COVID 19, CPAP, Ventilator MEGA THREAD...everything go here please

[Lifeisabeach]

Saw this article and chortled over one of the photos. Using a CPAP to help with viral pandemics was a thing even in 1918. Ok ok, not a CPAP, but sure as heck looks like a precursor to one. But I am curious what that thing is supposed to be doing exactly.

https://www.bbc.co.uk/news/in-pictures-52564371

[ger365]

I keep seeing stats that show 90%+ people on vents die
please prove me wrong.
If true you have the answer to keep others alive!!
Shabbot Shalom.

[palerider]

I keep seeing stats that show 90%+ people on vents die
please prove me wrong.

And just how is someone supposed to "prove you wrong" about what you keep seeing?

[raisedfist]

I keep seeing stats that show 90%+ people on vents die
please prove me wrong.
If true you have the answer to keep others alive!!
Shabbot Shalom.

It probably varies highly by hospital. Who controls the vent often varies by hospital. Some hospitals are 100% protocol driven and are using ARDS protocols that are decades old, regardless of the actual patient and disease process that is being presented to them. If the patient has a low sat but is just laying their texting and looks comfortable, talking to you in full unbroken sentences, they are learning that you don't need to freak out and intubate. Some people are getting worse as soon as they are intubated. Some hospitals are skipping straight to intubation and not taking the time to safely try non-invasive measures to oxygenate the patient first (assuming they are breathing spontaneously and can protect their own airway). Some are adamant that CPAP/Bi-Level must not be used because it can aeroslolize the virus; but there are ways around that, such as using a surgical mask over a high flow nasal cannula, bi-level or cpap with a non-vented mask and/or extra filters, laying someone on their stomach with a NC or hfnc.

If I was hospitalized for covid-19 and they wanted to intubate me, and I was not in distress, I would probably refuse. If they didn't want to use other means to oxygenate me first to see what happens, I would just be discharged against medical advice and treat myself at home. What I would do is not medical advice of course.

[McSleepy]

Saw this article and chortled over one of the photos. Using a CPAP to help with viral pandemics was a thing even in 1918. Ok ok, not a CPAP, but sure as heck looks like a precursor to one. But I am curious what that thing is supposed to be doing exactly.

https://www.bbc.co.uk/news/in-pictures-52564371

"An advertisement of the day is for a “flu nozzle” designed to prevent infection while sitting at your desk—ostensibly to be used by people whose jobs required them to be in contact with the populace.

It passed air through tubes and chambers, which would merely by construction cause micro-droplets of expelled mucous to drop out of circulation. But, you can see that its volume would build up carbon dioxide so readily the wearer would be poisoned unless they removed it or alternately breathed out through the mouth."

Source: http://pediatric-house-calls.djmed.net/ ... n-and-now/

[jimbud]

https://www.sciencedaily.com/releases/2 ... 121353.htm

Get some sun.

JPB

The sun is our best natural source of vitamin D. Spending even a short time in the sun can provide the body with all of the vitamin D it needs for the day. According to the Vitamin D Council, this could be: 15 minutes for a person with light skin.Aug 28, 2019

[Dog Slobber]

I keep seeing stats that show 90%+ people on vents die
please prove me wrong.
If true you have the answer to keep others alive!!
Shabbot Shalom.

One of the sources for this statistic was from a study published in the AMA, and it is extremely flawed.

The study only considered those who died or those who were treated until release. It did not consider those still on the ventilator. The study also doesn't have a good comparison group, and many of the readers (I'll put you in this group) fail to recognize that those put on ventilators were already in a position where they were not likely to survive anyway.

The Journal has since retracted its 88% death figure, as more of the of those originally on ventilators have successfully come off them and more are expected to survive.

And BTW if you're going to assert something, then you should back up your assertion with something. Simply asserting and then taking the position, "I have spoken, prove me wrong", is moronic.

[chunkyfrog]

An illustration of the mentality behind the original flawed study.
Congratulations--you have achieved recursive nonsense.

[jnk...]

If I was hospitalized for covid-19 and they wanted to intubate me, and I was not in distress, I would probably refuse.

