M
member 1013
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Never mind
the wait hasn't been about serialization vs parellization, AFAIK.
Is someone going to move the FDA? It always seems like the bureaucrats are the long pole in the tent.
Also how everything online is forced to flow through google.
Name any device you purchase which doesn't have default software on it that is impossible to uninstall. Why the hell cant I uninstall Facebook from my phone when I've never used the site?
I'm pretty sure I can move my pixel down to nothing but android (disable what you want from there).
But that doesn't change that google AMP ( their mobile sites that are required for high rankings) are an active threat to the open web and just becoming more ubiquitous.
Same with google results that take this forums content and shows the first few posts on google, never requiring the searchers to click the forum to view the content. Just taking, not giving.
Exactly. But the masses, for the most part will be fine with it as long as they have their flash apps and filter. Tiktok and zoom.
Some E-sleight of hand going on. Distract with one hand while you steal with the other.
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FROM NYC ICU: DOES COVID-19 REALLY CAUSE ARDS??!!:
View: https://youtu.be/k9GYTc53r2o
@Splinty
@SC MMA MD
View: https://youtu.be/k9GYTc53r2o
@Splinty
@SC MMA MD
He knows better than me if he's an intensivist I'd guess. Hes doing this. He knows better than me.FROM NYC ICU: DOES COVID-19 REALLY CAUSE ARDS??!!:
View: https://youtu.be/k9GYTc53r2o
I think him just tossing out "this may be nothing more than the ventilator causing damage" is kind of bad. You don't just say that without some evidence. He's talking about the increased use of PEEP (part of the pressure setting to keep the lungs inflated and overcome inflammatory processes in something called ARDS) on vents that was started from the earliest patients. That's a heavy accusation to just throw out there. Lots of other docs running vents on these patients are finding that is the only way to get these patients oxygenated.
So it might not be the final answer but its sort of foolhardy to accuse the world of being dogmatic on this when everyone is being pretty open that this is all new and we don't know.
Some doctors have suggested a viral induced hemoglobinopathy in which the issue is the ability for your blood cells to hold oxygen. This would be the type of thing this doctor is referencing. Like are we just ventilating and missing that extra piece. Sure, I think everyone agrees that could be the case. What's the fix? Without the meds, the fix is to oxygenate and ventilate them unfortunately. So I don't think its okay to use the words "dogmatic" as everyone is responding acutely to patients without a known treatment.
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Thanks for the response.
Here's why I am forever calling this kind of casual innuendo out. Here's what youtube now feels is a normal gradient from him trying to just push that we need to go farther and in his experience this isn't just ARDS:
Golden Ages4 hours ago
Unable to uptake oxygen. Almost as if they were bathing in 60GHz radio frequencies? Strange. Almost as if NY turned on 60GHz 5g?
albertosaurus605 hours ago
Cameron you are spot on with this not being COVID19. According to PubMed via Dr Thomas Cowan, no one has purified the virus to identify it. But pls do your own research. But 5G runs at 60GHz. At this frequency it absorbs all the oxygen from the air. Hence, the altitude sickness. Whatever happened in Wuhan has NOTHING to do with what’s going on around the globe. The Chinese only locked down Wuhan, and not the rest of China. The seafood market is now open again. Is it a coincidence that all the places with the highest deaths have rolled out 5G?
droidcrasher8 hours ago (edited)
The PROBLEM seems to be ACIDIC BLOOD !!! It is a CHEMICAL IMPOSSIBILITY for ACIDIC BLOOD to CARRY OXYGEN!!! YOU HAVE TO ALKALIZE THE BODY and THE BLOOD!!! GIVE THEM BAKING SODA!!! (and any other minerals capable of carrying oxygen in the blood... Like MSM (organic sulphur), and ESPECIALLY IRON. (creates Hemoglobin - Vitamin C helps that process)
Nate Carr's Quest to Save the World3 hours ago
Thanks for speaking up and recognizing the hypothesis that that medical professionals are exacerbating the situation. This actually matches up with the data point of almost a 0% mortality risk amongst children. Please remember, it's the impoverished children of the world who are suffering. The amount of money spent to temporarily prolong the life of a wealthy elderly american, could save the lives of hundreds of impoverished children. In what psychopathic universe is the life of 1 elderly person worth the lives of hundreds of children?
