peg: New York City has emerged as the epicenter of the nation’s coronavirus crisis, with over 1,100 dead and over 44,000 cases as of Wednesday morning, according to NBC’s New York affiliate. Overflowing morgues have prompted officials to send refrigerated trucks to hold the dead. Governor Andrew Cuomo has ordered the statewide public and private hospital systems to work together to share resources and the patient load, but details are still being worked out, the Post reported.
Key background: Reports emerged last week that hospitals were weighing changes to their DNR policies, as coronavirus cases spiked around the country and as masks, ventilators and other medical equipment quickly became in short supply. DNR policies spark ethical debates in nonpandemic times, and the emergence of coronavirus has forced some doctors to make life-or-death, game-time decisions for crashing patients. During a resuscitation, a patient’s ribs can be broken, while veins can be punctured by doctors rushing to place IV lines. Nearly all will require a ventilator afterwards to breathe, and many will die within 24 to 48 hours, according to the Post.
