- Direct.Latest news about the coronavirus crisis
- The map: the advance of the coronavirus in Spain
- Collapse.Catalonia advises against admitting coronavirus patients "with a poor prognosis"
New evidence that, in the face of collapse, Catalonia limits the referral to hospitals of patients who are less likely to survive. The Generalitat has given instructions to ambulance workers to justify families why the transfer of patients suspected of contracting coronavirus and with a poor prognosis due to age or pre-existing diseases is discarded.
In a protocol addressed to the Emergency Medical Service , the Ministry of Health suggests "not referring to the fact that there are no beds for everyone as a reason to deny intensive cures" and to explain that "death at home, at the moment, is the best option ", with palliative care.
The guide lists recommendations for "limiting therapeutic effort for patients with suspected Covid-19 and acute respiratory failure." In it, it advises against using invasive mechanical ventilation for those over 80 years of age and those who are dependent or with advanced ailments.
In these cases, it indicates that "oxygen therapy with a mask will only be received" and it will be considered to provide medication in the event of a feeling of suffocation. The guideline delimits that it is intuited "as the first option" only to non-octogenarians without affections or who are controlled.
The document alleges that "admissions should be avoided in patients with little benefit, whether due to Covid-19 respiratory pathologies or others that condition the critical condition." He adds that "age is an important criterion" to ration the most forceful therapy, although he clarifies that "it should never be the only one".
On the other hand, he postulates that "the objective is to save the maximum number of years of life in patients with maximum chances of survival."
"These orientations have never existed"
"As there are not enough intensive care and hospital beds, priorities are channeled," explains a nurse who has received the guidelines. "They had never existed. Before, we took an elderly person without autonomy to the hospital and everything was done to him, as if he were going to live 200 years. Now the quality of the patient is valued so that the system does not collapse."
The protocol proposes to persuade that hospitalization is dismissed as a "good" to "avoid suffering" without abandoning the patient. "We are not deciding who lives and who dies, only who can benefit the most from aggressive treatments."
It raises to warn that the families "cannot accompany them in the last moments" in many centers, reason why it defends "to assure the comfort" in the home. If it is not guaranteed, the priority is to transfer infected persons with previous deterioration "to a social health center instead of hospital emergencies."
These new recommendations join those unveiled this Tuesday by EL MUNDO, in which the Generalitat opened the door to not refer patients with "very poor prognosis" or "short life expectancy" to hospitals, in which it was estimated that the treatment was not going to work.
The Minister of Health, Alba Vergés , justified these recommendations because, "in moments of maximum tension," "the intensity of the therapies have nothing to do with whether or not he was referred to a hospital." "The best care is what the patient needs based on their health status," he argued.
According to the criteria of The Trust Project
Know more- Catalonia
- Infectious diseases
- Health
- Coronavirus
Covid-19Barcelona enables sports centers to expand the capacity of hospitals against coronavirus
CoronavirusCatalonia confines 60,000 residents of Igualada and three other populations due to an outbreak of coronavirus
The chief of Infectious Diseases of La Paz: "We can run out of UVI beds" in this coronavirus epidemic