Latest Coronavirus - Yikes

#45,129
#45,129
volfanhill said:
How is that worse then death?
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It appears to me as if the implication was either hydroxychloroquine treatment with the potential complication of long qt or death. Seems to be a false dichotomy as one may not 'die' from covid ordinarily but now they've got a heart arrhythmia...
 
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#45,130
#45,130
NurseGoodVol said:
liver panels with covid19 are elevated, they all have AKI and show R heart strain. All have jugular neck vein distention. This is before treatment started.
Their Crp, ferratin and d dimers are through the roof. It's kinda how you know they are gonna come back positive.
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Interesting about the D dimer, I heard on the news today lots of covid folks were having clots. Gotta be a correlation there.
 
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#45,131
#45,131
Septic said:
It appears to me as if the implication was either hydroxychloroquine treatment with the potential complication of long qt or death. Seems to be a false dichotomy as one may not 'die' from covid ordinarily but now they've got a heart arrhythmia...
Click to expand...
Agreed. But the biggest study on this hasn’t released its results. And again they didn’t do it bc Trump said. They did it bc it made sense to try it medically
 
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#45,132
#45,132
Septic said:
It appears to me as if the implication was either hydroxychloroquine treatment with the potential complication of long qt or death. Seems to be a false dichotomy as one may not 'die' from covid ordinarily but now they've got a heart arrhythmia now...
Click to expand...
Given support the liver panels, creatinine resolve.... So does the Qt prolongation. The reason they die is from an inability to ventilate them. There's no false dichotomy, it's a side effect we tracked with ekgs consistently. We get side effects from many critical care drugs, we still use them.
 
#45,133
#45,133
NurseGoodVol said:
Given support the liver panels, creatinine resolve.... So does the Qt prolongation. The reason they die is from an inability to ventilate them. There's no false dichotomy, it's a side effect we tracked with ekgs consistently. We get side effects from many critical care drugs, we still use them.
Click to expand...

I don't think it'd be medically prudent to continue to give hydroxychloroquine, a drug known to cause prolonged qt to a patient exhibiting a long qt.... In hopes that the hydroxychloroquine anecdotally was reported to help. As has been noted, the poorest outcomes come from patients with comorbidities, I'd argue that heaping a arrhythmia on someone that didn't already have one isn't a great plan of attack.
 
#45,134
#45,134
Septic said:
Interesting about the D dimer, I heard on the news today lots of covid folks were having clots. Gotta be a correlation there.
Click to expand...
D dimers 8 x normal range. They act like they are in DIC, clotting and bleeding in lungs yet pull a peripheral IV and hold pressure for 10 minutes. They are definitely different to care for. Trying to resolve AKI and keeping them dry at the same time.
 
#45,135
#45,135
NurseGoodVol said:
D dimers 8 x normal range. They act like they are in DIC, clotting and bleeding in lungs yet pull a peripheral IV and hold pressure for 10 minutes. They are definitely different to care for. Trying to resolve AKI and keeping them dry at the same time.
Click to expand...

Are you keeping them prone or turning them prone intermittently? That’s what we’ve done and it seems to help.
 
#45,137
#45,137
NurseGoodVol said:
D dimers 8 x normal range. They act like they are in DIC, clotting and bleeding in lungs yet pull a peripheral IV and hold pressure for 10 minutes. They are definitely different to care for. Trying to resolve AKI and keeping them dry at the same time.
Click to expand...

Volume or pressure control?
 
#45,138
#45,138
Septic said:
I don't think it'd be medically prudent to continue to give hydroxychloroquine, a drug known to cause prolonged qt to a patient exhibiting a long qt.... In hopes that the hydroxychloroquine anecdotally was reported to help. As has been noted, the poorest outcomes come from patients with comorbidities, I'd argue that heaping a arrhythmia on someone that didn't already have one isn't a great plan of attack.
Click to expand...
I get that. I struggled with what I saw on the monitors and the ekgs I was doing because I know where it leads. ( no pun intended )
Unknown territory with this virus. Do something or do nothing. The docs decided to do something with the regimen. The pts survived and issues resolved. We can't point at why yet. Too early.
 
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#45,139
#45,139
RavinDave said:
Here’s one small business owner who is getting nada from the SBA program. Initially I tried but only half-heartedly, to apply via Chase where I have a business account. But on Day One they said “we’re not taking applications yet, and we’ll let you know when we are” but I never heard back. Based on only drawing a salary of $48k as the only employee my “entitlement” was capped at $10k which I hate to let it go but in the overall scheme of things it’s chump change and though business is way down right now should be able to pay for the $500k worth of catalyst we had on order months ago and keep the IRS paid up and still remain solvent. Assuming the economy doesn’t go completely off the rails.
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I hear you. Loud and clear. Bankf of America, Wells, all of them are swamped with applications. BoA ups the ante by narrowing their terms and conditions. I rarely defend them but in this case, they weren't ready for this high volume environment.

Employees, we assist them in filing for unemployment. Two small busineeses are Florida based. Seven of every eight Floridians who managed to file claims during the three weeks from mid-March until early April were waiting to have them processed — the worst rate in the country.

So we setup our own unemployment insurance system, We pay the employees what they aren't getting from their claims. Sounds generous, yes?

No.

We can't inventory perishables (milk, ice cream, eggs, blah yada) for e.g. so it's cash reserves doing nothing. I'd rather keep the possibility that employees will be able to return to work whenever b/c if not I'm fooked.

Ok, we gathered everyone up and offered to cruise ship them to St. John's where my partners have large homes. Nope, violating lease terms, they lose their rentals or mortgages for non-occupancy. then the cruise lines shutdown until July.

