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Stories from the Front Lines (✨COVID-19 Healthcare Workers only: posting rules imposed)

  1. BenBagbag

    BenBagbag Mar 22, 2020

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    Figured we have a few medical providers on here and we can share our stories. This chat is not designed for speculation about what will be, or stories we are hearing from other sources. First-hand accounts only please. Tell us where you are if possible, and what your role is. (Here is the thread for general COVID-19 discussions.)

    I'm a volunteer EMT in NYC.

    I was on the first suspected COVID-19 call in my community in early March (Back when there were only 100 cases in New York State). A little kid looking like he was suffering from flu-like symptoms. "Would you have called us if she just had the flu?" No. "Okay, call your doctor and stay home." We did not step into the house until we figured out what was going on. "Was she in contact with another positive case?" No. Okay, we still have to do an assessment even if we don't transport. I put on a full PPE kit: N95, faceshield, gown, hairnet and shoe covers and was the only one who entered the residence to assess the kid. She had a fever but no other critical symptoms that would require hospitalization. It was chaotic as the pediatrician did not know if the hospital would test the kid and said that the hospital would not even accept the patient (this was false - this hospital legally cannot turn a patient down). It was unclear where testing would be done and by who. We've got medical Control on the phone and our medical director. Kid would not be referred for testing because the testing was so limited and they were saving it for people with confirmed contact with a positive case. Kid was never tested to my knowledge. At that time there was no buzz in the air of hospitals being overwhelmed. No mention of flattening the curve. No social distancing.

    Fast forward to yesterday March 21st. It's starting to ramp up a lot here. Our older crew members are being advised not to take calls and a few EMT's have preexisting conditions which prevent them from taking calls. I'm covering 4x more shifts than I was before this started. Today we brought in a likely COVID-19 case. Third likely COVID-19 call in the day. Cases in NYS have topped 10,000 and we no longer try to connect a patient to a positive case - we assume every patient is potential case.

    Our patient is a late 80's man with fever, difficulty breathing, O2 sat in low 80's. History of congestive heart failure. They decided to intubate him as soon as we got to the hospital. Our crews are being instructed to try to delay intubation until we get to hospital unless seconds matter, as risk of infection skyrockets when you intubate in a small area like an ambulance. None of the nurses were wearing PPE, just simple facemasks. It looked like the crew that would be doing the intubation had full PPE (though my friend who is a residents at another NYC hospital told me the ER docs are not getting PPE for intubations anymore... another resident told me he is being given one N95 mask per week). They were trying to identify a room they could intubate patient in. No more negative pressure rooms available. "Clear out orthopedic operating room?" Nope, an immuno-compromised patient is being isolated there away from the ER. Finally they settled on intubation in a room they hoped to keep open for more acute critical cases. Not sure where the next patient will fit. This is a top-rated US hospital. Later in the day we had our first COVID-19 transport from a large local nursing home that often relies on our service. They said they got their first confirmed case a few days ago...

    Would love to hear from and connect with other healthcare providers. Thank you all for your service!
     
  2. JanV

    JanV Mar 22, 2020

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    Excellent idea, so please respect the rules before posting!! :thumbsup:
    I would love to hear first hand reports instead of speculations right now!!

    This chat is not designed for speculation about what will be, or stories we are hearing from other sources. First-hand accounts from professionals in the field/ battle only please!”
     
    Edited by a mod Mar 22, 2020
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  3. BenBagbag

    BenBagbag Mar 22, 2020

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    Three hours ago, I went an another suspected COVID-19 call (late 40's patient with high fever and dizziness/weakness - patient has been taking the subway all week trying to find work.). After the call I spoke to my partner whoand spoke to took yesterday's suspected nursing home COVID-19 case. He told me there was a body bag in the room they intubated our patient in. Trying to get confirmation that it was indeed our patient, and if he was positive for COVID-19.
     
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  4. Wetworks

    Wetworks Mar 22, 2020

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    ED RN in NYC. I will say I don't agree wholeheartedly with the posting rules OP. I think speculation about the disease, treatments, trends, as well as sharing info from other medical sources (like the video I shared about vents) is important. Tell me if you feel those are acceptable exceptions.

    Otherwise, fantastic idea!!
     
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  5. BenBagbag

    BenBagbag Mar 22, 2020

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    I think it's a slippery slope. Certainly worth a try. If it gets too broad and loses scope let's revisit it. Let's stick to Healthcare Workers sharing. Again, best if this stuff is being seen firsthand.
     
