Anonymous
03/30/2020 16:55
Subject: Intubated ventilator in Coronavirus patients. Soultion or problem. Why not to use unintubated?
Anonymous wrote:OP question makes no sense - how do you forcibly ventilate someone who is not intubated or trached? You looking to bring back iron lungs from polio days? What do you do with the saliva and emesis (vomit), let it roll into the lungs to cause further damage? How do you create a seal between the trachea and the vent? Have to intubate or trach somebody to put on a control type ventilator, only way to maintain airway when someone cannot breath themselves. And vents are not just ambu bags being pumped as shown in the $100 self made ones- have to determine and set cc’s of air to be pumped each breath, respiratory rate, assist or control settings, sigh frequency, pressure alarm levels, positive end expiratory pressure settings, O2 saturation ranges among other settings. Maybe let the med professionals handle critical care - this is far more complicated than home made solutions.
Do you hear yourself? No sense whatsoever.
Anonymous
03/30/2020 13:21
Subject: Intubated ventilator in Coronavirus patients. Soultion or problem. Why not to use unintubated?
Anonymous wrote:Anonymous wrote:Anonymous wrote:Anonymous wrote:My brother's a pulmonologist in CA treating COVID patients. He said in their general exprience, folks who need ventilators due to pneumonia caused by typical influenza or other common causes recover about 80% of the time. But with COVID, it's flipped, at they have seen 80% who need a ventilator end up dying.
I would think that the problem is that with COVID VERY important thing is to cough. The people who have it complain
on chest tightness, their chest X rays show a hot mess in their lungs, so if you intubate them and hey can not cough
this alone can contribute to the high death rate if you ask me, but instead asks someone who knows better.
Would suctioning help with intubation?
Yes, people who are intubated often need a lot of suctioning.
Correct--they're suctioned. So it's not like they're forced onto a ventilator and left alone. It takes a LOT of management and monitoring. It's not plug and play.
Anonymous
03/30/2020 13:03
Subject: Intubated ventilator in Coronavirus patients. Soultion or problem. Why not to use unintubated?
Anonymous
03/30/2020 12:58
Subject: Intubated ventilator in Coronavirus patients. Soultion or problem. Why not to use unintubated?
Anonymous wrote:Conquer correct spelling and clear writing.
And then come back here to conquer respiration technology.
hear, hear!
Anonymous
03/30/2020 12:57
Subject: Intubated ventilator in Coronavirus patients. Soultion or problem. Why not to use unintubated?
Anonymous wrote:Anonymous wrote:Anonymous wrote:I am going with doctors tried everything and what you are suggesting led to death.
The question:
Intubated ventilator in Coronavirus patients. Soultion or problem. Why not to use unintubated?
was just that, for people like you to voice our concerns and to help us all to understand if there are other options, risk and all. Don't you like a meaningful discussion where everyone can learn something?
This isn’t meaningful. It’s stupid to think that some random people on a chat board know better than the experts. Hubris.
Nothing about her question was meaningful nor can we have a meaningful chat about it unless surgeons here step in to talk about it.
Anonymous
03/30/2020 12:40
Subject: Intubated ventilator in Coronavirus patients. Soultion or problem. Why not to use unintubated?
Anonymous wrote:Anonymous wrote:Anonymous wrote:My brother's a pulmonologist in CA treating COVID patients. He said in their general exprience, folks who need ventilators due to pneumonia caused by typical influenza or other common causes recover about 80% of the time. But with COVID, it's flipped, at they have seen 80% who need a ventilator end up dying.
I would think that the problem is that with COVID VERY important thing is to cough. The people who have it complain
on chest tightness, their chest X rays show a hot mess in their lungs, so if you intubate them and hey can not cough
this alone can contribute to the high death rate if you ask me, but instead asks someone who knows better.
Would suctioning help with intubation?
Yes, people who are intubated often need a lot of suctioning.
Anonymous
03/30/2020 12:27
Subject: Intubated ventilator in Coronavirus patients. Soultion or problem. Why not to use unintubated?
Anonymous wrote:Anonymous wrote:My brother's a pulmonologist in CA treating COVID patients. He said in their general exprience, folks who need ventilators due to pneumonia caused by typical influenza or other common causes recover about 80% of the time. But with COVID, it's flipped, at they have seen 80% who need a ventilator end up dying.