And to make things even grander, the states will, sooner than later, start filing bankruptcy. Who knows what happens then.

IMO, chances are in favor of this getting worse. Our mortgage payments aren't vanishing for a few locales, we are fortunate to own most of our buildings. We are about to shutter the whole kitnkabbodle then the IDIOT Fl Guv declares that "flower businesses are essential" WTF? No!

Customers call and want to know why our doors aren't open for walk-ins. Here's a clue. None of our employees who perform this specialized work...will come to work.

As a last straw, now this is funny...wait for it...we agreed to pay for any employee to get their marijuana card. ~$400. We pointed them to online, no-visit doctor appointments to qualify. All you have to say is that you are "anxious", well yes they're anxious. Takes 2-4 weeks. Good news. They can eat all the ice cream, etc they want. We have a two months supply...that will be gone in less than 2 weeks.

<sigh>
 
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#45,140
#45,140
#45,141
#45,141
Septic said:
Volume or pressure control?
Click to expand...
Pressure control. PEEP of 14 to 16 with recruitment measures daily. Once you drop the PEEP their PaO2 plummeted and wob increased dramatically. Alveolar thickening. We paralyzed one because we could not get him to ride the vent. 300 fentanyl, 20 versed and still trying to sit up. VEC.
 
#45,142
#45,142
OHvol40 said:
Are you keeping them prone or turning them prone intermittently? That’s what we’ve done and it seems to help.
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From my understanding they proned the worst one once during the day. They almost lost him. I kept him lung over lung with continuous rotation, that he tolerated once he was paralyzed.
 
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#45,143
#45,143
0nelilreb said:
Not going to lie , there are some military videos that are supposed to be verified , I would really like answers to concerning “ UFOs” .
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Some are real UFO's, some are not. the ones that show physics-deviant behaviours are not from Earth. in comes the ET=aliens question which, imo, is no question at all.

The ETs who are showing us a lot of this and a little of that are coming. Only ????? left is when.
 
#45,144
#45,144
#45,145
#45,145
Dumbledorange said:
Clearly, crystal clearly, this F!!k of a POTUS doesn't give a single, last-dropped turd about anyone except his severely dwindling base. Of half-witted, clinically-qualified mentally institutionables who pander at his feet like salivating bull terriers on speed.

Ain't life dandy?
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Really wish you would stop holding back.... Sorry about your business situation, this is a **** show for everyone.
 
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#45,146
#45,146
NurseGoodVol said:
Really wish you would stop holding back.... Sorry about your business situation, this is a **** show for everyone.
Click to expand...

Thank you for that. I'm one of the very lucky ones. My wife handles the books and she socked away enough money to see us through. Now she pulls in the reins so tight that...I went to buy a new $13 vols cap on sale but NOOOOOOOOOOOOOOOOOOOOO.

Both my immense respect for your service and undying appreciating for all of you in the line of COVID fire. I don't think I would be up to it, very frankly.

Now go f*** yourself.

:)

D.

P.S. Edit - there are not many fans in this great land of ours that have the resouce we have of each other, brought to us by Freak and it is warm comfort to watch us all come together as One.

Now go f*** yourself.

:)
 
#45,147
#45,147
NurseGoodVol said:
Given support the liver panels, creatinine resolve.... So does the Qt prolongation. The reason they die is from an inability to ventilate them. There's no false dichotomy, it's a side effect we tracked with ekgs consistently. We get side effects from many critical care drugs, we still use them.
Click to expand...
I remember a patient we had once that was allergic to vanc but that was the only option we had to treat MRSA we hung it after dosing with diphenhydramine...sometimes you have no choice
 
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#45,148
#45,148
Dumbledorange said:
Thank you for that. I'm one of the very lucky ones. My wife handles the books and she socked away enough money to see us through. Now she pulls in the reins so tight that...I went to buy a new $13 vols cap on sale but NOOOOOOOOOOOOOOOOOOOOO.

Both my immense respect for your service and undying appreciating for all of you in the line of COVID fire. I don't think I would be up to it, very frankly.

Now go f*** yourself.

:)

D.

P.S. Edit - there are not many fans in this great land of ours that have the resouce we have of each other, brought to us by Freak and it is warm comfort to watch us all come together as One.

Now go f*** yourself.

:)
Click to expand...
Tell your wife it's a vols hat for 13$ let the reins go for one hot minute. Appreciate the thoughtful words. The comrodery is nice and freak hosts the best site among all college sites, none compares.

Your turn to go f*** yourself. 🙃
 
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#45,149
#45,149
@ NurseGoodVol

Let me bring your service, and the selfishness service of others like you, to a personal level.

We jumped into our motorhome b/c we could find a trailer park (lol) pad where we could be 50-100 yards from anyone. Off season in Florida, all the Canucks snowbirds had to run back home.

While the pool was open, we met two young friends, Carmen and Tabatha, females, who had fallen in love. Carmen is an emergency room nurse = COVID caretaker these days. you understand this perfectly, yes.

Tabatha lost her job, Carmen is working 60-80hrs/wk, they have no car so we pick them up and do whatever. I'm unsure I can get through this post.

Carmen cries all the way home. Tabatha is so distraught, she cries seeing Carmen come back. I don't cry until I drop Carmen off. Then it's Niagara Falls.

They are so young, and so vulnerable and so selfless. so selfless. And that's all I can speak about it now. Time to pickup Carmen, need to reel in the emotions.<out>
 
#45,150
#45,150
VolnJC said:
I remember a patient we had once that was allergic to vanc but that was the only option we had to treat MRSA we hung it after dosing with diphenhydramine...sometimes you have no choice
Click to expand...
Prep em and run it slow. I usually try to stay with them if I can.
 
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