Latest Coronavirus - Yikes

#100,026
#100,026
NurseGoodVol said:
I’m sorry Louder, busy week.
Most of my pts were ventilated, sedated, medicated for pain and paralyzed. So I’m speaking from that microcosm that is icu and critical care.
The patients that faired the worst, I’m talking about 50% mortality or worse were 2 out of 3 for hypertension, diabetes and morbid obesity, recently remission cancer pts, recent runs of chemo, testing positive for longer than 30 days, those that weren’t anticoagulated, those that were kept at net negative fluid balance and those that had restrictive lung disease. If they had a combination of several of these mortality rose sharply. We could not ventilated these pts so we put them on their stomachs if they tolerated it.
Vitamin D was an issue and many of my pts nutritional panels were horrible coming in. We fed them per weight based caloric needs with tube feedings but with them being sedated and paralyzed their gut was not optimal for motility and absorption. We had many pts develop ileus. ( the gut stops moving which is always bad) Their nutritional panels didn’t get much worse but they didn’t get better. Vitamins and minerals for support of the immune system were not emphasized even when challenged on the subject.
When I was not doing critical care obesity and hypertension played a big roll. The pts required high O2 support like I’ve never seen before. Their lungs were acting like CO2 and O2 exchange were a foreign concept to them. I was thankful for every one we didn’t have to vent.
Keep in mind many of my pts were critically ill coming in. Their livers and kidneys had taken a hit from a low flow state and they had several systems compromised all at the same time. Their outlook was very bleak.
There were of course medical mistakes made specifically not anticoagulating pts that still, obviously, chaps my ass today. Providers couldn’t think independently at the clotting we were seeing because the cdc said don’t anticoagulant them. Lesson learned, the cdc does not always know what they are talking about.
That last paragraph was my own opinion, one I strongly believe in.
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I have to say that I much appreciate this post.
Thank you for sharing and Bless you and your family.
 
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#100,027
#100,027
NurseGoodVol said:
I’m sorry Louder, busy week.
Most of my pts were ventilated, sedated, medicated for pain and paralyzed. So I’m speaking from that microcosm that is icu and critical care.
The patients that faired the worst, I’m talking about 50% mortality or worse were 2 out of 3 for hypertension, diabetes and morbid obesity, recently remission cancer pts, recent runs of chemo, testing positive for longer than 30 days, those that weren’t anticoagulated, those that were kept at net negative fluid balance and those that had restrictive lung disease. If they had a combination of several of these mortality rose sharply. We could not ventilated these pts so we put them on their stomachs if they tolerated it.
Vitamin D was an issue and many of my pts nutritional panels were horrible coming in. We fed them per weight based caloric needs with tube feedings but with them being sedated and paralyzed their gut was not optimal for motility and absorption. We had many pts develop ileus. ( the gut stops moving which is always bad) Their nutritional panels didn’t get much worse but they didn’t get better. Vitamins and minerals for support of the immune system were not emphasized even when challenged on the subject.
When I was not doing critical care obesity and hypertension played a big roll. The pts required high O2 support like I’ve never seen before. Their lungs were acting like CO2 and O2 exchange were a foreign concept to them. I was thankful for every one we didn’t have to vent.
Keep in mind many of my pts were critically ill coming in. Their livers and kidneys had taken a hit from a low flow state and they had several systems compromised all at the same time. Their outlook was very bleak.
There were of course medical mistakes made specifically not anticoagulating pts that still, obviously, chaps my ass today. Providers couldn’t think independently at the clotting we were seeing because the cdc said don’t anticoagulant them. Lesson learned, the cdc does not always know what they are talking about.
That last paragraph was my own opinion, one I strongly believe in.
Click to expand...
Thank you for the reply. And thank you for the work you do.
 
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#100,028
#100,028
Septic said:
I read that list and immediately thought, "that's it?" Seems to me that the medical community does a damn good job at using empirical based research and recommending what it best based on the information at hand.
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Not with anticoagulating and covid they didn’t. They waited 3 weeks to suggest anticoagulating pts while we had many with major strokes and dvts. That’s why waiting for information to filter to the experts doesn’t take precedence over what my eyes can see. When a radiologist skips cms and uses inches to describe a clot to the mca , we have issues. Every line we put in has clots around it, don’t need the cdc to “guide” is in what is plainly evident. Empirical delay cost lives.
 
