C19 Notes

Doctors rethink rush to ventilate

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stog

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Doctors rethink rush to ventilate
« on: May 02, 2020, 09:25:02 PM »
"Voshaar, the German lung specialist, said some doctors were approaching COVID-19 lung problems as they would other forms of pneumonia. In a healthy patient, oxygen saturation - a measure of how much oxygen the haemoglobin in the blood contains - is around 96% of the maximum amount the blood can hold. When doctors check patients and see lower levels, indicating hypoxia, Voshaar said, they can overreact and race to intubate.

“We lung doctors see this all the time,” Voshaar told Reuters. “We see 80% and still do nothing and let them breathe spontaneously. The patient doesn’t feel great, but he can eat and drink and sit on the side of his bed.”

ie maybe too quick to respond to lowered SATs o2 sats, when as he puts it

“We see 80% and still do nothing and let them breathe spontaneously. The patient doesn’t feel great, but he can eat and drink and sit on the side of his bed.”




Rather than rushing to intubate, doctors say they now look for other ways to boost the patients’ oxygen. One method, known as “proning,” is telling or helping patients to roll over and lie on their fronts, said Scott Weingart, head of emergency critical care at Stony Brook University Medical Center on Long Island. 
“If patients are left in one position in bed, they tend to desaturate, they lose the oxygen in their blood,” Weingart said. Lying on the front shifts any fluid in the lungs to the front and frees up the back of the lungs to expand better. “The position changes have radically impressive effects on the patient’s oxygen saturations.” 
Weingart does recommend intubating a communicative patient with low oxygen levels if they start to lose mental clarity, if they experience a cytokine storm or if they start to really struggle to breathe. He feels there are enough ventilators for such patients at his hospital.
But for happy hypoxics, “I still don’t want these patients on ventilators, because I think it’s hurting them, not helping them.”

https://www.reuters.com/article/us-health-coronavirus-ventilators-specia/special-report-as-virus-advances-doctors-rethink-rush-to-ventilate-idUSKCN2251PE
« Last Edit: May 02, 2020, 09:29:09 PM by stog »

stog

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Re: Doctors rethink rush to ventilate
« Reply #1 on: November 01, 2020, 01:23:52 PM »
good latest info on case care at home and sats levels within virtual wards
Covid Oximetry at Home Toolkit   Programme(s):
 Covid Oximetry at Home (virtual ward)   

he Covid Oximetry at Home work (sometimes called a "virtual ward") describes an enhanced package of care for individuals with confirmed or suspected Covid-19 who are at risk for future deterioration.

The package of care involves the remote monitoring of the individual's condition through providing regular contact with a local health care team who will reassess the individuals symptoms (including oxygen saturation levels). This close monitoring enables the individual to remain at their usual place of residence whilst allowing early signs of deterioration to be identified and escalated quickly and appropriately.

This material has been designed primarily for use across the South East AHSN network by colleagues within the Wessex AHSN, Kent Surrey Sussex AHSN and Oxford AHSN regions. Colleagues from regions beyond the South East are also very welcome to make use of this toolkit in setting up their own local approaches to remote monitoring.

https://wessexahsn.org.uk/projects/388/covid-oximetry-at-home-toolkit