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LOS ANGELES — Thousands of public employees struck the nation’s most populous county Wednesday, slashing a wide range of services including health care used by the poor – already hit hard by a 26-day-old transit strike. 

The walkout by 42,000 Los Angeles County employees, nearly half its work force, forced severe cutbacks in hospital trauma care and other health services despite a last-minute court order barring essential nurses and other workers from striking. 

The long-threatened general strike cut back services in departments serving a county with nearly 10 million residents. But it hit especially hard at six hospitals and 42 health clinics that treat millions of people annually. 

At County-USC Medical Center, 21-year-old Daniel Lopez, paralyzed from the waist down when he was shot in the spine last week, waited to go to a rehabilitation center. 

“I was supposed to be transferred on Monday, and now I’m stuck. I’ll probably be here until this strike finishes,” Lopez said after being wheeled outside for air. 

Lopez complained that there was only one nurse for about 20 patients and that he waited four hours for a cup of water Wednesday. 

Teresa Ayala, 57, was two hours into a wait for an appointment to treat an eye injury. 

Her normal 45-minute bus trip to the east side hospital from Lynwood was not available so she was brought by her son-in-law, said her daughter, Eloisa Garcia, 35. 

“I’m not working because I can’t get to my job (by bus),” Garcia said. “It’s very important that she come for the appointment. And I’m worried now if they’re on strike, my mother can’t return.” 

In Norwalk, Jae Kim, 29, and fiancee Rebecca Hong, 27, waited in an unmoving line of 40 people at the recorder-registrar’s office to pick up a marriage license. 

“If we don’t get the license by Saturday then we can’t get married,” said Hong, who hadn’t known that the strike was looming. “I’m just mad,” she added. 

Military wife Tracy Lemon, 33, was upset as she tried to obtain her son’s birth certificate and her marriage license for a move Thursday to New York to join her husband, who is being transferred there from Korea. 

“I need this today,” she insisted. 

Negotiations to replace a three-year pact which expired Sept. 30 resumed late Tuesday for the first time in two weeks. But talks lasted just two hours before adjourning until noon Wednesday, said Mark Tarnawsky, spokesman for Service Employees International Union Local 660. 

“There’s been a little bit of movement on a couple of the tables,” Tarnawsky said of the complexity of drawing up contracts from 20 bargaining units involved in the talks. “Wages are a common issue but there are many side-issues unique to one unit.” 

The county’s last offer was a general 9 percent wage increase over three years, while the union seeks 15.5 percent. 

Due to the strike, public hospitals with trauma units were diverting ambulances to private hospitals, said county Department of Health Services spokesman John Wallace. 

A court order Tuesday required about 5,000 registered nurses and medical support staff to remain on the job because their work is considered essential to public health and safety. 

“We have talked to all the facilities, and the employees covered under the restraining order are reporting to their shifts,” Wallace said. 

“The emergency rooms remain open to walk-ins, people who present themselves at the hospitals,” Wallace said. “Doctors by and large are not participating in work actions.” 

Among those striking were welfare workers, clerks who issue marriage licenses and record property transactions, coroner’s office workers, librarians, beach maintenance employees and crews for sewer maintenance, said Bart Diener, assistant general manager of the striking union. 

Most county-employed doctors are represented by other non-striking unions. 

The county’s health system admits about 110,000 people a year to hospitals, and outpatient care brings the total number of people receiving care from the county to about 2.7 million per year, Wallace said.