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  6. Jwit

    Jwit Not a doctor, but plays one on ΩF Mar 22, 2020

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    Hey guys. EMT in Buffalo, NY here. Fortunately our confirmed case count in Erie county is low for now, ~50. However we only had 500 test kits to begin with. Hard to confirm more cases when you can’t test for it::facepalm2::

    I personally have had a couple potential cases. Mild cough or fever. Most of what we are seeing right now is fear. Hundreds of people call daily with one or two symptoms wanting to get tested. The unfortunate truth we need to tell them is that there are no tests, that the hospital will evaluate them but with no test and no life threatening symptoms they will be discharged. I normally don’t struggle emotionally with calls, but it’s increasingly fatiguing seeing hope wiped from people’s faces. I can't and I won’t lie to them.

    What really scares me is that I don’t feel our local infrastructure can handle even the smallest upticks in volume, not to mention the tidal wave that is on the horizon.
     
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  7. BenBagbag

    BenBagbag Mar 22, 2020

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    I'm feeling the emotional part too. Bringing patients to an ER I know is delivering suboptimal care and certainly is suboptimal infection control. I've started saying, "You can go to the ER to find out if you have COVID-19, and by the time you leave you'll definitely have it."

    Case-in-point - My ER resident friend at major NYC hospital just told us that he was told today (3/22) to bring a scarf to work this week to cover his face. New. York. City.
     
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  8. BenBagbag

    BenBagbag Mar 22, 2020

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    A few guys from our squad were saying that they feel guilty bringing elderly people who are sick with things other than COVID-19, knowing that they will be exposed to COVID-19 at these hospitals. Had a few of those the past few days.

    @Wetworks You in? Would love to hear what it's like for you out there.
     
  9. Wetworks

    Wetworks Mar 22, 2020

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    Yea, I'm seeing an uptick in 'dumps' from the residences lately. Seems like any pt who presents with even remotely associated symptoms is being sent to the ED. And like you said, the elderly people from those residences aren't exactly a healthy lot. We are pretty much out of isolation rooms, let alone negative pressure rooms, so we are putting rule-outs wherever we can at this point. Thankfully, outside of C19 stuff, acuity has been relatively low.
     
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  10. Wetworks

    Wetworks Mar 22, 2020

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    Oh, and we are pretty much bingo on PPE. I went ahead and ordered some neck gaiters to use as a mask. Hope all those shitbird hoarders are using their masks in their houses now that they are locked down and are facing little to no exposure risks. Assholes.
     
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  11. BenBagbag

    BenBagbag Mar 22, 2020

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    I yelled at a guy walking down the street with an N95. Said - you know people in the hospital need these. Another guy was wearing it the wrong way in the supermarket earlier I said if you're gonna take one of these from a healthcare worker at least wear it correctly. Very angering.
     
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  12. Wetworks

    Wetworks Mar 22, 2020

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    Yea, I think going forward I won't be above publicly shaming this people as they are 1) ignorant and 2) selfish. Hate being that guy...
     
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  13. zrleopold

    zrleopold Mar 22, 2020

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    Hey OF. Medical student in NJ here. The various hospitals we rotate out now how many COVID + patients. All medical students of every year have been relinquished if all their clinical duties at the moment. To be honest I have mixed feelings. On one hand, we could be of use to the medical teams depending on our year. Yet, on the other hand our presence required extra PPE that could go to more experienced clinicians. I see uninsured patients at a student run clinic, which has since been forced to close due to the circumstances. Many of these patients have trouble accessing resources to navigate their health and everyday living on a good day. I imagine even more people are going to fall through the social safety net as we move forward.

    On a more personal note, I am scheduled to take the first round of my board exams in June. The testing centers have closed through mid April for now, and studying for a genuinely career altering exam in this environment is not ideal.

    To echo those above: thank you to the physicians, pharmacists, RNs, techs, paramedics, hospital staff etc who are working through this tough situation.
     
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  14. WatchCor

    WatchCor Mar 23, 2020

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    Surgeon here, not working in the frontline but I am behind the main line of defense. ICU and ward.

    We're seeing the first cases that need NIV's and the first case that is critical on ventilation. We have five ECMO's but this patient is deemed too far gone for any meaningful chance of recovery.