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#100,030
#100,030
NurseGoodVol said:
I just saw a Lysol commercial where they sanitized an outdoor playground before allowing children to play. My thoughts were if we didn’t have children exposed to all those germs they wouldn’t have an immune system to speak of. I’m all for cleanliness, but kids have to exercise their immune systems in order to fend off whatever comes at them. Fauci wants 3 year old to wear a mask. He’s a fool.
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I said this exact same thing to my youngest when she put her kids into a daycare and they got sick almost immediately. Obviously no one wants their kids to get sick, but I told my daughter that her kids needed to get sick and be exposed to other kids so they can put their immune system to work.
 
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#100,032
#100,032
VolStrom said:
I said this exact same thing to my youngest when she put her kids into a daycare and they got sick almost immediately. Obviously no one wants their kids to get sick, but I told my daughter that her kids needed to get sick and be exposed to other kids so they can put their immune system to work.
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Not bemoaning this pandemic, but Fear has become contagious. Sprinkle in politics, misinformation, and the lack of the ordinary citizen medical knowledge and here we are. The lack of discussion about therapeutics makes me more cynical.
 
#100,034
#100,034
VolStrom said:
I said this exact same thing to my youngest when she put her kids into a daycare and they got sick almost immediately. Obviously no one wants their kids to get sick, but I told my daughter that her kids needed to get sick and be exposed to other kids so they can put their immune system to work.
Click to expand...
Believe it or not the healthiest thing we can do is just let our kids be kids and have those temporary illnesses. Kids illnesses are minor inconveniences compared to an unhealthy unchallenged immune system.
 
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#100,036
#100,036
NurseGoodVol said:
I’m sorry Louder, busy week.
Most of my pts were ventilated, sedated, medicated for pain and paralyzed. So I’m speaking from that microcosm that is icu and critical care.
The patients that faired the worst, I’m talking about 50% mortality or worse were 2 out of 3 for hypertension, diabetes and morbid obesity, recently remission cancer pts, recent runs of chemo, testing positive for longer than 30 days, those that weren’t anticoagulated, those that were kept at net negative fluid balance and those that had restrictive lung disease. If they had a combination of several of these mortality rose sharply. We could not ventilated these pts so we put them on their stomachs if they tolerated it.
Vitamin D was an issue and many of my pts nutritional panels were horrible coming in. We fed them per weight based caloric needs with tube feedings but with them being sedated and paralyzed their gut was not optimal for motility and absorption. We had many pts develop ileus. ( the gut stops moving which is always bad) Their nutritional panels didn’t get much worse but they didn’t get better. Vitamins and minerals for support of the immune system were not emphasized even when challenged on the subject.
When I was not doing critical care obesity and hypertension played a big roll. The pts required high O2 support like I’ve never seen before. Their lungs were acting like CO2 and O2 exchange were a foreign concept to them. I was thankful for every one we didn’t have to vent.
Keep in mind many of my pts were critically ill coming in. Their livers and kidneys had taken a hit from a low flow state and they had several systems compromised all at the same time. Their outlook was very bleak.
There were of course medical mistakes made specifically not anticoagulating pts that still, obviously, chaps my ass today. Providers couldn’t think independently at the clotting we were seeing because the cdc said don’t anticoagulant them. Lesson learned, the cdc does not always know what they are talking about.
That last paragraph was my own opinion, one I strongly believe in.
Click to expand...

I'm sorry for all the pain you had to witness in the course of your duties. Thank you for being a nurse to some of the hardest cases to heal.
 
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#100,039
#100,039
AshG said:
I'm sorry for all the pain you had to witness in the course of your duties. Thank you for being a nurse to some of the hardest cases to heal.
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This was the first time in my nursing career I was totally distraught for families. They couldn’t come to comfort their family members. I’ve never seen anything so cold and clinical. They could only view them outside the rooms. Their is a beauty in touching another human being that was taken away with this virus. So I’m making sure that human touch is part of my routine now that there are no covid cases where I am.
 
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#100,040
#100,040
NurseGoodVol said:
This was the first time in my nursing career I was totally distraught for families. They couldn’t come to comfort their family members. I’ve never seen anything so cold and clinical. They could only view them outside the rooms. Their is a beauty in touching another human being that was taken away with this virus. So I’m making sure that human touch is part of my routine now that there are no covid cases where I am.
Click to expand...

I am cutting onions
 
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#100,049
#100,049
NurseGoodVol said:
I agree. As a parent I let my kids do everything. They played in sand boxes, neighbors houses playgrounds. They are healthy now because of it.
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As a kid in South Carolina in the 70s, I played in ditches, flooded yards, ate mud pies, and probably drank enough water from a garden hose to fill an Olympic size pool. Covid kicked my ass, but if not for all the crap I as exposed to as a kid, it probably would have killed me.
 
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