Ventilators causing more harm than good.

Here's a doctor that thinks we might be on the wrong track with ventilators.
Anyone with any knowledge/experience have any thoughts?


 
The abattoir used for those scenes was Ziffs old slaughterhouse near Beckton.
A beautiful part of the country renowned for its alpine scenery.


The " Becton Alps " are slag heaps from the gas works but nonetheless a ( highly toxic ) wonder of nature.
 

BratMedic

LE
Book Reviewer
I'm a trained nurse so have a very informed view. Most people who have had a general anaesthetic will have been on a ventilator for a short period, maybe hours. So no, ventilators arent designed specifically for comatose patients. Originally ventilators were for surgical procedures. Most ventilators are used for those who are too weak to breathe without assistance, for many reasons. There are several types of ventilation, from positive airway pressure (CPAP) laryngeal mask to full intubation (basically a tube into the windpipe)

OK if you need a ventilator it is because you cannot breathe on your own. This is due to COVID causing pneumonia. . If it is at that stage you are well on the way to being rubber ducked. Its not the ventilator its the disease that causes the problem.

It is very simplistic to say that the lungs are bags of fluids in pneumonia as it is not that accurate, there is fluid in the lungs, but the important thing is that oxygen cannot get to the sacs in the lungs unless you have respiratory pressure. If you cannot breathe on your own then death is 100%. Pushing oxygen into the lungs gives a chance.

That said I am a little surprised that the focus is on ventilators. Certainly we are going to need them, but there are a spectrum of people who are going to need support of some kind, but less than ventilation. The most fortunate are those who have the odd sniffle. The next lot are going to feel awful, with fever and coughing, far worse than any flu. Then those who are suffering respiratory problems but can breathe unaided. This is the category (which I fall into) where things like typical asthma inhalers could be useful, but the press does not focus on this. A steroid inhaler could be immensely useful here. You know, the brown one? The blue one, salbutamol is also a standard treatment for breathlessness, but it works only for a short time. When I have felt breathless, although I am far from asthmatic, I have taken a blast of steroid inhaler and felt better for some hours. What I fear is that this category of patients are going to be ignored but with treatable respiratory issues, and descend into respiratory failure.

The worst categories fall broadly into two parts (and I am speaking very generally here) Pneumonia on its own causing respiratory failure and also sepsis. I suspect that the younger patients who have no underlying conditions who have died have developed sepsis. The latter is the most dangerous, and can cause death within a few hours. This is not a new phenomenon. Sepsis is when the infection is not just the lungs but the whole body and organs just PUFO. Ventilatory support during sepsis is vital, whilst the medics can get to work sorting out getting the other organs working again. Blood transfusion is important* and is a very important reason that if you are OK, donate blood NOW. Difficult if the onus is on self-isolating but we are going to need the red stuff in huge quantities soon.

Would I want to be ventilated if the need arise? I would stick the tube down my own bronchus and squeeze the bag myself!

*Get the crimson in me Jim son!
Now that's a proper reply - cheers!
 
Here's a doctor that thinks we might be on the wrong track with ventilators.
Anyone with any knowledge/experience have any thoughts?


He's a bloke wearing hospital scrubs. How do we know he's a doctor and not some conspira-loon? Or a conspira-loon doctor? The US tends to have an excess of conspira-loons, in case you hadn't noticed.
 

mercurydancer

LE
Book Reviewer
Here's a doctor that thinks we might be on the wrong track with ventilators.
Anyone with any knowledge/experience have any thoughts?


Largely I agree, ventilators are mainly programmed for those with NO respiratory pressure. There will be many (see my previous post) who have some respiratory pressure. The ideal would be to match the pressure from the ventilator to the patients respiratory pressure. That is difficult to do. Incidentally he is not saying that ventilators are useless, but that they are crude tools at the moment. It is a huge difference. He is a good and sensible doctor, but you must listen to what he is saying carefully. Indeed a badly used ventilator can cause harm, they always have had that potential, but they have the potential to save lives. Please remember that no respiratory capacity is 100% death.
 
The worst categories fall broadly into two parts (and I am speaking very generally here) Pneumonia on its own causing respiratory failure and also sepsis. I suspect that the younger patients who have no underlying conditions who have died have developed sepsis. The latter is the most dangerous, and can cause death within a few hours.

and you can get a runaway immune system response that kills you - some Italian doctor fixed up a couple of fading fast patients with Tocaluzimad, nuclear grade immunosuppressant, and they lived.
 

mercurydancer

LE
Book Reviewer
and you can get a runaway immune system response that kills you - some Italian doctor fixed up a couple of fading fast patients with Tocaluzimad, nuclear grade immunosuppressant, and they lived.
I was referring specifically to a runaway infection rather than a runaway immune system, but I suppose there is no reason to say that a runaway immune response would not be destructive. I am not aware of that drug at all. I will have a google.
 

mercurydancer

LE
Book Reviewer
Googled it. Contraindicated during acute infections.
 
I'm a trained nurse so have a very informed view. Most people who have had a general anaesthetic will have been on a ventilator for a short period, maybe hours. So no, ventilators arent designed specifically for comatose patients. Originally ventilators were for surgical procedures. Most ventilators are used for those who are too weak to breathe without assistance, for many reasons. There are several types of ventilation, from positive airway pressure (CPAP) laryngeal mask to full intubation (basically a tube into the windpipe)

OK if you need a ventilator it is because you cannot breathe on your own. This is due to COVID causing pneumonia. . If it is at that stage you are well on the way to being rubber ducked. Its not the ventilator its the disease that causes the problem.