    We've been bracing for impact at this point for a week or two now. Training extra nurses for ICU's and wards. Shutting down elective surgery. Creating ad-hoc ICU wards and re-assinging wards as Covid-Wards

    I know that we are the lucky ones. It didn't arrive here first so we have had time to prepare. I don't fear it but I am feeling a sense of nervousness of how well and far will our preparation carry us and our patients.
     
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  15. M'Bob

    M'Bob Mar 23, 2020

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    My patient emailed me that he confronted someone about a dense funeral gathering at a Catholic Church, and was subsequently assaulted, getting his face smashed into the ground, and hurting his shoulder. Unfortunately, as his PT, I have not yet sorted out a safe way to resume seeing patients. Nor has my dentist...
     
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  16. watch3s

    watch3s Mar 23, 2020

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    RRT here from NYC working at a major hospital, the shortage of ppe can be dangerous and an alarming situation. Fellow RRTs in other hospitals have adapted a full face bibap mask with a filter in order to make the best use of equipment available. This solution covers the eyes, prevents face touching and the HEPA filter will filter out bacteria/viruses.
     
  17. rcs914

    rcs914 Mar 23, 2020

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    If this post violates, please delete, as I am not a front line provider myself, however my wife is an RN, my sister in law is an NP, and her husband is a Critical care pulmonologist in an ICU in Los Angeles. I saw him last weekend, and his hospital had 2-3 COVID patients at the time, he had not seen one of them yet. In that week, everything has changed, and now every day is full suit up, and they are swamped. When asked how many COVID patients he had, his reply was that he had lost count.

    Here's the kicker - my wife works for an Ambulatory surgery center, and they are proceeding essentially as if nothing has happened. Elective surgeries are still being scheduled and performed, pain injection procedures that have upwards of 30-45 patients per day are still being done, etc. While there are some "elective" procedures that do need to be done in a timely manner, they are doing nothing to curb non-essential procedures. Similarly in my sister in law's clinic (I won't say what specialty as I don't want to get too identifying) she is seeing 40 patients a day for completely non-emergent issues. In both cases it feels like the companies are more concerned with money than patient or worker safety.

    Both my wife and my sister in law are DEEPLY angry about how their respective companies, that should know better and be leading the fight on social distancing, are doing none of that and are still cramming as many patients though the doors as they can on a daily basis.
     
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  18. BenBagbag

    BenBagbag Mar 23, 2020

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    Thanks for the support pouring in from people. It means a lot.

    Last night we had a call for a community doctor who had an exacerbation of a painful chronic condition that required her to be brought to the hospital. She is older than 70 at this point and until her medical practice was put on hold she was working every day. I felt horrible bringing her to the hospital, knowing that they won't be able to prevent infection. The same doctors are treating COVID-19 patients and non-COVID-19 patients (assuming that the ones who don't have symptoms don't have it - which is very far from a certainty). She's and her spouse have been doing such a good job self-isolating and social-distancing only to be forced into a situation which almost certainly will expose her to COVID-19.

    I called her this morning to check in on her and she said that she was in debilitating pain for 3 hours hours before even being seen by a doctor and given pain medication and only after 9 hours on the ER main floor was she transferred to a different area which likely has less COVID-19 patients and is more specialized to treat the chronic condition.

    Maybe that will put into perspective another one of our crew's calls from the past two days. A patient who is 90+ fell out of bed and clearly fractured bones and was in pain. In any normal scenario, we would have transported the patient to the hospital and the extent of injuries would have prevented us from allowing them to "refuse transport" as doing so would be considered a dereliction of duty on our part as medical providers (any pre-hospital care really can't rule out internal bleeding secondary to fractured bones). The family healthcare proxy fought so hard with our medical control team to keep the patient from being brought to the ER knowing that going right now could very well be a death-sentence to a 90-year-old as patient would very likely contract COVID-19 there. Medical control agreed that it was within their rights to refuse. So the family was scrambling to see if they could find a doctor who could provide some kind of outpatient services the next day to help the patient... There is no right answer anymore for these patients.
     
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  19. BenBagbag

    BenBagbag Mar 23, 2020

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    Feel comfortable sharing which general area you are from?
     
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  20. WatchCor

    WatchCor Mar 23, 2020

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    Finland, northern parts. The capital (Helsinki, which is way south of here) is the epicenter of Covid nastiness.

    I am concerned that the lack of travel restrictions will cause major issues here. Additionally, alot of people from the southern parts spend their ski-holidays in the north, which of course coincided with the Covid. Fortunately we have had a week or two to prepare (and continue to do so)
     
    Edited Mar 23, 2020
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