Paramedics ordered to take more coronavirus sufferers to hospital as ‘scorecard’ threshold lowered


Paramedics have been told to take more coronavirus patients to hospital, after a ‘scorecard’ threshold was lowered because of fears only seriously ill people were being taken to A&E. 

The London Ambulance Service has changed how it uses the scorecard, which is called News2 and helps assess whether people who call 999 are at risk of deteriorating from coronavirus. 

News2 helps operators assign a score to callers to decide how serious their symptoms are and looks at breathing rate, oxygen saturation, temperature, blood pressure, pulse rate and level of consciousness. 

Initially, a score of five meant a patient would need to be monitoring every hour, however, paramedics were told on March 12 that suspected coronavirus patients may not be admitted to hospital even if they scored as high as six. 

This was changed again on April 10, with paramedics told that people scoring between three and five should be taken in for assessment. 

News of the change is likely to raise questions over whether some patients may have become seriously unwell or even died because they were not taken to hospital between March 12 and April 10, believed to be the peak of the pandemic, under the guidance.  

An ambulance crew deliver a patient to the Royal London Hospital in London. The LAS has changed the guidance it gives its paramedics on which coronavirus patients to take to hospital

Speaking to the Sunday Times, the LAS declined to say whether its change in guidance was as a result of concerns over previous advice.

It insisted that the scoreboard was never used in isolation and that it was a part of several other assessments.   

The LAS added: ‘We are constantly updating our guidance to staff to better reflect the national understanding of this new disease.’

However, the revelation will only add to fears that patients arriving at hospital only do so when already critically ill.  

Previously, it was revealed that coronavirus patients who get put on a ventilator have just a 34 per cent chance of survival, according to a study which seems to lend weight to a growing chorus of medics sceptical about the course of treatment.

What is the London Ambulance Service’s scorecard system? 

The London Ambulance Service uses the News2 scorecard to help assess whether people who call 999 are at risk of deteriorating from coronavirus. 

News2 helps operators assign a score to callers to decide how serious their symptoms are and looks at breathing rate, oxygen saturation, temperature, blood pressure, pulse rate and level of consciousness. 

Initially, a score of five meant a patient would need to be monitoring every hour, however, paramedics were told on March 12 that suspected coronavirus patients may not be admitted to hospital even if they scored as high as six. 

This was changed again on April 10, with paramedics told that people scoring between three and five should be taken in for assessment. 

News of the change is likely to raise questions over whether some patients may have become seriously unwell or even died because they were not taken to hospital between March 12 and April 10, believed to be the peak of the pandemic, under the guidance.  

The figures come from the Intensive Care National Audit and Research Centre (ICNARC) and are based on a sample of 6,720 critically-ill coronavirus patients.

Of those who required advanced respiratory support – known as invasive ventilation – just under two-thirds of patients died.

Data showed that 1,744 (65.4 per cent) died after requiring mechanical ventilation in critical care, while some 923 (34.6 per cent) on the same treatment were discharged.

For those who required basic respiratory support – such as oxygen through a face mask, which is known as non-invasive ventilation – 894 patients (81.9 per cent) recovered and some 198 (18.1 per cent) died.

The research tips the scales towards a growing weight of evidence suggesting the procedure does not provide life-saving treatment, and could even be harming patients.

Some doctors have voiced concerns that ventilators flare up lung inflammation and are explicitly warning against their early use in critical care.  

It comes as the UK’s coronavirus death toll increased by 413 today – the lowest recorded this month – as NHS bosses said social distancing is ‘paying off’ but warned breaking the rules now could result in a second peak of the deadly disease. 

Stephen Powis, the national medical director of NHS England, said the latest government statistics showed there had been a ‘slight uptick’ in the number of people using their cars and going outside in recent days. 

Data showed that 1,744 (65.4 per cent) died after requiring mechanical ventilation in critical care, while some 923 (34.6 per cent) on the same treatment were discharged (pictured, ventilators in Oxfordshire ready to be shipped to NHS hospitals)

Data showed that 1,744 (65.4 per cent) died after requiring mechanical ventilation in critical care, while some 923 (34.6 per cent) on the same treatment were discharged (pictured, ventilators in Oxfordshire ready to be shipped to NHS hospitals) 

He told the daily Downing Street coronavirus press conference that the nation needed to ‘remind ourselves that this has been a really tough four weeks and we don’t want to lose the benefits’ which have resulted from people staying at home.  

Mr Powis said nobody could be ‘absolutely confident’ that the UK is now firmly on a downward trajectory as he urged Britons to continue to adhere to draconian lockdown measures. 

The 413 new fatalities represents a significant drop on yesterday’s UK figures – and are also lower than previous Sundays, which typically see a lower toll than weekdays. 

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