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Jingthing

New thinking about ventilators and Covid 19

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Interesting. That's the scary thing about a new virus - there is always going to be a degree of trial and error. This part is especially spooky:

 

"What’s driving this reassessment is a baffling observation about Covid-19: Many patients have blood oxygen levels so low they should be dead. But they’re not gasping for air, their hearts aren’t racing, and their brains show no signs of blinking off from lack of oxygen."

 

It's almost like Covid 19 is tricking medics into taking the wrong course of action. 

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2 minutes ago, CG1 Blue said:

Interesting. That's the scary thing about a new virus - there is always going to be a degree of trial and error. This part is especially spooky:

 

"What’s driving this reassessment is a baffling observation about Covid-19: Many patients have blood oxygen levels so low they should be dead. But they’re not gasping for air, their hearts aren’t racing, and their brains show no signs of blinking off from lack of oxygen."

 

It's almost like Covid 19 is tricking medics into taking the wrong course of action. 

I agree. That definitely sounds remarkable. Viruses are only doing their thing and it's silly to anthropomorphize them but sorry, this is one EVIL virus.

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Posted (edited)

The role of doctor is far more procedural in Thailand. That is very good for well-established treatments that require less out-of-the-box thinking.

Culturally, there is less inclination towards innovation. There is a greater fear of being seen to fail. Playing it save and doing what everyone else is doing is a successful strategy in Thailand. We see this in other professions too, not least anything involving bureaucracy.

In general, doctors in Thailand are also less comfortable with explaining what they are doing or answering questions. They are certainly not happy bunnies if they perceive that their authority is being challenged. Where a Western doctor might actually be interested if a patient drew their attention to some new research or approach to their illness, a Thai doctor is more likely to perceived an implicit criticism that he did not already know about it.

So, sadly, I would guess that most Thai doctors would be both less likely to be aware of these findings, and less likely to react positively to being told about them.
 

Edited by donnacha
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There are a couple of oxygen stages prior to the ventilator, there's the tube down the throat, then there seems to be the face mask. 

 

They could test the theory easy enough, 2 people in similar conditions, one goes on the ventilator and the other keeps using just oxygen

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Yeah, apparently only 20% of patients survive after being put on a ventilator. If you reach the point where you're put on one, you're pretty much already a goner.

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2 hours ago, Why Me said:

And whoever dies first don't use that method. I find your ideas intriguing and wish to subscribe to your newsletter.

I'm sure even you could work out they would pick a trial size

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Posted (edited)

Depends on the patient of course. Some seem to be able to tolerate lower oxy levels for some strange reason. If I was evil I'd say their brains don't operate at a level where much oxygen is needed. A study into the methods of the free divers would be interesting.

 

One interesting thing is proning: https://emcrit.org/pulmcrit/proning-nonintubated/ . It's very simple, place the patient so that the <deleted> flows out of the lungs thanks to gravity. From what I've seen most are sitting upright on the beds, exactly the wrong way. Strange that proning is not used more widely.

Edited by DrTuner

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19 hours ago, CG1 Blue said:

Interesting. That's the scary thing about a new virus - there is always going to be a degree of trial and error. This part is especially spooky:

 

"What’s driving this reassessment is a baffling observation about Covid-19: Many patients have blood oxygen levels so low they should be dead. But they’re not gasping for air, their hearts aren’t racing, and their brains show no signs of blinking off from lack of oxygen."

 

It's almost like Covid 19 is tricking medics into taking the wrong course of action. 

This virus thrives in oxygen rich environments be they airborne or cellular is how I read this.   Ventilators are self contained units however and CPAP/high flow are not.                    "One problem, though, is that CPAP and other positive-pressure machines pose a risk to health care workers, he said.  The devices push aerosolized virus particles into the air, where anyone entering the patient’s room can inhale them. The intubation required for mechanical ventilators can also aerosolize virus particles, but the machine is a contained system after that. "                                                                    

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On 4/9/2020 at 6:51 AM, Jingthing said:

but sorry, this is one EVIL virus.

Erm, viruses are not evil. They don't have free will and just do what viruses do. Only human's with choice can, IMO, be "evil".

Cars probably kill as many people as viruses, so are cars "evil"?

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12 hours ago, DrTuner said:

It's very simple, place the patient so that the <deleted> flows out of the lungs thanks to gravity. From what I've seen most are sitting upright on the beds, exactly the wrong way. Strange that proning is not used more widely.

I'm not going to read the link ( not going to take the chance of a computer VIRUS being introduced to my computer ), but does it involve tilting the patient head down? On the ortho ward I worked on we often had patients legs up with traction, but they were never head down as well, which would be pretty hard to tolerate for an extended period of time.

As I see it, viruses bind to body cells; they don't float around in the lungs, which are not large empty spaces, so how would it work anyway?

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20 hours ago, Why Me said:

And whoever dies first don't use that method. I find your ideas intriguing and wish to subscribe to your newsletter.

How do you think any new medical innovation is trialed? It's often by putting patients with similar problems in different treatments to see which ones work. Sometimes they just give a placebo which doesn't do anything at all.

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