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JPE.88305
·Hope you have a speedy recovery!
Stories from the Front Lines (✨COVID-19 Healthcare Workers only: posting rules imposed)
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sah
·Got my result today, positive, no surprise there. Still dealing with a fever over a week later, cough is slightly worse, no SOB. Fatigue is becoming an issue as I don't have an appetite and I am seemingly never normothermic. Would not recommend.
MD Internal Medicine
Glad you are still able to manage care at home. Wishing you a continued improving course and recovery. Your efforts at work saved many patients. Thank you for being there.
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BenBagbag
·Got my result today, positive, no surprise there. Still dealing with a fever over a week later, cough is slightly worse, no SOB. Fatigue is becoming an issue as I don't have an appetite and I am seemingly never normothermic. Would not recommend.
(EMT NY)
We've had an increase in nursing home calls in the past few days. I picked up a woman at an assisted living facility whose husband was already in ICU few days ago. Brought her to the hospital with low oxygen and altered mental status. Just found out that she was released next morning (would she if our hospitals weren't unbelievably overwhelmed? I think not...) and that husband passed. Family is now scrambling to deal with burial of dad and trying to get mom home oxygen therapy so she doesn't have to return to hospital. Also more of our EMS crew is out now with COVID-19 and one just lost an aunt.
But yesterday was slightly quieter from call volume perspective. Hoping that the two weeks we've been doing social distancing translate into results. This week (as every week will be in foreseeable future) will be a pivotal week in NY.
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larryganz
·Got my result today, positive, no surprise there. Still dealing with a fever over a week later, cough is slightly worse, no SOB. Fatigue is becoming an issue as I don't have an appetite and I am seemingly never normothermic. Would not recommend.
Thanks for your service in helping to treat those who are sick and taking one for the team!
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Yak1
·Spent last week rounding in this hospital for specialty consults. The hospitalists were kind about not demanding covid patients be seen physically unless it was necessary (preserve ppe, minimize contact), but it seems, with the number of presumed cases, we should almost assume everyone may have it. Volumes were low, clearly the quiet before the storm. Still had patients who needed urgent procedures but very few since every patient was being intubated (which was the exception before COVID)—I anticipate needing to be back in the hospital to care for patients if complex and sick patients require that we admit our own less complex patients—I’m self isolating from the family for three weeks ( 1 week while rounding, two weeks to make sure I’m clear), and I can’t wait until rapid antibody testing is available. Hospitals are odd places without family members, and in many ways, even more profoundly depressing to see patients without that key family support. Kudos to the nurses, techs, pharmacists, emts, cleaning personnel, food services teams, and all of the er/critical care/hospitalists who have been doing this daily for weeks.
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Wetworks
·Morning all,
Been a rough few days, fever and energy level took a turn for the worse. Today I am able to manage the fever yet again. Changed the sheets on the bed (that was exhausting), my pulse ox remains high (96-99), and my cough is managed with periods of laying prone for 10 minutes (only have to do this a couple of times a day). So it appears I have a pretty tough, moderate case. Anyway, just wanted to let you all know I didn't die, lol
Been a rough few days, fever and energy level took a turn for the worse. Today I am able to manage the fever yet again. Changed the sheets on the bed (that was exhausting), my pulse ox remains high (96-99), and my cough is managed with periods of laying prone for 10 minutes (only have to do this a couple of times a day). So it appears I have a pretty tough, moderate case. Anyway, just wanted to let you all know I didn't die, lol
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sah
·Sorry to hear you have the second wave hitting you. Hopefully you will finish this part up in the next few days. Do you have support if you need it with shortness of breath or dropping oxygen to get you help?
Wishing you well.
PS I have to be weird, hopefully humorous, but last night changing your sheets, I was seeing how your Omega Forum name is apropo.
Wishing you well.
PS I have to be weird, hopefully humorous, but last night changing your sheets, I was seeing how your Omega Forum name is apropo.
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Wetworks
·Back to work yesterday (no rest for the essential worker, lol). Gun to head I'd have to say we didn't have the volume we did previously as far as new cases, but we are still pretty packed. Had a guy come in symptomatic, AAOx3, satting ~90, by the end of my shift he was intubated. Most insane thing I've ever seen was a SpO2 of 7(!) with a perfect wave form during the intubation despite bagging on 100%. Scary!!!
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sah
·Can you please translate the last part for those of us who don’t speak doctor?
Wetworks, glad you made it thru to the other side. You are now superhuman strong in the fight.
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Börn
·
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sah
·Not being a doctor, but I guess this explains why patients die, despite intensive care?
