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keikla

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  1. Silly me. I thought this thread was supposed to be about the actual medical aspect of the virus and not the same old rehashing from the other thread.
  2. I doubt it, but we are trying to get actemra. It is being approved on a case by case basis by the manufacturer for covid use. We hope it will help with the massive cytokine release in critical patients. We are starting to trial steroids a bit, but don't have enough data to report back. We have had some ventilator patients that we were successfully able to extubate, mostly the young and healthy who you didn't expect to be intubated in the first place. Many others have not been so fortunate. One thing we've noticed is the use of paralytics. For those who aren't familiar, vented patients may or may not need a paralytic agent. It depends on the patient's ability to sync with the vent. We're seeing that many vented covid patients are requiring paralytics for much longer and at much higher doses than what we would see for the normal vented population. It's higher than we would normally even see for ARDS patients. My hospital has flipped like 8 or 9 units from their original intended purpose (i.e a post-op rehab unit to covid med surg) in the past week and a half. We have more than doubled our ICU capacity and still have those beds filled. Our census goes up by 20% every day, mostly for covid, many critical. Today we added some beds to a small gym and some more to a small kitchen area. This is not sustainable. Some nearby hospitals have started to ask families of all covid patients about DNR status, because the resources are not there to save those who code. I wouldn't be surprised if we have that discussion in the next couple days.
  3. We have seen no benefit from this combination in critically ill patients. Many colleagues at nearby hospitals are noting the same. The cytokine storm present in critically ill patients is too much for anything that this combo is likely to touch. We're transitioning to use hydroxychloroquine for med surg level patients (patients requiring admission but who are not critically ill) in the hopes that it provides more benefit at that level.
  4. That 2008 regional final against Wisconsin was on the NCAA facebook website tonight. I just watched the third period and OT. Not quite like being at a regional in person this weekend...
  5. Actually, I have one more thing to add. The other day NY put out a call to all retired or currently unemployed healthcare workers and also those in other states who would be willing to come help. As of this morning, over 40,000 HCP have volunteered. AMEN.
  6. Yeah I can't deal with this thread anymore. My tolerance for the endless debate has rapidly declined to nothing. If someone has a medical question related to covid and our experience here please just send me a private message. Hopefully I'll be back (and sane) on the other side of this.
  7. Early trends we're seeing on most covid *even in patients without comorbidities: Lymphopenia Elevated d dimer High troponin Reduced EF
  8. NY published similar restrictions saying that use has to be part of the state's clinical trial for covid treatment. The repeating question for many of these state decrees is related to the use of the word "prescription." Do any restrictions apply within a hospital? I know Cuomo's executive order today sent hospitals into a frenzy statewide trying to clarify.
  9. Interesting that they excluded any patients with comorbidities.
  10. Godspeed to them in this madness. I hope they are still finding ways to get outside (but away from people) for the sake of sanity.
  11. He has zero credibility as a medical professional after some of the crap he's touted.
  12. Yep, some places use UV light machines to sterilize ORs. Definitely something to consider for places that can afford the machines.
  13. Anesthesia, for one. You have a ton of anesthesiologists without scheduled surgeries except for emergencies. NY allowance of CRNAs to temporarily work without the standard MD oversight increases the numbers even more. Plus the plea for outside providers to come. And the plea for military providers. Right now the lack of meds necessary for vented patients (sedation, paralytic, pain control) seems like it will be as much of an issue as the vents themselves.
  14. I work in both Westchester county, which is just north of the Bronx, and Rockland county, which is just across the river.
  15. And also, if there are any HCP who are bored... NY passed an executive order that any providers (including nurses, RTs, PAs, NPs, etc) who are licensed in any state and in good standing can practice in NY without risk of penalty for not having a NY license. Also, all liability suspended except for gross negligence. So come on out and enjoy the fun!
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