Tracking the next pandemic: Avian Flu Talk |
10 New Yorkers on Ventilators |
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abeamreach
advanced Member Joined: February 21 2006 Location: United States Status: Offline Points: 28 |
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Posted: May 29 2009 at 12:38pm |
abeamreach
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Technologist
Admin Group Joined: May 05 2009 Location: California Status: Offline Points: 1192 |
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That same article says NY has 356 Confirmed Cases and 100 are hospitalized.
2 in NY have already died and 10 out of 356 confirmed cases are already on Ventilators. This is something to be concerned about. When the hospitals are full just about everyone that needs a ventilator will not live. So 12 out of 356 = 3.37%. Thats a 3.37% mortality rate. When this virus spreads the mortality rate will climb around the 3.37% range. Most likely the confirmed cases are really much higher like 7,000. Helping drop the mortality rate to 1/20 that. If not this virus will be VERY deadly. Latest predictions are that 1/3 of the world will catch it. The reporting of cases are GROSSLY underestimated or The Mortality rate going to be very high like 3.37% in NY. |
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Albert
Admin Joined: April 24 2006 Status: Offline Points: 47746 |
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Next flu season could get a little ugly. |
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Annie
Valued Member Joined: April 06 2009 Location: East Texas Status: Offline Points: 319 |
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WHO tally of novel H1N1 cases reaches 15,510
The numbers reported are low. They are not testing everyone who arrives with the flu. Does anyone know how the selection is made on which patient to test that arrives with flu like symptoms? Plus, many will never go to the hospital. Annie
Fifty-three countries have reported a total of 15,510 cases of novel H1N1 influenza with 99 deaths, the World Health Organization (WHO) said today. Countries added to the list since the WHO's last update on May 27 are the Czech Republic, the Dominican Republic,Romania, Slovakia, and Uruguay. The United States, Mexico, and Canada continue to lead the list. Other countries with more than 100 cases are Japan (364), Britain (203), Chile (165), Australia (147), Spain (143), and Panama (107). [WHO update 41] |
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Dense populations are going to be hit very hard by this pestiferousness little (flu virus) monster. "Technologist"
Stock 3 months water, food, weapon/ammo, meds, supplies, and some money at home. |
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Littleraven
V.I.P. Member Joined: May 10 2006 Location: United States Status: Offline Points: 438 |
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Haven't posted in awhile due to taking care of my Mom who has had bacterial spinal meningitis--got her over most of that with the great help of antibiotics special herbs and some good staff at the hospital where we admitted her after she could not fight it off anymore--we did not know it was meningitis at first but quickly figured it out after she developed an extremely high fever and would not eat as well as nausea and pain in her neck (which she did not present with at first) She has never been in the hospital before except for a difficult child birth with my brother. She now has partial loss of hearing due to nerve damage but is otherwise recovering. This was due to an extremely bad viral condition resulting from one of the viruses running loose right now. Please watch and be vigilant for secondary infections which can be associated with these viral outbreaks. Bacterial meningitis can be deadly very quickly and is most notably the illness is often denied by the person who may be infected because it infects the brain. Many times the one who is infected will deny being sick at all and will fight it and those who may try to help--precious time is wasted and it can result in death very quickly. We were lucky, so I send out this message. Be very vigilant and take special care and not be afraid to respond or be insistent. Take care and be well.
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There's a Bad Moon on the Rise
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Littleraven
V.I.P. Member Joined: May 10 2006 Location: United States Status: Offline Points: 438 |
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Sorry probably put this in the wrong thread accidentally--Littleraven
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There's a Bad Moon on the Rise
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MelodyAtHome
Valued Member Joined: May 16 2006 Location: United States Status: Offline Points: 2018 |
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Sorry littleraven about your mom. Hope she has a complete recovery.
Also, does anyone know how many ventilators a typical NYC hospital would have??
Melody
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Melody
Emergency Preparedness 911 http://emergencypreparedness911.blogspot.com/ |
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hope4bestprep4wrst
V.I.P. Member Joined: August 01 2008 Status: Offline Points: 148 |
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http://www.nyc.gov/html/doh/downloads/pdf/bhpp/bhpp-focus-bio-vent-results.pdf
here is the breakdown according to NYC.Gov as of 2005 but I can try to find a more recent survey total by this survey is 2,688 full feature machines and over 1500 portables, anesthesia machines and automatic resucitators |
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Be Well
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MelodyAtHome
Valued Member Joined: May 16 2006 Location: United States Status: Offline Points: 2018 |
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Does full feature mean ventilator?? I'm curious. Let me know if you know. Thanks.
