Faced with a crush of patients, besieged NYC hospitals struggle with life-or-death decisions

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The decision is a reflection of a grim reality where thousands of health care workers have fallen ill, ventilators are so scarce that some hospitals are putting two patients on one machine, and protective equipment like masks and gowns are in such short supply that some workers are sewing their own.

deaths are mounting so quickly that freezer trucks have been set up as makeshift morgues, several hospitals have taken the unprecedented step of allowing doctors not to resuscitate people with covid-19 to avoid exposing health care workers to the highly contagious virus.

Spokespeople for Montefiore, NYU Langone Health, and New York-Presbyterian’s Brooklyn Methodist said no new systemwide resuscitation protocols have been adopted. But doctors and nurses at those facilities say some doctors have been informally allowed in recent days to override a covid-19 patient’s “code status” — the part of their medical record that expresses their desire for lifesaving medical intervention.

The patient “was turning blue and we were literally watching him die,” the doctor recalled. He said that he was thinking the man was young and had a family. At NYU Langone Health on Saturday, the head of emergency medicine emailed other doctors urging them to “think more critically” about who gets ventilators, according to The Wall Street Journal. Robert Femia emphasized that doctors have “sole discretion” to put patients on ventilators and that they will be supported if they decide to “withhold futile intubation” for covid-19 patients.

A physician at New York-Presbyterian’s Brooklyn Methodist said doctors have been told not to perform CPR except in rare cases where the patient is young, otherwise healthy and is judged to have a good chance of recovery. For some patients, he said, “we are pretty much doing nothing.” The doctor spoke on the condition of anonymity because he was not authorized to speak to the media.

The overload of covid-19 patients, meanwhile, is leading to reduced medical care for patients who have other serious conditions.

 

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