We can’t however cure the virus. And if it progresses far enough then no amount of oxygen will save a patient. These cases are hard because we have to watch someone die without any means to save them. Doing cpr on a patient with covid can feel pointless. If the lungs do work then no amount of chest compressions, oxygen, and cardiac drugs will save that person.
I first encountered the concept in a new york times article where the interviewed nurse was saying the problem was people got bored and stopped doing it. That sounded... dumb. And as though being prone should be plastered all over the public health recommendations.
Proned patients are just people lying on their stomachs, are they not? I get that its something you would recommend to someone who is really low on oxygen, but why aren't people who aren't too sick to survive at home being told to do this also? Is there a downside?
Like if your pulse oximeter starts readying 88 and slowly dropping, its probably a good idea to start proning, in the very least at night while sleeping?
https://www.evms.edu/covid-19/covid_care_for_clinicians/#d.e...
I have never found this to be the case.
Generally, if I was fighting with a doctor, it was because he was trying to be too aggressive and do too much, not too little.
But if they feel you know medicine or are capable of understanding medicine or have a drive to learn more about your condition, then they will try harder, do more tests, ask more questions, etc.
A few months later, a friend who works at the hospital told me: I wish you had called me, I could have gotten you a room. And I thought: this is just like a third world country, where you need connections to get basic care.
Well, I was admitted and personally walked out with a gall bladder about to explode. Yeah, I was back in the hospital 24 hours later ... not my finest hour. So, I can absolutely confirm that you can be stubborn and buck the system.
I will absolutely defend your ability to spend time and research your treatment when dealing with doctors normally--especially for chronic conditions. Doctors page fault on every patient and if you are being responsible you may very well be better informed than your general practitioner about what is going on with your body.
However, if you are actually admitted to a hospital with something acute, do you really have the wherewithal to diagnose and manage it? By the time I hit the hospital, I was probably on 72 hours with very little sleep and pain that took hydromorphone to even dent. I guarantee I wasn't thinking clearly by then.
The biggest problem with hospitals is that you need an advocate for you, personally. Without someone in the room with you, you won't know if the nurse missed that medication round, isn't paying attention to your increasing temperature, didn't bring you your lunch, etc.
The problem isn't when the system works. The problem is that without someone else there you don't have someone to watch for if the system hiccups.
Just checked and it is quite the stark difference.
https://www.npr.org/sections/health-shots/2020/05/15/8567680...
Quote from the article
Old information:
Early reports from China, the United Kingdom and Seattle found mortality rates as high as 90% among patients on ventilators.
And more recently, a study of some New York hospitals seemed to show a mortality rate of 88%.
The mortality rate among 165 COVID-19 patients placed on a ventilator at Emory was just under *30%* .
And unlike the New York study, only a few patients were still on a ventilator when the data were collected.Old information:
Early reports from China, the United Kingdom and Seattle found mortality rates as high as 90% among patients on ventilators.
And more recently, a study of some New York hospitals seemed to show a mortality rate of 88%.
New information:
The mortality rate among 165 COVID-19 patients placed on a ventilator at Emory was just under 30% .
And unlike the New York study, only a few patients were still on a ventilator when the data were collected.
Anecdotal evidence seems to be that the doctors are getting better at treating the worst Covid patients. It's still not something you want to get, but it's not quite the death sentence it was.
Apparently, high-flow ventilation is a big improvement over intubation, but until everybody had enough/proper protective equipment it simply wasn't on the table (it aerosolizes the virus).
Which drug cocktails help and how to administer them is also improving.
We're not getting a good treatment until monoclonal antibodies or a vaccine, but were not simply standing still, either.