Ventilators are not a panacea
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I also hear that a ventilator alone is pretty useless unless it is operated by an expert on the matter (as opposed to any random doctor), and that those experts are the real bottleneck.
@Klaus yes.
I've commented several times that staff, not equipment is a major problem. Not just ventilator drivers, but nurses, respiratory technologists, x-ray technicians, are critical to this.
The fact that driving a ventilator is complicated speaks against the simplistic solution of sharing ventilators with two or more patients.
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I'm thinking Jolly's SIL and George's wife are right. I think those things sound frightening.
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I'm thinking Jolly's SIL and George's wife are right. I think those things sound frightening.
@brenda When I've been harassed by docs in the past for not taking care of my asthma, the end of their lecture has always been something like, "and trust me, you don't want to be intubated." Luckily I've never had any experience with that. It does indeed sound terrible.
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I'm thinking Jolly's SIL and George's wife are right. I think those things sound frightening.
@brenda said in Ventilators are not a panacea:
I'm thinking Jolly's SIL and George's wife are right. I think those things sound frightening.
When I woke up from heart surgery I was intubated and restrained. I can only say it was like a prolonged aspiration event. The nurse tried to hold my hand and talk me down, while another person out me under again.
My wife apologized to my nurse when she saw her hand. I almost broke it.
“Cry havoc and let slip the DOGE of war!”
Those who cheered as J-6 American prisoners were locked in solitary for 18 months without trial, now suddenly fight tooth and nail for foreign terrorists’ "due process". — Buck Sexton
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@brenda said in Ventilators are not a panacea:
I'm thinking Jolly's SIL and George's wife are right. I think those things sound frightening.
When I woke up from heart surgery I was intubated and restrained. I can only say it was like a prolonged aspiration event. The nurse tried to hold my hand and talk me down, while another person out me under again.
My wife apologized to my nurse when she saw her hand. I almost broke it.
@Jolly said in Ventilators are not a panacea:
@brenda said in Ventilators are not a panacea:
I'm thinking Jolly's SIL and George's wife are right. I think those things sound frightening.
When I woke up from heart surgery I was intubated and restrained. I can only say it was like a prolonged aspiration event. The nurse tried to hold my hand and talk me down, while another person out out me under again.
My wife apologized to my nurse when she saw her hand. I almost broke it.
Just to put that in perspective, I'm somebody with a pretty high pain tolerance. After getting my chest cracked and then extubated, I took one pop of Fentanyl post-op. Other than that, acetaminophen.
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@brenda said in Ventilators are not a panacea:
I'm thinking Jolly's SIL and George's wife are right. I think those things sound frightening.
When I woke up from heart surgery I was intubated and restrained. I can only say it was like a prolonged aspiration event. The nurse tried to hold my hand and talk me down, while another person out me under again.
My wife apologized to my nurse when she saw her hand. I almost broke it.
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Most Critically Ill Patients with COVID-19 Survive with Standard Treatment
Clinicians from two hospitals in Boston report that the majority of even the sickest patients with COVID-19—those who require ventilators in intensive care units—get better when they receive existing guideline-supported treatment for respiratory failure. The clinicians, who are from Massachusetts General Hospital and Beth Israel Deaconess Medical Center, published their findings in the American Journal of Respiratory and Critical Care Medicine.
During the COVID-19 pandemic, hospitals around the world have shared anecdotal experiences to help inform the care of affected patients, but such anecdotes do not always reveal the best treatment strategies, and they can even lead to harm. To provide more reliable information, a team led by C. Corey Hardin, MD, PhD, an Assistant Professor of Medicine at Mass General and Harvard Medical School, carefully examined the records of 66 critically ill patients with COVID-19 who experienced respiratory failure and were put on ventilators, making note of their responses to the care they received.
The investigators found that the most severe cases of COVID-19 result in a syndrome called Acute Respiratory Distress Syndrome (ARDS), a life-threatening lung condition that can be caused by a wide range of pathogens. “The good news is we have been studying ARDS for over 50 years and we have a number of effective evidenced-based therapies with which to treat it,” said Dr. Hardin. “We applied these treatments—such as prone ventilation where patients are turned onto their stomachs—to patients in our study and they responded to them as we would expect patients with ARDS to respond.”
Importantly, the death rate among critically ill patients with COVID-19 treated this way—16.7%—was not nearly as high as has been reported by other hospitals. Also, over a median follow-up of 34 days, 75.8% of patients who were on ventilators were discharged from the intensive care unit. “Based on this, we recommend that clinicians provide evidence-based ARDS treatments to patients with respiratory failure due to COVID-19 and await standardized clinical trials before contemplating novel therapies,” said co–lead author Jehan Alladina, MD, an Instructor in Medicine at Mass General.
