Anonymous
03/29/2020 22:52
Subject: Intubated ventilator in Coronavirus patients. Soultion or problem. Why not to use unintubated?
I'm a PP who was a real crabbucket -- I'm sorry. Time for me to step back. But I thought about this link for OP:
http://www.fammed.usouthal.edu/Pulmonology/Self-StudyAids/Mechanical%20Ventilation/MechanicalVentilationCaseQuestions&Answers.pdf
This may or may not be helpful. There is a discussion of when to use invasive vs. non-invasive ventilation at the bottom of the page 1. (for Family Medicine training)
PP is right that CPAP and BIPAP aerosolize the virus, but it's also true that most COVID-18 patients are too ill and worsening too fast for that to provide sufficient support anyway.
http://www.fammed.usouthal.edu/Pulmonology/Self-StudyAids/Mechanical%20Ventilation/MechanicalVentilationCaseQuestions&Answers.pdf
This may or may not be helpful. There is a discussion of when to use invasive vs. non-invasive ventilation at the bottom of the page 1. (for Family Medicine training)
PP is right that CPAP and BIPAP aerosolize the virus, but it's also true that most COVID-18 patients are too ill and worsening too fast for that to provide sufficient support anyway.
Anonymous
03/29/2020 22:28
Subject: Intubated ventilator in Coronavirus patients. Soultion or problem. Why not to use unintubated?
Anonymous wrote:OP, do you seriously believe that docs and nurses want to intubate patients? That they will skip less invasive procedures and go right for the more difficult procedure that places all of them at greater risk in the hopes of saving the patient? What color is the sky in your world?[/quote
For most other diseases doctors will try to use non invasive ventilatory support for patients before intubation. Unfortunately with the coronavirus, using non invasive options such as cpap and bipap will cause more contamination and aerosolising of the coronavirus and causing more doctors and nurses to get sick. They will want to go right to intubation.
Anonymous
03/29/2020 22:21
Subject: Re:Intubated ventilator in Coronavirus patients. Soultion or problem. Why not to use unintubated?
Anonymous wrote:Anonymous wrote:Anonymous wrote:Who does operate this, a patient? A first responder? A nurse? ..
National guard.
Ok crazy question I know but could these be used at home?
Are you talking about the ambu bag that the PP seemed to be responding to?
I'm the parent of a kid who uses a vent at home. My kid is far more stable than an ARDS patient in the ICU. We have an ambu bag (with a trach attachment, so not exactly like the one pictured) for a true emergency, but it's not a long term solution, and by long term I mean longer than it would take for an ambulance to get here if the vent failed. It's nowhere near as precise as a vent.
In the hospital, it's a thing you use for a few breaths while you're doing CPR, or when you need a few minutes to get a vent set up. It's not a long term thing.
If you're asking whether you could just use this instead of taking your loved one with COVID to the ER, then no.
Anonymous
03/29/2020 22:21
Subject: Intubated ventilator in Coronavirus patients. Soultion or problem. Why not to use unintubated?
I’ve heard that intubation is not great, but ECMO is the really serious sh—t. I hope if I get there, they just let me go.
Anonymous
03/29/2020 22:15
Subject: Intubated ventilator in Coronavirus patients. Soultion or problem. Why not to use unintubated?
Anonymous wrote:Anonymous wrote:Anonymous wrote:MIT has invented a machine that can pump an ambu bag (the manual one above) and can be made for 100 bucks
https://e-vent.mit.edu/
Somebody CALL MIT NOW!!!! Did they find some production for it or is it still just an invention?
They have shared the plans and specifications so that anyone can produce them.
And just to be clear, the kind of precision that a patient with ARDS on a vent needs makes this device very very risky. Yes, it might be better than nothing, and result in a few people making it, but it's not the solution.
And no, not anyone can produce them. It needs to be very carefully calibrated.
Anonymous
03/29/2020 22:02
Subject: Intubated ventilator in Coronavirus patients. Soultion or problem. Why not to use unintubated?
Anonymous wrote:Anonymous wrote:MIT has invented a machine that can pump an ambu bag (the manual one above) and can be made for 100 bucks
https://e-vent.mit.edu/
Somebody CALL MIT NOW!!!! Did they find some production for it or is it still just an invention?
Go for it. Let us know what they say.
