Oregon issues hospital care standards for crisis as COVID rises

FILE - A nurse cares for a critically ill patient in the intensive care unit at <a class=Oregon Health and Science University in Portland, Ore. On August 19, 2021. Oregon health officials have released new interim guidelines for hospitals to follow in the event of an increase in COVID-19 patients require them to activate crisis care standards. (Public broadcast by Kristyna Wentz-Graff / Oregon via AP, Pool)” title=”FILE – A nurse cares for a critically ill patient in the intensive care unit at Oregon Health and Science University in Portland, Ore. On August 19, 2021. Oregon health officials have released new interim guidelines for hospitals to follow in the event of an increase in COVID-19 patients require them to activate crisis care standards. (Public broadcast by Kristyna Wentz-Graff / Oregon via AP, Pool)” loading=”lazy”/>

FILE – A nurse cares for a critically ill patient in the intensive care unit at Oregon Health and Science University in Portland, Ore. On August 19, 2021. Oregon health officials have released new interim guidelines for hospitals to follow in the event of an increase in COVID-19 patients require them to activate crisis care standards. (Public broadcast by Kristyna Wentz-Graff / Oregon via AP, Pool)

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

The guidelines will only come into play if a hospital has exhausted all other options for treating each patient, including transfers to other facilities, postponement of surgeries and elective care, storage of supplies, and reassignment of medical supplies. existing beds and spaces for intensive care patients.

The new policy comes as Oregon faces a wave of the highly contagious, but milder, omicron COVID-19 variant. The state has set new records for new COVID-19 cases several times over the past week and on Thursday state health officials said hospitalizations were up 12% from the previous day.

There are only 42 beds available in adult intensive care units and 95% of non-ICU adult beds with state personnel are full, the Oregon Health Authority said. Governor Kate Brown announced Friday that she would deploy up to 500 members of the Oregon National Guard to help in hospitals, with the first 125 members arriving at some of the hardest hit hospitals next week.

“Right now we want to put a triage tool in the hands of clinicians who will likely be faced with some very difficult decisions in the weeks to come as the Omicron variant is wreaking havoc and putting more patients in the hospital,” said Dana Hargunani, OHA’s chief medical officer.

“This interim tool is not perfect, but it ensures that clinicians can be confident that they are using criteria that are firmly anchored in Oregon’s values ​​of non-discrimination and health equity as ‘they are faced with these heartbreaking decisions. “

The agency acknowledged that the increase in the number of omicron cases “has not left the time for the necessary strong, comprehensive and fully inclusive community and clinical engagement” and that the interim standards are “flawed.” A new committee to be established this winter will review the policy and make revisions and additions as needed, the OHA said in a preface to the guidelines.

The standards are based on those developed in Arizona, Massachusetts and Washington amid the COVID-19 pandemic. They replace precedents that were stripped after Disability Rights Oregon, an advocacy group, filed a federal civil rights lawsuit alleging the rules discriminated against seniors, people with disabilities, and people with pre-existing conditions. serious.

The guidelines ask hospitals to classify patients by rating the likelihood of their short-term survival without passing judgment on their overall quality of life or long-term survival before current illness.

In the event of a tie between two patients needing the same resources, the person already treated would continue to benefit from them, unless their condition worsened. In the links between two patients with similar conditions presenting at the same time, hospitals would use a blind drawing to decide who receives care.

Unlike other states, Oregon’s standards do not prioritize any particular group of people for life-saving care. Other states, for example, give more points to pregnant people, those under 18, healthcare workers or single parents, Oregon Public Broadcasting reported.

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

Hospitals in Oregon can create their own standards of crisis care, but they must adhere to the state’s rubric.


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