12 April 2020, 12:04 AM
QuirtEvansDoctors Resisting Using Ventilators
quote:
Generally speaking, 40% to 50% of patients with severe respiratory distress die while on ventilators, experts say. But 80% or more of coronavirus patients placed on the machines in New York City have died, state and city officials say.
Higher-than-normal death rates also have been reported elsewhere in the U.S., said Dr. Albert Rizzo, the American Lung Association’s chief medical officer.
Similar reports have emerged from China and the United Kingdom. One U.K. report put the figure at 66%. A very small study in Wuhan, the Chinese city where the disease first emerged, said 86% died.
https://apnews.com/8ccd325c2be9bf454c2128dcb7bd616d12 April 2020, 01:26 AM
DanielI believe what Cuomo and others say here. Many or even most Covid-19 patients will probably be on ventilators for a prolonged amount of time and will die anyway.
“If we’re able to make them better without intubating them, they are more likely to have a better outcome — we think,” Habboushe said."
Well, yes.
This is to say nothing of the fact (actually it was mentioned) that being put on a ventilator is not therapeutic. I believe I read in someone's post (I forget whose) that it causes serious lifetime damage.
I do not want to be put on a ventilator.
In fact, I would refuse it if I knew of a legal and practical way.
There is: "DNR." There is an equivalent for: do not incubate (DNI?).
How can a person communicate his or her desires regarding both of these and have them actually followed by hospitals and doctors? I don't know.
12 April 2020, 09:28 AM
Piano*DadDNI is a standing order one can give to the hospital.
14 April 2020, 03:09 PM
wtgInteresting piece on the local news here. Seems that what's being observed is that the lungs remain elastic, but that oxygen levels are low. Some docs think that trying to improve oxygenation, but not necessarily raise to normal levels, is a better way to go rather than heading straight to intubation.
https://wgntv.com/news/coronav...ed-doctors-weigh-in/14 April 2020, 04:58 PM
ShiroKuroI was just reading about how now docs are trying different things to bring oxygen levels up and avoid intubation as long as possible... and now I can't find what I reading. I think it was on NYT...
Anyway, the techniques mentioned include having the person lie on their stomach or sit up, or use a pregnancy bed, all of which are supposed to give the lungs more room and less pressue than you would have lying on your back. The article mentioned something called "proning," which is leaning forward...
Anyway, hopefully some of this pans out, while simultaneously being supported by science, and hopefully it improves treatment and outcomes.
15 April 2020, 05:07 PM
piquéMy DO posted instructions on how to relieve the lungs the way it was done in the days before ventilators, and it does indeed involve bending the patient forward. At home you can lie over a tipped chair.