JayeBird1 hour ago (edited)
Ventilators has a warning about VAP=Ventilator Associated Pneumonia!!!! Antivirals like Ribavirin lowers your red blood cell count leading to Anemia which causes fluid in the lungs, Pneumonia!!!! They’re killing the patients for their COVID19 numbers!!!! We’ve been lied to on Massive scale!!! STOP MEDICAL MARTIAL LAW!!!!!!! BEFORE ITS TOO LATE!!!!! #WEDONOTCONSENT
It’s seriously awesome that you’re willing to share your knowledge and try to call out the BS. Kudos man.Here's why I am forever calling this kind of casual innuendo out. Here's what youtube now feels is a normal gradient from him trying to just push that we need to go farther and in his experience this isn't just ARDS:
Golden Ages4 hours ago
Unable to uptake oxygen. Almost as if they were bathing in 60GHz radio frequencies? Strange. Almost as if NY turned on 60GHz 5g?
albertosaurus605 hours ago
Cameron you are spot on with this not being COVID19. According to PubMed via Dr Thomas Cowan, no one has purified the virus to identify it. But pls do your own research. But 5G runs at 60GHz. At this frequency it absorbs all the oxygen from the air. Hence, the altitude sickness. Whatever happened in Wuhan has NOTHING to do with what’s going on around the globe. The Chinese only locked down Wuhan, and not the rest of China. The seafood market is now open again. Is it a coincidence that all the places with the highest deaths have rolled out 5G?
droidcrasher8 hours ago (edited)
The PROBLEM seems to be ACIDIC BLOOD !!! It is a CHEMICAL IMPOSSIBILITY for ACIDIC BLOOD to CARRY OXYGEN!!! YOU HAVE TO ALKALIZE THE BODY and THE BLOOD!!! GIVE THEM BAKING SODA!!! (and any other minerals capable of carrying oxygen in the blood... Like MSM (organic sulphur), and ESPECIALLY IRON. (creates Hemoglobin - Vitamin C helps that process)
Nate Carr's Quest to Save the World3 hours ago
Thanks for speaking up and recognizing the hypothesis that that medical professionals are exacerbating the situation. This actually matches up with the data point of almost a 0% mortality risk amongst children. Please remember, it's the impoverished children of the world who are suffering. The amount of money spent to temporarily prolong the life of a wealthy elderly american, could save the lives of hundreds of impoverished children. In what psychopathic universe is the life of 1 elderly person worth the lives of hundreds of children?
JayeBird1 hour ago (edited)
Ventilators has a warning about VAP=Ventilator Associated Pneumonia!!!! Antivirals like Ribavirin lowers your red blood cell count leading to Anemia which causes fluid in the lungs, Pneumonia!!!! They’re killing the patients for their COVID19 numbers!!!! We’ve been lied to on Massive scale!!! STOP MEDICAL MARTIAL LAW!!!!!!! BEFORE ITS TOO LATE!!!!! #WEDONOTCONSENT
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yes but only in a small percentage of peopleFROM NYC ICU: DOES COVID-19 REALLY CAUSE ARDS??!!:
View: https://youtu.be/k9GYTc53r2o
When it hits home
I can't take him serious after desus and mero do impressions of him on their show.
FROM NYC ICU: DOES COVID-19 REALLY CAUSE ARDS??!!:
View: https://youtu.be/k9GYTc53r2o
I started digging into this and of course I'm just scratching the surface. The Italians have started a camp suggesting that the response to this with high levels of PEEP it's not effective and there's observational data that the problem is not needing more pressure to overcome inflammatory processes as ards.
Rather the problem is blood vessel shunting and recruitment due to viral pneumonia. The lungs themselves are expanding fine with each breath. This means that you don't need extra pressure to push those lungs open because they're opening fine with just a little pressure already.
So run really high oxygen and only turn the peep up as much as you need to maintain oxygen saturations.
https://www.atsjournals.org/doi/abs/10.1164/rccm.202003-0817LE
This guy is in that camp and is seeing some evidence in his patients suggesting the same thing. this is in line with some of the other reports that these patients tolerate a remarkably low oxygen level without distress. they're sitting there and they're oxygen is just going down and down and down but they're not huffing and puffing real hard.
