Coronavirus Discussion Thread

[DesertMedic66]

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.

Yep. I got it back in July. Work put me out 2 months for it.

 

[silver]

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.

Yep, never in my career did I anticipate that I would be suctioning tubes, providing oral care and brushing teeth, hanging meds, emptying urine etc and not see a RT or ICU RN for days. I am still very thankful we didn't have to turn people away.

 

[Fezman92]

Too much?

 

[Medic511]

I have been an EMT and Medic for 20+ years, much of it essentially a volunteer. I never regretted a minute of it and have always felt like an important part of an essential service and thankful that other circumstances allowed me to do EMS because I loved the chance to help. I lived through the Swine Flu II pandemic of the early 2000's. EMS were in the first group to receive vaccinations.

Now, it appears that politics and big money have entered into the prioritization of COVID vaccine and that nursing home residents are more important that those of us on the streets. That is a pill too sour for me to swallow. Yes, older are at risk, BUT if their caregivers are vaccinated and the older patients do not interact with others outside their facilities, they are NOT at risk. EMS, on the other hand, are at grave risk on every call that we run. We have to deal with non-mask compliant people and face homes that are filthy and full of people who will lie about their medical histories and possible exposure.

But the meat cutter at the slaughterhouse and the cashier at the grocery and liquor store are just as "essential" as we in EMS are deemed to be. I think it's time for me to retire.

 

[DesertMedic66]

I have been an EMT and Medic for 20+ years, much of it essentially a volunteer. I never regretted a minute of it and have always felt like an important part of an essential service and thankful that other circumstances allowed me to do EMS because I loved the chance to help. I lived through the Swine Flu II pandemic of the early 2000's. EMS were in the first group to receive vaccinations.

Now, it appears that politics and big money have entered into the prioritization of COVID vaccine and that nursing home residents are more important that those of us on the streets. That is a pill too sour for me to swallow. Yes, older are at risk, BUT if their caregivers are vaccinated and the older patients do not interact with others outside their facilities, they are NOT at risk. EMS, on the other hand, are at grave risk on every call that we run. We have to deal with non-mask compliant people and face homes that are filthy and full of people who will lie about their medical histories and possible exposure.

But the meat cutter at the slaughterhouse and the cashier at the grocery and liquor store are just as "essential" as we in EMS are deemed to be. I think it's time for me to retire.

Last I heard the CDC was recommending that both frontline healthcare providers and nursing home residents will be the first ones to get the vaccine. I haven’t seen any information that says nursing home residents will be put above anyone in the frontline healthcare field.

 

[ffemt8978]

Last I heard the CDC was recommending that both frontline healthcare providers and nursing home residents will be the first ones to get the vaccine. I haven’t seen any information that says nursing home residents will be put above anyone in the frontline healthcare field.

Considering it will be up to each state to determine how it distributes the vaccine, Im sure we'll see plenty of variations and complaints about it.

 

[mgr22]

I have been an EMT and Medic for 20+ years, much of it essentially a volunteer. I never regretted a minute of it and have always felt like an important part of an essential service and thankful that other circumstances allowed me to do EMS because I loved the chance to help. I lived through the Swine Flu II pandemic of the early 2000's. EMS were in the first group to receive vaccinations.

Now, it appears that politics and big money have entered into the prioritization of COVID vaccine and that nursing home residents are more important that those of us on the streets. That is a pill too sour for me to swallow. Yes, older are at risk, BUT if their caregivers are vaccinated and the older patients do not interact with others outside their facilities, they are NOT at risk. EMS, on the other hand, are at grave risk on every call that we run. We have to deal with non-mask compliant people and face homes that are filthy and full of people who will lie about their medical histories and possible exposure.

But the meat cutter at the slaughterhouse and the cashier at the grocery and liquor store are just as "essential" as we in EMS are deemed to be. I think it's time for me to retire.

Has that decision been made in your state, or are you speaking in general terms?

 

[CCCSD]

Nursing home residents are priority, as it should be. They are the most vulnerable.

 

[Summit]

I was always a bit shocked that nursing homes were initially tier 1C instead of 1A. CFR in a nursing home can exceed 20%! It is the ethical thing to do to vaccinate them first.

Your PPE works better than isolating nursing homes. A single point of failure in nursing homes can hospitalize and kill scores. Plus, some of these people haven't been able to have a visitor since March! Imagine what not seeing your family for another few months, or ever, may mean to these people?

 

[Carlos Danger]

I have been an EMT and Medic for 20+ years, much of it essentially a volunteer. I never regretted a minute of it and have always felt like an important part of an essential service and thankful that other circumstances allowed me to do EMS because I loved the chance to help. I lived through the Swine Flu II pandemic of the early 2000's. EMS were in the first group to receive vaccinations.

Now, it appears that politics and big money have entered into the prioritization of COVID vaccine and that nursing home residents are more important that those of us on the streets. That is a pill too sour for me to swallow. Yes, older are at risk, BUT if their caregivers are vaccinated and the older patients do not interact with others outside their facilities, they are NOT at risk. EMS, on the other hand, are at grave risk on every call that we run. We have to deal with non-mask compliant people and face homes that are filthy and full of people who will lie about their medical histories and possible exposure.

