Latest Coronavirus - Yikes

#108,576
#108,576
DynaLo said:
We’ve been told that Covid is a respiratory virus that causes pneumonia which requires hospitalization.
So what are we going to call that forced protocol of intubation, IV administered Remdesivir with its lovely side effect of renal dysfunction and saline drips to add even more fluid removal to already distressed kidneys, that all results in pulmonary edema in patients that initially presented with pneumonia?
Should that be considered involuntary, voluntary or premeditated?
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The pathophysiology of what covid does to the body is extremely complicated. The results are found on autopsies showing covid can affect every major organ. It involves viral load and the ability of the body to stop viral replication. Stopping viral replication is key and unfortunately by the time they get to me the damage is already done. They already have acute kidney injury, shock liver, damaged alveoli and are hypotensive.
The reason the comorbidities play to covids strengths is endothelial cell damage. Look up where endothelial cells are in the body. Covid damages them and guess who already have compromised endothelial systems? Hypertensive, diabetes, the elderly and obese people.
Remdesivir, if given too late will do no good. It’s only 1000cc of fluid like 4 cups of coffee over 5 days. These people we see are given medication about 5-8 days too late to stop the replication and prevent cell damage. Any medication given to prevent viral replication needs to be started after symptoms appear and positive covid. We are treating too late.

We only ventilate people who are in respiratory failure, altered mental status ( hypoxia and hypercarbia) that prevents them from receiving O2 by non invasive measures like hi flow nasal cannula or bipap or if they can’t maintain their airway. It’s a last resort now and they are usually in full blown covid pneumonia sepsis. Pulling someone from the hospital at this point would absolutely be 100% mortality. With that last resort can come several things like medically paralyzing, the use of pressers to maintain bp, sedation and drips for pain. Even though we concentrate our drips, it is still fluid we are adding. (They are usually in leaky capillary syndrome by now)

Have I said we are treating people too late with positive covid and symptoms? I’ve learned allot since April 2020 in several hospitals in covid ICUs and my own covid experience. I’m still learning.
 
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#108,577
#108,577
NurseGoodVol said:
The pathophysiology of what covid does to the body is extremely complicated. The results are found on autopsies showing covid can affect every major organ. It involves viral load and the ability of the body to stop viral replication. Stopping viral replication is key and unfortunately by the time they get to me the damage is already done. They already have acute kidney injury, shock liver, damaged alveoli and are hypotensive.
The reason the comorbidities play to covids strengths is endothelial cell damage. Look up where endothelial cells are in the body. Covid damages them and guess who already have compromised endothelial systems? Hypertensive, diabetes, the elderly and obese people.
Remdesivir, if given too late will do no good. It’s only 1000cc of fluid like 4 cups of coffee over 5 days. These people we see are given medication about 5-8 days too late to stop the replication and prevent cell damage. Any medication given to prevent viral replication needs to be started after symptoms appear and positive covid. We are treating too late.

We only ventilate people who are in respiratory failure, altered mental status ( hypoxia and hypercarbia) that prevents them from receiving O2 by non invasive measures like hi flow nasal cannula or bipap or if they can’t maintain their airway. It’s a last resort now and they are usually in full blown covid pneumonia sepsis. Pulling someone from the hospital at this point would absolutely be 100% mortality. With that last resort can come several things like medically paralyzing, the use of pressers to maintain bp, sedation and drips for pain. Even though we concentrate our drips, it is still fluid we are adding. (They are usually in leaky capillary syndrome by now)

Have I said we are treating people too late with positive covid and symptoms? I’ve learned allot since April 2020 in several hospitals in covid ICUs and my own covid experience. I’m still learning.
Click to expand...

Assuming pressure, not volume control? Is barotrauma a concern or is it just whatever keeps the sats up? High PEEPs?
 
#108,578
#108,578
Septic said:
Assuming pressure, not volume control? Is barotrauma a concern or is it just whatever keeps the sats up? High PEEPs?
Click to expand...
Not usually VC but yes PC 100% FiO2 and 14 to 18 of peep initially. With that still only getting paO2 of 60 the paCO2 is usually around 70 to 100. Their pH usually sucks too 7.0 7.1. Minimum vc just under the 6-8 per kg they normally do. The V:q mismatch is unbelievable. They just aren’t exchanging.
 
#108,579
#108,579
NurseGoodVol said:
Not usually VC but yes PC 100% FiO2 and 14 to 18 of peep initially. With that still only getting paO2 of 60 the paCO2 is usually around 70 to 100. Their pH usually sucks too 7.0 7.1. Minimum vc just under the 6-8 per kg they normally do. The V:q mismatch is unbelievable. They just aren’t exchanging.
Click to expand...

is ecmo considered or is that no longer a viable treatment?
 
#108,581
#108,581
NurseGoodVol said:
The pathophysiology of what covid does to the body is extremely complicated. The results are found on autopsies showing covid can affect every major organ. It involves viral load and the ability of the body to stop viral replication. Stopping viral replication is key and unfortunately by the time they get to me the damage is already done. They already have acute kidney injury, shock liver, damaged alveoli and are hypotensive.
The reason the comorbidities play to covids strengths is endothelial cell damage. Look up where endothelial cells are in the body. Covid damages them and guess who already have compromised endothelial systems? Hypertensive, diabetes, the elderly and obese people.
Remdesivir, if given too late will do no good. It’s only 1000cc of fluid like 4 cups of coffee over 5 days. These people we see are given medication about 5-8 days too late to stop the replication and prevent cell damage. Any medication given to prevent viral replication needs to be started after symptoms appear and positive covid. We are treating too late.

We only ventilate people who are in respiratory failure, altered mental status ( hypoxia and hypercarbia) that prevents them from receiving O2 by non invasive measures like hi flow nasal cannula or bipap or if they can’t maintain their airway. It’s a last resort now and they are usually in full blown covid pneumonia sepsis. Pulling someone from the hospital at this point would absolutely be 100% mortality. With that last resort can come several things like medically paralyzing, the use of pressers to maintain bp, sedation and drips for pain. Even though we concentrate our drips, it is still fluid we are adding. (They are usually in leaky capillary syndrome by now)

Have I said we are treating people too late with positive covid and symptoms? I’ve learned allot since April 2020 in several hospitals in covid ICUs and my own covid experience. I’m still learning.
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Makes you wonder how many people have died due to doctors making this political and not throwing the kitchen sink at it.
 
#108,584
#108,584
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#108,588
#108,588
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#108,589
#108,589
mad4vols said:
No surprise here…

Schools without mask requirements experiencing higher COVID-19 case rates

https://www.wxyz.com/news/coronavir...ments-experiencing-higher-covid-19-case-rates

View attachment 406187
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So the average infection rate peaked at 644 per 100k. Current 7 day rolling average per 100k is 155. So a jump from 25 to 75 doesnt seem as concerning. And just seems to show that kids are less vulnerable than adults.

Also I wonder what happens to that data if you roll the clock forward the rest of the month? Seems like the cut off of this chart coincides with drop off of cases we have seen lately.
 
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