View: https://youtu.be/_T_KT4j4oS4&t=60m49s
The problem right now is thatnot having other treatments once they're on the vent you still have to maintain adequate oxygen saturations and sometimes more pressure is the only way to do that.
So some questions become:
is there something about this disease process that would let me run the patient more hypoxemic than I'm normally comfortable with?
Should I be intubating this patient much earlier in the disease process and running them on oxygen long before they start dropping their numbers?
It could be that we are only seeing this outcome because we are waiting so long in the disease process that we are forced to use the higher pressures due to lack of other adjuvant interventions.
There is something called ECMO, extracorporeal membrane oxygenation, in which you essentially oxygenate the blood with an intake in return like a bypass machine. This is very invasive and not something that is used except for the sickest of patients typically.
However, this kind of thing might be the only thing that can save some of these patients if the ventilator itself can cause damage trying to get the oxygenation needed. And still these are no solution. There are less of them than ventilators and even fewer facilities have them.
However, this kind of thing might be the only thing that can save some of these patients if the ventilator itself can cause damage trying to get the oxygenation needed. And still these are no solution. There are less of them than ventilators and even fewer facilities have them.
maybe we can buy some of those machines from china like we are buying ventilators and test kits.
This guy was one of my attendings. He's probably one of the smartest people I've ever met in my entire life. You know how some people become an emergency doctor or some people becoming an internal medicine doctor? So he decided to do both. No biggie. Still works doing both.
He bought into what that New York City doctor is saying.
View: https://mobile.twitter.com/srrezaie/status/1245942292265029635
He's suggesting that the solution is high flow nasal cannula (lots of oxygen up front) and then only intubate when you have to. Still very subjective on when choosing to intubate. But all the nerds and the emergency medicine critical care world seem to be going this route and away from the ARDS route.
He bought into what that New York City doctor is saying.
View: https://mobile.twitter.com/srrezaie/status/1245942292265029635
He's suggesting that the solution is high flow nasal cannula (lots of oxygen up front) and then only intubate when you have to. Still very subjective on when choosing to intubate. But all the nerds and the emergency medicine critical care world seem to be going this route and away from the ARDS route.
medical martial law netflix has a show on this.
JayeBird1 hour ago (edited)
Ventilators has a warning about VAP=Ventilator Associated Pneumonia!!!! Antivirals like Ribavirin lowers your red blood cell count leading to Anemia which causes fluid in the lungs, Pneumonia!!!! They’re killing the patients for their COVID19 numbers!!!! We’ve been lied to on Massive scale!!! STOP MEDICAL MARTIAL LAW!!!!!!! BEFORE ITS TOO LATE!!!!! #WEDONOTCONSENT
Since we have no treatment of the virus your only job is supportive care.
Without additional treatment, you could be stuck with some really weird moves in medicine.
Normally we make all these decisions on intubating you based on how hard you're working to breathe and if you're keeping yourself up and going. That's because usually your oxygen is going down because you've been working harder to overcome whatever it is keeping you from getting good oxygen. You're going to tire out.
The covid19 patients are widely reported to decline rapidly when they do. That's where the recommendation for early intubation came from originally. They're doing okay and then suddenly they're not.
In this case these patients are doing pretty okay with a relatively low oxygen. So maybe just turn up the nasal cannula really high and just let it flow and give them as much extra as they can. No pressure. Their lungs are working fine. The lungs just aren't physiologically attached to blood vessels properly at the molecular level of the disease is going. Not getting perfused.
So then you need to intubate when that stops working and not do the intermediate steps we usually do.
Now they're intubated and you probably should keep your pressure down at 5-8 and not running up to 15 like we're currently doing for ards.
And if the five to eight doesn't work in these patients maybe that's all we can do on a ventilator and you're looking at something like ecmo it's the only option. But again I want to stress it's not really an option. it's highly invasive and there's lots of risk and some patients aren't a candidate for it. And I bet the patients who aren't a candidate often are the same patients that do poorly on a vent and die from this stuff. It's just normally you wouldn't even think about ecmo and now I'm just kind of toying with the idea without other interventions you hit the ecmo level way faster than you normally do
We need some other interventions to go along with this but learning respiratory protocols here is a pretty big deal.
tire out sounds like a brutal way to die
At work monitoring vents. So far we have 5 employees that have tested positive or have symptoms and are awaiting results.