Melody
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Melody
Emergency Preparedness 911 http://emergencypreparedness911.blogspot.com/ |
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comment: Good to hear from you again Littleraven and sad to hear about your mom. There is 'something else' that is hooked to encephalitis that has been making the rounds. The irony on this ventilator thing is that most of the cases of flu we are seeing - at least people I know- don't have a lot of respiratory complications and are heavily GI tract with only low grade fever. Although flu is classically a respiratory virus, as with H5N1- we found increasing GI presence and involvement. However a classic symptom of this (Swine Flu) is a headache. That must mean there is neural involvement and IMHO inflammation of meninges (not a doctor here.. ) I know at least 6 people who have had subdural hematomas in the family and friends as well as one ex-legislator who eventually was disabled by the disease. Since there was a lot H3N2 moving with the Swine Flu and there may as yet be a third viral strain- the terms keeps coming up- other complications. We should differentiate between pre-existing other complications- and possible secondary or concurrent other viral and bacterial problems. Significant in terms of the difference between sickness and fatal. Medclinician |
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hope4bestprep4wrst
V.I.P. Member Joined: August 01 2008 Status: Offline Points: 148 |
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hope4bestprep4wrst
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Melody
I looked into it a little more. A portable ventilator is like a pack that you can carry and seems it would be used out in the field or in areas of hospital outside of ICU where full service vents are housed. An automatic resuscitator is a much more limited machine that can be hooked up to an oxygen source to help an intubated patient breath. I think the full service ventilator has many more features and is the best thing if you need one in a hospital setting but the others can be used as backup I suppose. |
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HoosierMom
Valued Member Joined: June 15 2006 Status: Offline Points: 334 |
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The portable ventilator they are referring to is probably like a LTV- Lap Top Ventilator, used for the patient usually in a home setting that is transported it is actually about 20"x12" and about 5 inches depth. It can run on a internal battery and sepereate individual batteries for a bit but not like on standard electricity. The internal battery tends to run down quicker than the manufacture's report in my experience. HoosierM.
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comment: When they triaged me, the headache was one of the symptoms they were looking for novel influenza A, Swine Flu. It is possible, but since they only test people who are pretty ill, you may only find out when wave 2 comes through and you do better than those who didn't have it. People have talked about getting it on purpose. I wouldn't do that. But I sure am not sorry I caught it and today has been my best day, fever is gone, and I am recovering. That's why I have been camped here today. Because I can. Also, this place, if you haven't noticed is really hopping in terms of people posting- especially from infected areas. I worked MH. It is a whole different world. Passing meds is pretty good- your patients come to you.. at least mine did..made a line and I was in an enclosed area- we had some pretty intense cases. Before there was the luxury of RT (Repiratory Therapy) which was always STAT to ER- we had to do full vents in ICU and CCU. This may have been the days when we had glass IV bottles that would clink during the earthquakes. For those of you who may not have been in ICU or worked it, a Vent was often a one on one- if the patient was fragile (unstable). Airway is number one and someone on a vent has a tube and that tube has to be kept clear- and even if the machine if puffing away- if it is set to trigger (on demand) breathing, it can get tricky. RT is a whole world and in ER it is really one. In Operating Room you need an airway and general anesthesia. So a most important thing is that airway. Except massive hemorrhage, vtach or arrest, no airway is deadly. Bleeding lung diseases or lots of fluid, bad news. Avian and Influenza are classic fill up the lungs with gunk (like pneumonia) and give us one big problem. You tie up a qualified nurse or RT who could be doing respiratory treatments, bagging (assist breathing) , or something else to a patient(s). Most of my vents were one on one (they were brittle anyway) and RT would come in and out sometimes draw an arterial blood gas- to see if the vent was getting enough oxygen into the patient. point here- big point for the laymen readers- high care patients would be triaged out in a real emergency. They are not going to tie up nurses, RTs, and doctors running 20 vents when they may have 1000 sick people to deal with. All these how many vents do we have things, or in consideration of a really atypical situation. An ICU full of vents before they call it a day. The whole concept of vent supply and even hospitalizing that many people is impractical. You can afford TLC when you have the staff- if you are looking at 350 real sick people in ER or tons more- we aren't going to see lines of vents. if they are doing this I can't see how they are pulling if off. The 10 people on Vents must be at different hospitals. 