Anonymous
03/29/2020 22:02
Subject: Re:Intubated ventilator in Coronavirus patients. Soultion or problem. Why not to use unintubated?
Anonymous wrote:Anonymous wrote:Anonymous wrote:Who does operate this, a patient? A first responder? A nurse? ..
National guard.
Ok crazy question I know but could these be used at home?
Theoretically, yes, but I wouldn’t pin my hopes on that.
Anonymous
03/29/2020 22:00
Subject: Intubated ventilator in Coronavirus patients. Soultion or problem. Why not to use unintubated?
Anonymous
03/29/2020 22:00
Subject: Re:Intubated ventilator in Coronavirus patients. Soultion or problem. Why not to use unintubated?
Anonymous wrote:Anonymous wrote:Who does operate this, a patient? A first responder? A nurse? ..
National guard.
Ok crazy question I know but could these be used at home?
Anonymous
03/29/2020 21:59
Subject: Intubated ventilator in Coronavirus patients. Soultion or problem. Why not to use unintubated?
Anonymous wrote:Anonymous wrote:MIT has invented a machine that can pump an ambu bag (the manual one above) and can be made for 100 bucks
https://e-vent.mit.edu/
Somebody CALL MIT NOW!!!! Did they find some production for it or is it still just an invention?
They have shared the plans and specifications so that anyone can produce them.
Anonymous
03/29/2020 21:58
Subject: Intubated ventilator in Coronavirus patients. Soultion or problem. Why not to use unintubated?
Anonymous wrote:MIT has invented a machine that can pump an ambu bag (the manual one above) and can be made for 100 bucks
https://e-vent.mit.edu/
Somebody CALL MIT NOW!!!! Did they find some production for it or is it still just an invention?
Anonymous
03/29/2020 21:57
Subject: Intubated ventilator in Coronavirus patients. Soultion or problem. Why not to use unintubated?
Anonymous wrote:People who are asking about the helmets:
These work up to a certain point. If you need high pressure in the lungs to keep someone alive, you have to seal the tube in the throat. This is done below the nasal passages.
Nobody intubates someone because they have other alternatives, but can't be bothered. In ARDS, what you suggest would be pissing in the wind.
Please watch some YouTube videos on respiratory therapy, or read a few textbooks. This is really not plausible.
Great info there. Thank you so much PP!
Anonymous
03/29/2020 21:56
Subject: Intubated ventilator in Coronavirus patients. Soultion or problem. Why not to use unintubated?
MIT has invented a machine that can pump an ambu bag (the manual one above) and can be made for 100 bucks
https://e-vent.mit.edu/
https://e-vent.mit.edu/
Anonymous
03/29/2020 21:56
Subject: Intubated ventilator in Coronavirus patients. Soultion or problem. Why not to use unintubated?
Anonymous wrote:
***Intubation is used when the alternative is death.***
Yes, intubation is injurious. My husband is a doctor and hates it.
Again, it’s used when there is no other choice, when less invasive oxygenation is not working. It’s also why very old or very fragile patients are seldom intubated - their chances of recovery are slim.
It is absolutely understandable, the only question was if we can learn something here, not all of us is doctors nurses and know everything. So for those who are snarky or mean, we just ask questions to learn. Please tell us so we can better understand, options and risks.
There is whole bunch of people out there who runs to the hospital thinking it is better option when they don't truly need to and take away the resources from others. Perhaps they also need to learn the options and the risks?
Thank you PP for meaningful post.
Anonymous
03/29/2020 21:54
Subject: Intubated ventilator in Coronavirus patients. Soultion or problem. Why not to use unintubated?
People who are asking about the helmets:
These work up to a certain point. If you need high pressure in the lungs to keep someone alive, you have to seal the tube in the throat. This is done below the nasal passages.
Nobody intubates someone because they have other alternatives, but can't be bothered. In ARDS, what you suggest would be pissing in the wind.
Please watch some YouTube videos on respiratory therapy, or read a few textbooks. This is really not plausible.
These work up to a certain point. If you need high pressure in the lungs to keep someone alive, you have to seal the tube in the throat. This is done below the nasal passages.
Nobody intubates someone because they have other alternatives, but can't be bothered. In ARDS, what you suggest would be pissing in the wind.
Please watch some YouTube videos on respiratory therapy, or read a few textbooks. This is really not plausible.