For ICU types - mildly technical

Goatman

ADC
Book Reviewer
Some old sod in another thread:
You are the EM Consultant at Tommy's Westminster - and I claim my ten sovs.

As mentioned elsewhere, I was a sedated Intensive Care Patient for a total of ten days in 2018, three weeks in ICU altogether.

Intubated at Southampton ,going downhill, Blues+Twos'd to St Thomas' in London for ECMO treatment.

I was very lucky that a place was available: at that time Tommy's was one of only five hospitals in the UK with the kit and a swept up team to offer ECMO treatment....

Thank you to all the skilled, dedicated ,NHS professionals without whom I would now be a faint memory and a light patina of soot blowing across the South Coast.

So personal interest declared.

Found this, which for a non-medical grunt like me was QI. I didn't know any of the history behind the treatment so :shrug:



For patients and their loved ones it can all get a tad intimidating.


I guess it is even mildly current:


How many ECMO machines are available?

In the event of patients requiring ECMO is only available at a few specialist hospitals in England. There are five adult ECMO centres in the UK, two of which are in London and the others are based in Leicester, Manchester and Cambridge.

On average, the cost of ECMO treatment per patient in England is £45,000 and there are 15 available beds for adults at five centres across England.

Inevitably, this will mean ECMO will have to be rationed. NHS doctors have spoken out about the “three wise men” protocol, where three senior consultants in each hospital would have to decide which patients would be mostly to benefit from care such as ventilators and beds, in the event hospitals were overwhelmed with patients.

Until a viable vaccine or treatment has been developed for this COVID-19, we should focus on prevention and stopping its spread to vulnerable patients.




And now, back to the records....

( Cues up ' I'm a Survivor ' )
 
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Old Stab

LE
Book Reviewer
Some old sod in another thread:


So personal interest declared.

Found this, which for a non-medical grunt like me was QI. I didn't know any of the history behind the treatment so :shrug:



For patients and their loved ones it can all get a tad intimidating.

And now, back to the records....

( Cues up ' I'm a Survivor ' )
I shall ask SWMBO tomorrow morning if I can.

She was an Intensive Care nurse before moving up the ladder.
 
I’m out of date, but Extra Corporeal Membranous Oxygenation, essentially bypassing the lungs because infection or injury has made them unable to exchange gases.

Very much a last ditch step when I was current, it’s rarity always meant it was rationed in ‘normal’ times. If you were sick enough to need it you were already 3/4 fubar bundy.
 

Goatman

ADC
Book Reviewer
Yeah.....

I understand Norn Iron now (2021) has an ECMO team working in Belfast but standing by to be told different.

Scotland has one in Aberdeen.


Welsh patients get sent to London, Cambridge (Papworth) or Leicester.

( I was slightly gobsmacked to meet a guy in the post-op chat session who was sent from Cardiff to St Thomas' by ambulance. Another from Falmouth)

I dread to think what ECMO would cost a patient's medical insurance company in the U.S - but the NHS guesstimate for internal accounting purposes is about £45K a go

The machinery itself is not the big-ticket number, its the staff cost. The video shows the incremental steps since 1916.

No idea what the side effects of Heparin are, but I imagine its not the healthiest thing to mainline for several weeks.
 
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Yeah.....

I understand Norn Iron now (2021) has an ECMO team working in Belfast but standing by to be told different.

Scotland has one in Aberdeen.


Welsh patients get sent to London, Cambridge (Papworth) or Leicester.

( I was slightly gobsmacked to meet a guy in the post-op chat session who was sent from Cardiff to St Thomas' by ambulance. Another from Falmouth)

I dread to think what ECMO would cost a patient's medical insurance company in the U.S - but the NHS guesstimate for internal accounting purposes is about £45K a go

The machinery itself is not the big-ticket number, its the staff cost. The video shows the incremental steps since 1916.

No idea what the side effects of Heparin are, but I imagine its not the healthiest thing to mainline for weeks.

Most transplant surgery in the South happens in the South East so blue light runs across the country are fairly commonplace. The further you are away the less likely you are to be the first through the door with a suitable tissue type.

Couldn’t comment on cost these days, but I know that 20 years ago and ITU bed without anything more technical than a ventilator was costed at 2.5k per night. 45k sounds cheap to be honest.

The main side effect of heparin is a lack of clotting oddly enough, definitely stay away from sharp objects, or falling, banging your head etc.
 

Goatman

ADC
Book Reviewer
hah.....the three hour nose bleed was enough fun thanks...gods forbid anyone gets whacked in my old flat ....the investigating team would be like;

' So - any blood traces? '
' Yeah....'
' Uh-huh - where in particular?
' Take your pick Inspector.....'



And I wasn't a transplant case.

Which is good because I don't have to take any drugs for life, or what remains of it.
 
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