Trump to quarantine awaiting Covid test
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https://thehill.com/homenews/administration/524911-mark-meadows-tests-positive-for-coronavirus
Trump’s Chief of Staff Mark Meadows tested positive for COVID-19.
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https://www.nytimes.com/2021/12/06/us/politics/trump-covid-blood-oxygen.html
On Friday, Oct. 2, 2020, hours after the president announced on Twitter that he had tested positive for the virus, he recorded a blood oxygen level of about 86 percent, Mr. Meadows wrote. That is roughly 10 points below what would be considered normal. Most healthy people have a blood oxygen level of about 95 to 98 percent, although some people may have lower normal readings.
Just so everyone understands, the percentage of O2 saturation says that his red blood cells are carrying 86% of the O2 they're capable of.
The dangerous thing is that the correlation between how much oxygen you're exposed to and how much your blood can carry is not linear. At about 85% or so, the curve starts to fall steeply, meaning that the hemoglobin is more likely to RELEASE oxygen than to carry it to tissues.
Whenever I saw SpO2 of less than 90, I would get worried - very worried. This turn to shit quickly below that.
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Yes, but from what I remember, haven’t they found that for some reason COVID patients did okay with lower O2 levels than what would have been expected and one of the biggest mistakes made early on in treatment was venting these patients too early?
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@lufins-dad said in Trump to quarantine awaiting Covid test:
biggest mistakes made early on in treatment was venting these patients too early?
For the medical folks here, are there better protocols now on treating covid patients? I remember something about massages to move the mucous around, etc.
Do any anti-virals work or is treatment mostly just "wait and see"?
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@xenon said in Trump to quarantine awaiting Covid test:
@lufins-dad said in Trump to quarantine awaiting Covid test:
biggest mistakes made early on in treatment was venting these patients too early?
For the medical folks here, are there better protocols now on treating covid patients? I remember something about massages to move the mucous around, etc.
Do any anti-virals work or is treatment mostly just "wait and see"?
Well we know that the Monoclonal Antibodies have been effective, the Merck pill is being used under EA and is effective, I am sure there are others…
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@lufins-dad said in Trump to quarantine awaiting Covid test:
Yes, but from what I remember, haven’t they found that for some reason COVID patients did okay with lower O2 levels than what would have been expected and one of the biggest mistakes made early on in treatment was venting these patients too early?
Indeed.
One has to understand that ventilation ≠ oxygenation. Ventilation is simply moving air in and out of the lungs. One reason to put someone on a ventilator is when they can no longer sustain the work of breathing (muscle fatigue, whatever). In fact, you can put someone on a ventilator at low inspired O2 levels (FiO2) - typical as low as 25-30%. Remember room air is 21%.
In the last decades, algorithms were developed which pointed to when someone should be put on a ventilator. One of the criteria was the SpO2, which presumably meant that the lungs were falling and the patient couldn't sustain that work, he needed help. As you point out, in the case of SARS-CoV-2 infection, that thinking was frequently wrong.
There are a couple of factors at play.
- Oxygen, by itself, is toxic, so you always want to give the least amount compatible with stability and maintenance of organ function.
- Ventilators are dangerous. Pushing air in, particularly into stiff lungs (from disease) can cause "barotrauma" - you can "pop" a lung if the pressure's too high. Not only that, pulmonary hygiene is difficult, predisposing to infection, etc.
So, as far as COVID goes, the thinking has changed to avoid ventilation as much as possible, and use as high an FiO2 as necessary to maintain patient comfort, rather than treating numbers.
"Now look here, you Baltic gas passer... " - Mik, 6/14/08
The saying, "Lite is just one damn thing after another," is a gross understatement. The damn things overlap.
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@bachophile said in Trump to quarantine awaiting Covid test:
cant think of any book i hated more in medical school then this little rag from hell
I (obviously) enjoyed respiratory physiology. Struck me as being almost as simply as cardiovascular.
Now, if you want to get
- Obscure - nephrology
- OCD - endocrinology
- More obscure - neurology (I loved that too)
