CrosspoolClarets wrote: ↑Wed Oct 21, 2020 12:24 am
Re Inchy’s post. The actual clinical stuff I don’t know enough about, I have helped manage ICUs in the past but the medical detail is more specialist and harder to grasp than almost any other clinical area, hats off to them. So I might be totally wrong on this, but I was pondering Inchy’s hypoxia point.
With the hypoxic dangers I made sure that when this crisis started I got a pulse oximeter off Amazon and put it in my medicine box, also one of those cold zyme sprays that coat the throat to slow down colds and flu spreading.
Might be about as much use as a chocolate teapot, but my thinking is that if I catch the thing, in middle age, keeping the viral load as low as possible and keeping an eye on my blood oxygen levels regularly are likely to be important (calling for help immediately if the latter shows a problem).
Like i say, might be nonsense, but what amazes me is that these scientists are not standing at podiums advising us what to do if we get ill. Surely, surely, there are ways of doing it right and doing it wrong? e.g. I heard Trumps doctor saying something about it being good for him to be up and walking around.
Anyway, just musing.
The reasons why scientists and healthcare professionals are not standing up and advising on what to do is because there is very little you can do.
If a patient on the ward is deteriorating and I go to assess them, usually there are multiple things I can do and recommend to the home team clinicians which can assist in
Preventing further deterioration and admission to critical care. For example someone with sepsis can require loads of interventions to prevent deterioration. These patients are often already in multi organ failure
For covid patients there issue is single organ failure. Type 1 respiratory failure. That’s usually it, no other organ issues. By the time they are referred to me they usually are on 60% 02. Most people who need nearly 3 times the normal amount of 02 we function with are normally pretty sick and they look pretty sick. In general if someone looks sick they are very sick. This isn’t the case with covid. I’ve known patients take there 02 off to walk to the toilet (against the advise of the medics) because they feel fine, only for them to be peri-arrest on returning to their bed. I’ve known patient who have walked off the ward fed up because they feel well, with nurses chancing them to bring them back.
At the moment my advise to sick deteriorating covid patients is lay on your front as tolerated. That’s it. That’s the only thing that may help to prevent deteriorating. That and dexamethazone and possibly remdesivir, which they will already be on. That’s it! And with that it’s seem pot luck if you get better or not.
I’m not suggesting what someone should do if they get covid because i am not an expert, however having access to pulse oximetry isn’t a bad idea. I’ve heard stories of well looking people turning up in a and e with 02 levels not sustainable with life for long.
If I had covid and I was at home I would be laying on my front for periods every hour.
If I was overweight I would be doing something about it now. The vast majority of people I’ve taken to ICU are overweight men. Some huge but some just overweight. If you’re overweight you don’t ventilate as well as someone slim.
