Coronavirus Discussion Thread

RedBlanketRunner

Opheophagus Hannah Cuddler
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Meanwhile in Wonkyland, S.E. Asia. Border jumper. Socializing elite rich kid and suspected part time hooker develops classic symptoms, tests positive. Shared a cigarette with occupants of a 'girl bar'. Roamed a mall, shopping center and visited a theater. Contact tracing of around 350 people and growing by the hour. Nothing quite like spreading the joy.
Meanwhile government agency A fires a broadside at government agency B after 5 persons jumped another border. 4 went into quarantine, a fifth, who later tested positive, with some tenuous connections to various officials, was allowed to skip the mandatory isolation.

Waiting for the government to slam all the doors shut again.
 

Fezman92

IFT Hero
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I’m waiting for the next lockdown here in NJ/PA. Also wonder if there will be another NYC level spike.
 

NomadicMedic

Pot or Kettle? Unsure.
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I’m waiting for the next lockdown here in NJ/PA. Also wonder if there will be another NYC level spike.
Probably won’t be a full lockdown in PA again. But I expect additional mitigation measures within a week or two. Our region’s inpatient/ICU/vent use is going through the roof.
 

Fezman92

IFT Hero
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Probably won’t be a full lockdown in PA again. But I expect additional mitigation measures within a week or two. Our region’s inpatient/ICU/vent use is going through the roof.
I know Philly (is starting to see a spike)
 

GMCmedic

Forum Deputy Chief
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In Indiana our larger level ones are out (or nearly out) of critical care beds. Our local level IIs are in and out of diversion this week. At this point a lock down is basically using a garden hose on a fully involved fire.

Might as well let it run its course.
 

Summit

Critical Crazy
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"So... ICU can be 3:1 because we said so... and if we give you an office admin assistant to grab supplies for you, 4:1 or 5:1"

Patients are gonna die and nurses are gonna quit
 

Peak

ED/Prehospital Registered Nurse
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"So... ICU can be 3:1 because we said so... and if we give you an office admin assistant to grab supplies for you, 4:1 or 5:1"

Patients are gonna die and nurses are gonna quit

The alternative is turn patients away?

At a certain point, yes. Giving poor care to many isn’t better than giving adequate care to some. In a limited resource environment rationing becomes the ethical decision at some point, and you have to consider how to do the most good for the most number of people. That may mean those over 75 don’t get an ICU bed, or those with metastatic disease are not eligible for intubation.
 

Carlos Danger

Forum Deputy Chief
Premium Member
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At a certain point, yes. Giving poor care to many isn’t better than giving adequate care to some. In a limited resource environment rationing becomes the ethical decision at some point, and you have to consider how to do the most good for the most number of people. That may mean those over 75 don’t get an ICU bed, or those with metastatic disease are not eligible for intubation.
Rationing is always an option and is occasionally necessary, but a better option is to plan and staff for known eventualities instead of pretending they aren't going to happen in order to improve the bottom line of the healthcare orgs.
 

silver

Forum Asst. Chief
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At a certain point, yes. Giving poor care to many isn’t better than giving adequate care to some. In a limited resource environment rationing becomes the ethical decision at some point, and you have to consider how to do the most good for the most number of people. That may mean those over 75 don’t get an ICU bed, or those with metastatic disease are not eligible for intubation.
Totally.

Was more wondering has 3:1 ICU staffing met that threshold for them?
 

Summit

Critical Crazy
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There are some creative staffing models out there, and you can try to crosstrain staff, but at a certain point you cannot create competent ICU nurses out of thin air. Same for intensivists and RTs. You can crosstrain medics and hospitalists but they are in short supply. At a certain point you have to push anesthesia and PACU into your exploding ICUs (or rather you convert the PACU). When that stopgap hits overflow, you ration.
 

FiremanMike

EMS Coordinator
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There are some creative staffing models out there, and you can try to crosstrain staff, but at a certain point you cannot create competent ICU nurses out of thin air. Same for intensivists and RTs. You can crosstrain medics and hospitalists but they are in short supply. At a certain point you have to push anesthesia and PACU into your exploding ICUs (or rather you convert the PACU). When that stopgap hits overflow, you ration.
Our medical director works at a major local hospital. She said the docs were told "all hands on deck" to take care of inpatient units.. This included among other things, ER docs staffing their patients on the floor and... wait for it... dermatology residents working on gen med floors..
 

Fezman92

IFT Hero
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I feel like that I don’t deserve how people treat me when they find out that I’m an EMT. I just do transport.
 

Fezman92

IFT Hero
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Do any of you wear your mask in the ambulance when you aren’t transporting/treating?
 

DesertMedic66

Forum Troll
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Do any of you wear your mask in the ambulance when you aren’t transporting/treating?
Yes. N95 when I have a patient. Surgical or cloth when I am up front with my partner.

About a month ago we had an EMT who came to work for a week with symptoms but didn’t tell anyone and didn’t wear a mask. He ended up giving COVID to about 4 medics.

I don’t want to be labeled as a spreader and my facial hair also isn’t up to company standards so a face mask hides it.
 

PotatoMedic

Has no idea what I'm doing.
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Yes. N95 when I have a patient. Surgical or cloth when I am up front with my partner.

About a month ago we had an EMT who came to work for a week with symptoms but didn’t tell anyone and didn’t wear a mask. He ended up giving COVID to about 4 medics.

I don’t want to be labeled as a spreader and my facial hair also isn’t up to company standards so a face mask hides it.
My wife has been complaining that I'm only shaving once a week. The masks do really help hide it 😅
 

Fezman92

IFT Hero
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My dad is immunosuppressed so I have a P100. Side note: the immune system is weird.
 

VentMonkey

Family Guy
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My wife’s immunocompromised and has had a bit of a go with this. I’m fairly healthy for my age, but it still manages to remind me what a PITA the virus is.
Not all the way out of the woods yet.

Maybe I’ll type up a synopsis of it when we’re all done and recovered. Sh*t does suck *** though.
 

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