Intubated ventilator in Coronavirus patients. Soultion or problem. Why not to use unintubated?

[Anonymous]

Someone posted this doc's account in a new thread: https://texags.com/forums/84/topics/3102444

He addresses how many COVID patients die if they are sick enough to need a ventilator:

worldwide 86% of covid 19 patients that go on a vent die. Seattle reporting 70%.

[Anonymous]

https://texags.com/forums/84/topics/3102444

Disposition
I had never discharged multifocal pneumonia before. Now I personally do it 12-15 times a shift. 2 weeks ago we were admitting anyone who needed supplemental oxygen. Now we are discharging with oxygen if the patient is comfortable and oxygenating above 92% on nasal cannula. We have contracted with a company that sends a paramedic to their home twice daily to check on them and record a pulse ox. We know many of these patients will bounce back but if it saves a bed for a day we have accomplished something. Obviously we are fearful some won't make it back.

We are a small community hospital. Our 22 bed ICU and now a 4 bed Endoscopy suite are all Covid 19. All of these patients are intubated except one. 75% of our floor beds have been cohorted into covid 19 wards and are full. We are averaging 4 rescue intubations a day on the floor. We now have 9 vented patients in our ER transferred down from the floor after intubation.

Luckily we are part of a larger hospital group. Our main teaching hospital repurposed space to open 50 new Covid 19 ICU beds this past Sunday so these numbers are with significant decompression. Today those 50 beds are full. They are opening 30 more by Friday. But even with the "lockdown", our AI models are expecting a 200-400% increase in covid 19 patients by 4/4/2020.


Treatment
Supportive

worldwide 86% of covid 19 patients that go on a vent die. Seattle reporting 70%. Our hospital has had 5 deaths and one patient who was extubated. Extubation happens on day 10 per the Chinese and day 11 per Seattle.

Plaquenil which has weak ACE2 blockade doesn't appear to be a savior of any kind in our patient population. Theoretically, it may have some prophylactic properties but so far it is difficult to see the benefit to our hospitalized patients, but we are using it and the studies will tell. With Plaquenil's potential QT prolongation and liver toxic effects (both particularly problematic in covid 19 patients), I am not longer selectively prescribing this medication as I stated on a previous post.

[Anonymous]

Anonymous wrote:Someone posted this doc's account in a new thread: https://texags.com/forums/84/topics/3102444

He addresses how many COVID patients die if they are sick enough to need a ventilator:

worldwide 86% of covid 19 patients that go on a vent die. Seattle reporting 70%.

This part is interesting.. would be good to k now how t hose patients will do.

I had never discharged multifocal pneumonia before. Now I personally do it 12-15 times a shift. 2 weeks ago we were admitting anyone who needed supplemental oxygen. Now we are discharging with oxygen if the patient is comfortable and oxygenating above 92% on nasal cannula. We have contracted with a company that sends a paramedic to their home twice daily to check on them and record a pulse ox. We know many of these patients will bounce back but if it saves a bed for a day we have accomplished something. Obviously we are fearful some won't make it back.

[Anonymous]

Anonymous wrote:There is a study for every study proving the other study to be BS.. Believe what you want to believe.

This is a very dangerous attitude. Truth actually matters.

[Anonymous]

Anonymous wrote:Someone posted this doc's account in a new thread: https://texags.com/forums/84/topics/3102444

He addresses how many COVID patients die if they are sick enough to need a ventilator:

worldwide 86% of covid 19 patients that go on a vent die. Seattle reporting 70%.

Sounds like going on a vent is killing people. Sounds like going to a hospital is just asking for trouble. Can you see why separating cause and effect is important? Blind correlation isn't helping anyone.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Someone posted this doc's account in a new thread: https://texags.com/forums/84/topics/3102444

He addresses how many COVID patients die if they are sick enough to need a ventilator:

worldwide 86% of covid 19 patients that go on a vent die. Seattle reporting 70%.

Sounds like going on a vent is killing people. Sounds like going to a hospital is just asking for trouble. Can you see why separating cause and effect is important? Blind correlation isn't helping anyone.

Ice cream sales lead to an increase in violent crime.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Someone posted this doc's account in a new thread: https://texags.com/forums/84/topics/3102444

He addresses how many COVID patients die if they are sick enough to need a ventilator:

worldwide 86% of covid 19 patients that go on a vent die. Seattle reporting 70%.

Sounds like going on a vent is killing people. Sounds like going to a hospital is just asking for trouble. Can you see why separating cause and effect is important? Blind correlation isn't helping anyone.

What? No.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Someone posted this doc's account in a new thread: https://texags.com/forums/84/topics/3102444

He addresses how many COVID patients die if they are sick enough to need a ventilator:

worldwide 86% of covid 19 patients that go on a vent die. Seattle reporting 70%.

Sounds like going on a vent is killing people. Sounds like going to a hospital is just asking for trouble. Can you see why separating cause and effect is important? Blind correlation isn't helping anyone.

Ice cream sales lead to an increase in violent crime.

Science!

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Someone posted this doc's account in a new thread: https://texags.com/forums/84/topics/3102444

He addresses how many COVID patients die if they are sick enough to need a ventilator:

worldwide 86% of covid 19 patients that go on a vent die. Seattle reporting 70%.

Sounds like going on a vent is killing people. Sounds like going to a hospital is just asking for trouble. Can you see why separating cause and effect is important? Blind correlation isn't helping anyone.

What? No.

PP was not being serious.

[Anonymous]

People that know nothing about mechanical ventilation should stop making posts suggesting they know something. This entire thread is beyond stupid

[Anonymous]

From the stat article...

"But if oxygen can’t cross into the blood from the lungs in the first place, those measures, especially greater force, may prove harmful."

[Anonymous]

Anonymous wrote:

Anonymous wrote:This is for medical people to hash out, not laypersons on dcum.

Why?
Do you know how may pateints DCUM lay people killed? None.. while the "medical people" have less then stellar record.
Perhaps we here can come up with something to help the medical people who are tied bond and limited
by all he limitations and help them to see something they can not see?

I admire your trust and all but if you at all dig statistics they you must have encountered this:

A recent Johns Hopkins study claims more than 250,000 people in the U.S. die every year from medical errors. Other reports claim the numbers to be as high as 440,000. Medical errors are the third-leading cause of death

You planning to sue or something?

[Anonymous]

Anonymous wrote:From the stat article...

"But if oxygen can’t cross into the blood from the lungs in the first place, those measures, especially greater force, may prove harmful."

“I would do everything in my power to avoid intubating patients,”

[Anonymous]

OP uses the same sort of paranoid, non-scientific nonsense that idiot anti-vaxxers use.

[Anonymous]

Anonymous wrote:OP uses the same sort of paranoid, non-scientific nonsense that idiot anti-vaxxers use.

This. And I’m in healthcare.