10 vents in one ICU would be a nightmare. We might be staffed on a good day with 4-5 - often 3 nurses or RT. Don't worry about having enough ventilators. Worry about having enough people to run them. Often these "plans" look good on paper- but if you will look at Katrina- they evaced the well people first (I think) and then came back for the worst case. here's a book http://books.google.com/books?id=FX999MWvlhcC&pg=PA14&lpg=PA14&dq=nerc+disaster&source=bl&ots=Q0rmuuC_po&sig=_AD9ecuViJQesttyok1zwgpZ4sY&hl=en&ei=qJMhSo2oGZqqtgf89sXFBg&sa=X&oi=book_result&ct=result&resnum=5#PPA19,M1 http://tinyurl.com/nbth3y This will give you a feel for disaster scene compared to rush hour medicine. Hospitals probably will be shut down rather quickly. End of vents. Automatic Resucitator- this is a gem. Wish we had these when we used to go with paramedics in training on the ambulance. http://www.floteco2.com/htm/Products/B-VOR_Automatic_Resuscitator.htm You would need to intubate- http://en.wikipedia.org/wiki/Intubation RTs and anesthesiolgists could comment more on this. We all had to do it and fast when we got our ACLS as opposed to standard CPR. These are probably pretty pricey. Don't try this at home. We learned to do it. You find a spot anatomical, cut, and use an old style pen or straw (worse case- hard to keep open) to create an airway. http://www.medstudents.com.br/proced/cricotir.htm John (the MD one on here) - who can do these nowadays. We used to do them on the troops.. can a layman do this one.. or only medical people? Thought this post might be informative though a little lengthy since this is a vent thread. We nurses used to love to see RT not swamped. Made our double shift when someone didn't show, a lot less double. Medclinician |
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hope4bestprep4wrst
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HoosierMom
Valued Member Joined: June 15 2006 Status: Offline Points: 334 |
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" Don't worry about having enough ventilators. Worry about having people to run them" I could'nt agree more with your post.
So very true. If you think about it...How long before those who come to work are sick. If you imagine someones lungs filling with fluid the ventilator is not going to solve the problem, there is also suctioning of fluids in the airway to keep clear, if the patient could "cough" and just to keep the airway clear would be a constant job - ONE ON ONE CARE. Multiplied by even 30 persons in one institution and the average hospital will be DONE.
As far as creating a tracheostomy-stoma as the risk for infection alone makes me cringe, not to mention the lack of equipment to care for such needs unavailable at home, and then what if the caretaker became ill ? Not to mention the risk of bleeding to death or immediate shock. Medclinician I am not disputing you, I agree just want people to think about that type of procedure. I do appreciate your postings as always !
Either avoid getting it, pray for recovery/mild case.
Just be ready to meet your maker.
Ok seriously, Jesus up in Heaven just take me home ! |
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Littleraven
V.I.P. Member Joined: May 10 2006 Location: United States Status: Offline Points: 438 |
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Thankyou MelodyAtHome and thanks to Medclinician as usual for the great info. I fear we are really in for it with the coming of the Fall. To see so many nasties traveling in convienient little multi-packages whether "opportunistic" or "along for the ride" is very much a reason to be concerned. If the flu itself doesn't put you on a ventilator or worse, the secondaries can definatley take you out.
In the event of breathing difficulties with low oxygen absorption--does anyone know of the usefulness of oxygen concentrators when ventilators are not available and provided the patient is conscious? Are these used for less severe breathing difficulties when the patient is breathing on their own? Thanks |
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There's a Bad Moon on the Rise
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HoosierMom
Valued Member Joined: June 15 2006 Status: Offline Points: 334 |
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02 concentrators could in theory ease the efforts of someone having difficulties but they would have to be breathing on their own, ventilators are for those who cannot physiologically move air effectively or at all through the respiratory system ( alot of involuntary muscle movement ) I am not a RT but have cared for those on a few different types of vents. |
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Littleraven
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Thanks HoosierMom--this is not my area but I was curious since I have seen the concentrators being used for those who are having difficulties keeping their oxygen levels up--but they were certainly breathing on their own. I guess this kind of thing would be minimally useful for anything serious. Thanks for the info.--Littleraven
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There's a Bad Moon on the Rise
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MelodyAtHome
Valued Member Joined: May 16 2006 Location: United States Status: Offline Points: 2018 |
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I also wonder how many of the ventilators in existance are in good working condition. As you know many times any type of equipment ends up breaking down and maybe not fixed because of money contraints or cutbacks. I hope there will be enough for all who may need them. If not, how do they choose who gets the ventilator? First come first serve or who's more important??
Melody
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Melody
Emergency Preparedness 911 http://emergencypreparedness911.blogspot.com/ |
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hope4bestprep4wrst
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Melody
I hope you don't mind my responding. It is a little technical but these are some guidelines for NYC (does not apply anywhere else) which I have posted previously. http://www.health.state.ny.us/diseases/communicable/influenza/pandemic/ventilators/docs/ventilator_guidance.pdf It is complicated but has more to do with how likely you are to survive. Doctors and nurses do not get preference, age and general state of overall health more important. Maybe someone else can figure it out from there but that is what I have gleaned. |
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