I would think that the problem is that with COVID VERY important thing is to cough. The people who have it complain
on chest tightness, their chest X rays show a hot mess in their lungs, so if you intubate them and hey can not cough
this alone can contribute to the high death rate if you ask me, but instead asks someone who knows better.
Would suctioning help with intubation?
Anonymous
03/30/2020 11:11
Subject: Intubated ventilator in Coronavirus patients. Soultion or problem. Why not to use unintubated?
People on Reddit are quoting twiv by another NY doctor.Anonymous wrote:Anonymous wrote:I’m getting conflicting info on people on ventilator prognosis.
On Reddit people say most Covid patients die on ventilators. 50-70%
A critical care NYC pulmonologist in his video said the opposite- most patients eventually get off ventilators and start breathing on their own.
Which one is true?
Hmmmm, "people on Reddit" vs critical care pulmonologist. So hard to know.
Anonymous
03/30/2020 09:46
Subject: Intubated ventilator in Coronavirus patients. Soultion or problem. Why not to use unintubated?
Anonymous wrote:Anonymous wrote:Anonymous wrote:Anonymous wrote:Anonymous wrote:Anonymous wrote:My brother's a pulmonologist in CA treating COVID patients. He said in their general exprience, folks who need ventilators due to pneumonia caused by typical influenza or other common causes recover about 80% of the time. But with COVID, it's flipped, at they have seen 80% who need a ventilator end up dying.
Does your brother have a theory?
In general terms, "something" happens in some people that triggers an often fatal immune response. He doesn't seem to have theories about what, specifically. Which is what worries him. Initially based on early reporting, he was pretty laid back about this all. But as more stats are out and now he's seeing things first-hand, he's very concerned. Yes, many of those who die are "high risk." But then there are enough relatively young people without known issues who have this response, too and end up dying.
Thank you. Do you think the medications they took at the beginning of the symptoms could have an impact? Some are known to interfere with the outcome. Do the doctors like your brother has time and resources to check what self medication the patients did. For instance things like Aspirin or Advil.. etc.. those are not good to take.. also cough suppressants? I just wonder if anyone looks into this case by case.
I asked him about this because as a migraineur, I turn to ibuprofen and naproxen sodium regularly and was worried. He was not concerned about these medications at all--a lot of misinformation and panic led to the advice to avoid ibuprofen. He thinks that's tragic not only because it's not true re: COVID, but more people will take acetaminophen and end up with liver failure. When I asked if I should avoid ibuprofen or naproxen sodium because of COVID, he said no.
He's not a fan pretty much ever of cough suppressants.
You are lucky if you get migraines and that's all you have to take.
It's not all I take, but it's part of my cocktail. Thanks for your concern about my well-being, I'm sure.
Anonymous
03/30/2020 08:35
Subject: Intubated ventilator in Coronavirus patients. Soultion or problem. Why not to use unintubated?
Anonymous wrote:OP question makes no sense - how do you forcibly ventilate someone who is not intubated or trached? You looking to bring back iron lungs from polio days? What do you do with the saliva and emesis (vomit), let it roll into the lungs to cause further damage? How do you create a seal between the trachea and the vent? Have to intubate or trach somebody to put on a control type ventilator, only way to maintain airway when someone cannot breath themselves. And vents are not just ambu bags being pumped as shown in the $100 self made ones- have to determine and set cc’s of air to be pumped each breath, respiratory rate, assist or control settings, sigh frequency, pressure alarm levels, positive end expiratory pressure settings, O2 saturation ranges among other settings. Maybe let the med professionals handle critical care - this is far more complicated than home made solutions.
OP is all about Cargo Cult solutions to our most pressing problems. She flies like an eagle over mere obstacles while the “professionals” have to hack their way through reality’s jungle of facts.
Anonymous
03/30/2020 07:36
Subject: Intubated ventilator in Coronavirus patients. Soultion or problem. Why not to use unintubated?
OK. I will say without a doubt: Intibated people have really bad outcomes. But the outcome without intimation would be much worse.
I watched my father on a ventilator last year. Without the ventilator, his O2 saturation was under 85%. At it worst, on 100% O2, with the ventilator, it was 86%.