But the meat cutter at the slaughterhouse and the cashier at the grocery and liquor store are just as "essential" as we in EMS are deemed to be. I think it's time for me to retire.

Are you for real? Where exactly does the “big money” and political influence of nursing home residents come from?

The prioritization is based on risk and resource utilization. Long term care residents make up nearly 50% of all COVID deaths and place a higher strain on the healthcare system than any other demographic. Think about that. It makes perfectly good sense that they will be the first to be vaccinated.

Maybe it really is time for you to retire.

 

[CCCSD]

I have been an EMT and Medic for 20+ years, much of it essentially a volunteer. I never regretted a minute of it and have always felt like an important part of an essential service and thankful that other circumstances allowed me to do EMS because I loved the chance to help. I lived through the Swine Flu II pandemic of the early 2000's. EMS were in the first group to receive vaccinations.

Now, it appears that politics and big money have entered into the prioritization of COVID vaccine and that nursing home residents are more important that those of us on the streets. That is a pill too sour for me to swallow. Yes, older are at risk, BUT if their caregivers are vaccinated and the older patients do not interact with others outside their facilities, they are NOT at risk. EMS, on the other hand, are at grave risk on every call that we run. We have to deal with non-mask compliant people and face homes that are filthy and full of people who will lie about their medical histories and possible exposure.

But the meat cutter at the slaughterhouse and the cashier at the grocery and liquor store are just as "essential" as we in EMS are deemed to be. I think it's time for me to retire.

Yep. You are so far out of line that you need to leave the medical things to those that know how to Do No Harm.

 

[NomadicMedic]

Yep. You are so far out of line that you need to leave the medical things to those that know how to Do No Harm.

correct.
and in PA, its health care workers and vulnerable nursing home patients who will get the vax first.

 

[Akulahawk]

The prioritization is based on risk and resource utilization. Long term care residents make up nearly 50% of all COVID deaths and place a higher strain on the healthcare system than any other demographic. Think about that. It makes perfectly good sense that they will be the first to be vaccinated.

This, right here, is exactly why LTC residents (in particular) and other elderly people are going to be among the first to be vaccinated. They're the most vulnerable and will take up the most resources in hospital should they become sick. If you vaccinate this population, you effectively remove them from the pool that you'd have to worry about. In my ED, literally ALL of our very sick patients being boarded in the ED (because the ICU is full) that have COVID19 illnesses are ALL over 50 and ALL of them have co-morbidities. Nearly ALL of the COVID19 patients in our ICU are also in that same demographic. Take them out of the picture and we end up freeing up an entire floor along with 1/2 of the ICU.

HCW's will also be vaccinated so their availability will be maximized. Staffing can easily be the limiting component when considering being able to provide good (if not excellent) vs. substandard/poor care. The worse the staffing, the more likely it is someone (or a lot of people actually) end up having bad outcomes as a result.

It's absolutely true that you can't make ICU nurses out of thin air. I'm an ED RN (and a reasonably good one at that). While I do provide care for ICU patients, that's not the ONLY thing that I do, so I'm not an expert at it. Move me to the ICU and I'd best be used for providing care for "soft" ICU patients so that I can free-up the actual ICU nurses to care for the patients that need their expertise. It would still take me MONTHS to cross-train to ICU to the point where I'd become proficient.

 

[Fezman92]

Are you for real? Where exactly does the “big money” and political influence of nursing home residents come from?

You’ve never heard of Big Nursing Home? It’s right up there with the other big lobbyists groups, Big EMS and Big Air Freshener

 

[Fezman92]

Anyone else think that wearing masks for every call is going to stay even after all of this is over?

 

[NomadicMedic]

Anyone else think that wearing masks for every call is going to stay even after all of this is over?

No. Unless you have patients with respiratory complaints, it’s unnecessary.

I do think EMS agencies will continue to be more diligent in decontamination of the rigs and gear though.

 

[DesertMedic66]

No. Unless you have patients with respiratory complaints, it’s unnecessary.

I do think EMS agencies will continue to be more diligent in decontamination of the rigs and gear though.

This. Along with keeping a much larger supply of cleaning equipment and PPE on hand.

 

[Bullets]

Anyone else think that wearing masks for every call is going to stay even after all of this is over?

On every call? No, i think we will fall back into a lower level of PPE use. However i do think use of N95s and surgical masks will increase. Professionally, I will probably continue to wear clear safety glasses and some kind of respiratory protection on any call that involves an airway procedure. Nebs, tubes, ect, im gonna have my N95/100 on. In public life i also think mask wearing will become more normal. I know that i will probably continue to wear a mask, at least during flu season when going into commercial establishments and such.

 

[ffemt8978]

No. Unless you have patients with respiratory complaints, it’s unnecessary.

I do think EMS agencies will continue to be more diligent in decontamination of the rigs and gear though.

While I would hope that would be the case, the reality is that eventually cleaning will return to the same level of apathy it was before the pandemic.

There have always been diseases that require the rig to be cleaned appropriately yet after a while they fall by the wayside. MRSA, VRE, Hepatitis, etc...are just a few.

 

[GMCmedic]

Yes, older are at risk, BUT if their caregivers are vaccinated and the older patients do not interact with others outside their facilities, they are NOT at risk.

This isn't true