Tell your designated health proxy and family directly, and put your detailed wishes in writing about length of time you would be willing to be intubated under what circumstances and whether other measures (trache, feeding tube, etc.) in combination are or are not acceptable to you. Weeks down then weeks of rehab to regain partial function is what some want and others do not want. Your wishes are what matter. Don't wait until your wishes can't be expressed or followed. That makes it hard on the pros and on your loved ones alike when educated guesses have to be made by others. Don't assume you'll be able to speak for yourself. This thing can hit suddenly and move quickly.

[zonker]

If I was hospitalized for covid-19 and they wanted to intubate me, and I was not in distress, I would probably refuse.

Tell your designated health proxy and family directly, and put your detailed wishes in writing about length of time you would be willing to be intubated under what circumstances and whether other measures (trache, feeding tube, etc.) in combination are or are not acceptable to you. Weeks down then weeks of rehab to regain partial function is what some want and others do not want. Your wishes are what matter. Don't wait until your wishes can't be expressed or followed. That makes it hard on the pros and on your loved ones alike when educated guesses have to be made by others. Don't assume you'll be able to speak for yourself. This thing can hit suddenly and move quickly.

very well said.

end of life directives are important.

now i have to look at mine; not sure it includes intubation.

[raisedfist]

If I was hospitalized for covid-19 and they wanted to intubate me, and I was not in distress, I would probably refuse.

Tell your designated health proxy and family directly, and put your detailed wishes in writing about length of time you would be willing to be intubated under what circumstances and whether other measures (trache, feeding tube, etc.) in combination are or are not acceptable to you. Weeks down then weeks of rehab to regain partial function is what some want and others do not want. Your wishes are what matter. Don't wait until your wishes can't be expressed or followed. That makes it hard on the pros and on your loved ones alike when educated guesses have to be made by others. Don't assume you'll be able to speak for yourself. This thing can hit suddenly and move quickly.

Good reminder, I printed all the docs for IL at one time but I never got around to filling them out. I'm not against being intubated, I survived it before, but I don't want it as a first resort just because staff is afraid to try anything else.

[jnk...]

a first resort just because staff is afraid to try anything else.

My understanding is that at this point in the pandemic, most of what passes for protocols in this country do not involve rushing to invasive ventilation anymore for COVID-19 unless clinicians see little to no alternative. It isn't the intubation itself but the length of time being ventilated, it seems, that appears to be so damaging, as I understand it. And the length of time necessary is often not known for a particular patient ahead of time. The progression and complications are mysteriously unique from one patient to another. So docs and patients are both mostly flying blind over unknown terrain without instruments at this point when it comes to decision-making strategies related to this virus.

The limitations are real . . . Be suspicious of anyone who emphatically supports a particular therapy or treatment modality at this point. Their words may be amplified in the echo chamber created by the therapeutic void, but you can still tune them out.--https://www.medscape.com/viewarticle/929987

[DreamDiver]

Interesting news about connection with Vitamin D and Covid 19.

Science News from research organizations
Vitamin D levels appear to play role in COVID-19 mortality rates
Patients with severe deficiency are twice as likely to experience major complications
Date: May 7, 2020
Source: Northwestern University
Summary:
Researchers analyzed patient data from 10 countries. The team found a correlation between low vitamin D levels and hyperactive immune systems. Vitamin D strengths innate immunity and prevents overactive immune responses. The finding could explain several mysteries, including why children are unlikely to die from COVID-19.

[ChicagoGranny]

Interesting news about connection with Vitamin D and Covid 19.

A couple of things that should be emphasized:

severe vitamin D deficiency

This does not mean that everyone -- especially those without a known deficiency -- needs to start hoarding supplements, the researchers caution.

[palerider]

Interesting news about connection with Vitamin D and Covid 19.

A couple of things that should be emphasized:

severe vitamin D deficiency

This does not mean that everyone -- especially those without a known deficiency -- needs to start hoarding supplements, the researchers caution.

Nobody should hoard supplements, those things expire.

However, upping one's intake could very well be prudent.

Perhaps those people who had little to no reaction to the virus were the ones with very high VitD levels, more research would be welcome.