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larryganz
·AAOx3 = Awake Alert and Oriented times three (oriented x3 being knowing person, place, and time).
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marturx
·Basically. The oxygen cannot get in despite super high amounts, the blood pressure drops despite fluid and Adrenaline type med, many other organs fail for sometimes unclear reasons. The body makes chemicals (cytokines) to fight the virus but the chemicals cause more harm than good. We are just starting to understand the basics of the disease, and treatments are too early in development to know what to use.
Thank you.
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Wetworks
·Wetworks, glad you made it thru to the other side. You are now superhuman strong in the fight.
Thanks, but unfortunately that is now open for debate. I believe that I am, but people are confusing the 're-testing positive' (I think that's less concerning) with re-activations (more concerning). Of course all my bosses at work are like "wear full PPE anyway", so no chance for me to show off my fancy new antibodies. I was operating before getting infected with little in the way of fear anyway (not bragging, simply stating how I'm built), so.....
-Tom
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sah
·Not a lot of watch pics in this thread. Here is my front line watch....
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Wetworks
·Good point. Here's mine:
Thank you sir!!! Doing my best. Today that entailed intubating 3 of my 8 patients, all within 3 hours of each other. Kept them stable for the rest of my shift, so that's a small win. Imbibing some Auchentoshan while listening to Elbow as a reward.
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Wetworks
·RN, ED
So today I returned to see 2 of my patients still in the ED awaiting ICU beds, third went up on my day off. Managed to significantly reduce their ventilator settings to more acceptable levels (PEEP of 5 and 10 respectively) while maintaining good oxygenation levels ~95%. Both were on vasopressors for hypotension and I was able to titrate that and their sedation to gentler levels. Got them to the ICU before I left, so fingers crossed.
So today I returned to see 2 of my patients still in the ED awaiting ICU beds, third went up on my day off. Managed to significantly reduce their ventilator settings to more acceptable levels (PEEP of 5 and 10 respectively) while maintaining good oxygenation levels ~95%. Both were on vasopressors for hypotension and I was able to titrate that and their sedation to gentler levels. Got them to the ICU before I left, so fingers crossed.
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sah
·RN, ED
So today I returned to see 2 of my patients still in the ED awaiting ICU beds, third went up on my day off. Managed to significantly reduce their ventilator settings to more acceptable levels (PEEP of 5 and 10 respectively) while maintaining good oxygenation levels ~95%. Both were on vasopressors for hypotension and I was able to titrate that and their sedation to gentler levels. Got them to the ICU before I left, so fingers crossed.
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BenBagbag
·I'm hearing from MD friends that they are doing a lot of proning for patients in certain NYC hospitals but staffing is an issue (takes resources to actually do this and often no staff available). Apparently one hospital hired a team just to prone patients.
I'm hearing more talk about anti-coagulation treatment and how the antibody plasma treatments seem to be promising.
EMT, NYC experiences... We've been having less calls overall (and this is true for whole 911 system). Certainly seems less busy than it was, but our calls are typically more intense these days. A much larger % of our calls are at the nursing homes in the area. Clearly is still a slow spread through the hospital. They've lost many unfortunately.
I believe New York State issued guidance that CPR should not be initiated unless a patient has a shockable heart rhythm, but NYC which follows its own guidelines to begin with said they won't follow that and have a higher standard.
I have since found out that my first patient I talked about in OP passed away in the hospital, unfortunately, after being on a ventilator for around ten days. The nursing home patient whose husband died actually is slated to make a full recovery.
I'm hearing more talk about anti-coagulation treatment and how the antibody plasma treatments seem to be promising.
EMT, NYC experiences... We've been having less calls overall (and this is true for whole 911 system). Certainly seems less busy than it was, but our calls are typically more intense these days. A much larger % of our calls are at the nursing homes in the area. Clearly is still a slow spread through the hospital. They've lost many unfortunately.
I believe New York State issued guidance that CPR should not be initiated unless a patient has a shockable heart rhythm, but NYC which follows its own guidelines to begin with said they won't follow that and have a higher standard.
I have since found out that my first patient I talked about in OP passed away in the hospital, unfortunately, after being on a ventilator for around ten days. The nursing home patient whose husband died actually is slated to make a full recovery.
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Wetworks
·Have you had any patients pre-intubation that were de-sating get put into a prone position to improve their oxygen levels?
We are proning patients, and the PT team is also supposed to be handling it for patients admitted to the hospital. They did prone one of my two patients post-intubation, impressive considering they were a 400+ person.