They did an emergency procedure (on XMAS day) and he recovered. Took him a long time, and even today, 15 months later, he is not 100%. But without it, we would have had a funeral on Christmas Day (he would have died on the 23rd or 24th and we are jewish).
Ventilator and intubation are a last resort. I can safely say, 100% of the people that need ventilators and do not get it will die.
I watched my father on a ventilator last year. Without the ventilator, his O2 saturation was under 85%. At it worst, on 100% O2, with the ventilator, it was 86%.
They did an emergency procedure (on XMAS day) and he recovered. Took him a long time, and even today, 15 months later, he is not 100%. But without it, we would have had a funeral on Christmas Day (he would have died on the 23rd or 24th and we are jewish).
Ventilator and intubation are a last resort. I can safely say, 100% of the people that need ventilators and do not get it will die.
Anonymous
03/30/2020 06:51
Subject: Intubated ventilator in Coronavirus patients. Soultion or problem. Why not to use unintubated?
I’m not going to waste my time reading all 8 pages. The premise of this thread is madness.
There’s a difference between positive pressure breathing support and invasive ventilator support. They can control the percentage of supplied oxygen with both methods.
Only the sickest people get put on ventilators, so of course they’re more likely to die.
When their oxygen saturation drops too low while on positive pressure breathing support, they can be put on ventilators so they don’t die.
This is basic shit. I’ve seen it play it out twice with loved ones. One had lung cancer and the other had pneumonia. The one with lung cancer declined invasive measures and died. The ventilator wouldn’t have offered him any quality time, or helped him heal from cancer.
There’s a difference between positive pressure breathing support and invasive ventilator support. They can control the percentage of supplied oxygen with both methods.
Only the sickest people get put on ventilators, so of course they’re more likely to die.
When their oxygen saturation drops too low while on positive pressure breathing support, they can be put on ventilators so they don’t die.
This is basic shit. I’ve seen it play it out twice with loved ones. One had lung cancer and the other had pneumonia. The one with lung cancer declined invasive measures and died. The ventilator wouldn’t have offered him any quality time, or helped him heal from cancer.
Anonymous
03/30/2020 05:59
Subject: Intubated ventilator in Coronavirus patients. Soultion or problem. Why not to use unintubated?
Anonymous wrote:Anonymous wrote:Anonymous wrote:Anonymous wrote:Anonymous wrote:Are you guys really looking to Italy for their medical technology and techniques? Their death rate is currently about 10x ours
But bubblehelmets look so futuristic. That must mean something, right?
Hm.. apparently only those in the bubblehelmets make it.
As first demonstrated by the Chinese trying to avoid the virus by placing water jugs on their heads.
Note to self: add jumbo jug of cheese puffs to Costco list.
Thank you. I needed this.
Anonymous
03/30/2020 02:43
Subject: Intubated ventilator in Coronavirus patients. Soultion or problem. Why not to use unintubated?
OP question makes no sense - how do you forcibly ventilate someone who is not intubated or trached? You looking to bring back iron lungs from polio days? What do you do with the saliva and emesis (vomit), let it roll into the lungs to cause further damage? How do you create a seal between the trachea and the vent? Have to intubate or trach somebody to put on a control type ventilator, only way to maintain airway when someone cannot breath themselves. And vents are not just ambu bags being pumped as shown in the $100 self made ones- have to determine and set cc’s of air to be pumped each breath, respiratory rate, assist or control settings, sigh frequency, pressure alarm levels, positive end expiratory pressure settings, O2 saturation ranges among other settings. Maybe let the med professionals handle critical care - this is far more complicated than home made solutions.
Anonymous
03/30/2020 01:23
Subject: Intubated ventilator in Coronavirus patients. Soultion or problem. Why not to use unintubated?
Anonymous wrote:Anonymous wrote:Anonymous wrote:Anonymous wrote:Non-medical people should never be discussing how to do medicine, ever. My god.
You do realize that the birds do not have a pilot license yet it does no stop them from flying.
DP
It's more like building airplanes than flying. If you don't have the training, you don't understand why you can't intuit your way through it.
Dunning-Kruger effect.
My friend.. my thought will pass by yours so fast, you wont even know what just happened.
Doppler effect.
I will not stand in your way as you show the world who you are and what you are able to do. Best of luck, and stay safe in these troubled times.