It is very simplistic to say that the lungs are bags of fluids in pneumonia as it is not that accurate, there is fluid in the lungs, but the important thing is that oxygen cannot get to the sacs in the lungs unless you have respiratory pressure. If you cannot breathe on your own then death is 100%. Pushing oxygen into the lungs gives a chance.

That said I am a little surprised that the focus is on ventilators. Certainly we are going to need them, but there are a spectrum of people who are going to need support of some kind, but less than ventilation. The most fortunate are those who have the odd sniffle. The next lot are going to feel awful, with fever and coughing, far worse than any flu. Then those who are suffering respiratory problems but can breathe unaided. This is the category (which I fall into) where things like typical asthma inhalers could be useful, but the press does not focus on this. A steroid inhaler could be immensely useful here. You know, the brown one? The blue one, salbutamol is also a standard treatment for breathlessness, but it works only for a short time. When I have felt breathless, although I am far from asthmatic, I have taken a blast of steroid inhaler and felt better for some hours. What I fear is that this category of patients are going to be ignored but with treatable respiratory issues, and descend into respiratory failure.

The worst categories fall broadly into two parts (and I am speaking very generally here) Pneumonia on its own causing respiratory failure and also sepsis. I suspect that the younger patients who have no underlying conditions who have died have developed sepsis. The latter is the most dangerous, and can cause death within a few hours. This is not a new phenomenon. Sepsis is when the infection is not just the lungs but the whole body and organs just PUFO. Ventilatory support during sepsis is vital, whilst the medics can get to work sorting out getting the other organs working again. Blood transfusion is important* and is a very important reason that if you are OK, donate blood NOW. Difficult if the onus is on self-isolating but we are going to need the red stuff in huge quantities soon.

Would I want to be ventilated if the need arise? I would stick the tube down my own bronchus and squeeze the bag myself!

*Get the crimson in me Jim son!
Someone on FB posted that they lost a relative to sepsis because when they developed a temperature , the phone in people gave the standard instruction to self isolate and take paracetamol , whereas the persistent temperature is an indicator of sepsis ? Sepsis took hold and endex .
Muttering about suing the NHS , etc , good luck with that .
 
Largely I agree, ventilators are mainly programmed for those with NO respiratory pressure. There will be many (see my previous post) who have some respiratory pressure. The ideal would be to match the pressure from the ventilator to the patients respiratory pressure. That is difficult to do. Incidentally he is not saying that ventilators are useless, but that they are crude tools at the moment. It is a huge difference. He is a good and sensible doctor, but you must listen to what he is saying carefully. Indeed a badly used ventilator can cause harm, they always have had that potential, but they have the potential to save lives. Please remember that no respiratory capacity is 100% death.

if you want a crude ventilator then try the old minuteman or Pneupac systems.
 

mercurydancer

LE
Book Reviewer
Someone on FB posted that they lost a relative to sepsis because when they developed a temperature , the phone in people gave the standard instruction to self isolate and take paracetamol , whereas the persistent temperature is an indicator of sepsis ? Sepsis took hold and endex .
Muttering about suing the NHS , etc , good luck with that .
The symptoms of sepsis are ( but not limited to) -

Decreased urine
Patches of discoloured skin
confusion
abnormal heart function
Increased temperature.

Very similar and probably inclusive of coronavirus. Two of which would probably not have been known to the patient or relative. As I said before, sepsis is a known condition before coronavirus and the NHS is well accustomed to it. Coronavirus causes sepsis but other conditions do too. And the other conditions have not gone away.
 

mercurydancer

LE
Book Reviewer
if you want a crude ventilator then try the old minuteman or Pneupac systems.
Pneupac! I have not heard that word in a while, a little blue or yellow box that puffed away! I loved it! O2 pin connection in one end and a rubber (yes rubber) hose out of the other end!
 
But but but Tracy said that her mate Sharon on Facebook said that a friend of her sisters is a hospital porter's wife and he told her that a hospital cleaner told him that...


...and so on into chav-infested fuckwittery...
Indeed.
But surprisingly accurate.
 
Pneupac! I have not heard that word in a while, a little blue or yellow box that puffed away! I loved it! O2 pin connection in one end and a rubber (yes rubber) hose out of the other end!

Yeah the little yellow box that came in a red and yellow collapsable case.

and don't forget MAST

1586187184395.png


who doesn't want pneumatic pants?
 
He's a bloke wearing hospital scrubs. How do we know he's a doctor and not some conspira-loon? Or a conspira-loon doctor? The US tends to have an excess of conspira-loons, in case you hadn't noticed.
If you Google his name (Cameron Kyle-Sidell) you can make up your own mind as to him being gen or not.
 

Caecilius

LE
Kit Reviewer
Book Reviewer
I've already instructed the other half if I end up in hospital, no ventilator whatever happens. Was looking at stats re ventilators and the virus, was pretty grim. That was two weeks ago.
I think you may have mistaken cause and effect here. Yes, 50% of those with COVID who are on ventilators are dying but it's the COVID that's doing that not the ventilation. For people with COVID who need to be ventilated but either can't or don't want to be, the number is a lot closer to 100%
 
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