General COVID-19 Talk #4 MOD Warning

[Bandit]

You don’t need to school me first of all, I have been a practicing nurse for probably longer then you have been alive.
Secondly I am very scared if your doctors are prescribing ALL of those medications at one time in those dosages. I don’t want to be in your/there care. Sorry.. not sorry. That is not safe.

No offense, but that's probably the best reason for you to go back to school.

 

[Maynard]

You don’t need to school me first of all, I have been a practicing nurse for probably longer then you have been alive.
Secondly I am very scared if your doctors are prescribing ALL of those medications at one time in those dosages. I don’t want to be in your/there care. Sorry.. not sorry. That is not safe.

You couldn’t refute a single point of his post so you did the old “Hey buddy, I’ve been doing this a long time! Never heard of so many meds!”

Childish responses like this are valuable because it lets us know who we should be listening to, and which medical professional we should take serious in here.

 

[Dooney]

You couldn’t refute a single point of his post so you did the old “Hey buddy, I’ve been doing this a long time! Never heard of so many meds!”

Childish responses like this are valuable because it lets us know who we should be listening to, and which medical professional we should take serious in here.

Seriously I am shocked. I reached out to Dr Tsui, you may have seen him on Channel 7 world news tonight in the height of the pandemic. The head of the ICU here in Vegas who was not to proud to help the cleaning staff clean rooms. I emailed him the post. He is my friend and I worked with him, he also sees patients at UMC our trauma and county facility. He is chief of staff and I trust what he says.
His opinion is that dose of meds would never be given together for that period of time and they have not seen addiction as a problem in the patients.
Take it how ever you want. It was disrespectful for how Papa Moca approached me.

 

[Lt Dan]

I found a new toy recently on Covd Act Now

The death figures are by date reported and obvious lag cases, Hosp, ICU , etc plus have an extra lag for red tape

 

[Jason Squirties]

I must've tripped into a facebook account.

 

[Papa Mocha 15]

You don’t need to school me first of all, I have been a practicing nurse for probably longer then you have been alive.
Secondly I am very scared if your doctors are prescribing ALL of those medications at one time in those dosages. I don’t want to be in your/there care. Sorry.. not sorry. That is not safe.

I was between a night shift and was tired when I wrote part of that. Look, not every patient gets all that at once, start small and build up and switch around until they are riding the vent during the inflammatory phase until they move into the fibrotic phase and you can wean them down and extubate or trach them. I will back track there some in terms of the high concentrations of every single med because different people require different doses based on body weight and drug tolerance. If you get to max dose on one or two meds, you don't need to max dose all the others. If your patient is 300 lbs and 6 foot 6, guess what isn't going to work? 20 of propofol and 25 of fentanyl. They will self extubate in a NY minute. These patients are big, heavy and need higher doses. .

But other patients, if we go to versed, we can come down on propofol and fentanyl or we can drop the propofol concentration using ketamine but many patients require an adjunct to get them dialed into to vent. You can max dose on 2 meds and then drop the the dosing when you add a third. But you may get a heroine addict who needs massive dosing because they do drugs all the time. Another example, if they have PTSD already or panic attacks, you need Ketamine or Versed or both and titrate up as needed with a whisper of propofol. We don't just jump to the highest level to try and shatter a record, but meds get titrated, switched around in accordance to the vent and their labs and balanced with the need to protect their lungs and ease suffering. It's being compassionate. You can call it unsafe, but Covid isn't safe. It changed all the rules of the game. The other option is they die and they already said they wanted everything done possible.

On a side note, you seem to take offense the fact that I'm wordy or backed up my point, I was a lit major in college. I've apologized to my wife too for the size of the student loan. But the purpose of these boards is so we can all chat, disagree and argue to come to a conclusion. We do it so we can look smart when we see our families and fight with them later. I have learned more arguing with people like Kings17 because we go back and forth quite a bit and have learned and appreciate more about personal freedom and how people will place value over quality of life than anything else. It's a good experience if you are open to it and we can learn a ton from each other.

But you made a few assertions that I felt needed to be called out and not in line with the day to day of this disease process. You insinuated that trauma patients are intubated longer than Covid patients and through your studies and conversation with nurses across the country, we are giving these Covid patients sedation holidays and backing off sedation when the opposite is true, and there is no need to worry about addiction. I respectfully disagree. I felt you glossed over ARDS because that is what separates this disease process from others. It's not a crime to provide a counter argument regardless of your years experience or whatever type of practice you engage in. I explain things on the board here not to trap or defeat anyone in particular but to show people who are not in the field what this pandemic has done to patients, nurses and the families and how this disease works on more intimate level. Because otherwise, all we get is CNN vs Fox, which covers none of this,

But in my humble experience, I have seen techs run circles around RNs when it comes to EKGs. Phlebotomists get a blood draw using their non dominant hand the first try while the RN has already poked the patient twice and can't figure out which end is up. The license and years experience don't make the career or wisdom. If anyone makes a claim or argument, then provide a citation or two that is evidence based. It's not an unreasonable ask. We all call each other out for it. It's not schooling anyone, but it is going to be an uncomfortable process if anyone doesn't back up their point or makes assertions. We keep showing up to learn and grow and maybe understand a bit more about where this is pandemic is heading and each other in the process and how are coping.

No prob admitting when I need to backtrack or take the gas off a point, it's freeing to be able to adjust the argument to get to a better understanding. It's uncomfortable, but it's supposed to be.

XOXO

 

[Papa Mocha 15]

I must've tripped into a facebook account.

I just want to know what you all ate last night for dinner.

 

[Buddy The Elf]

Well, my brother who moved to Idaho a few years ago and was pretty much on the borderline conspiracy plane has gotten COVID. He did say he was going to get the vaccine in a week but didn't want to miss work. He now has missed work for a full week and maybe more. Long story short, he regrets it and he's pushing his diabetic wife who routinely posts conspiracy nonsense online to get it. I told him he doesn't want to be a Herman Cain Award winner and sent him the reddit link.

 

[Papa Mocha 15]

I found a new toy recently on Covd Act Now

View attachment 467074

Like giving crack to a drug addict.

 

[Buddy The Elf]

I just want to know what you all ate last night for dinner.

You'll find out when you do my colonoscopy.

 

[Papa Mocha 15]

You'll find out when you do my colonoscopy.

I'll put you in a roofie like trance and you'll never feel it when the Dr. goes in. However, I'll watch the content from the sidelines on the big screen. #medporn

Mental note to self: I recognize that may have gone too far but oh well.

 

[KINGS17]

I just want to know what you all ate last night for dinner.

This thread is now about blueberry pancakes.

Oh wait, we don't do that here?

 

[Buddy The Elf]

I'll put you in a roofie like trance and you'll never feel it when the Dr. goes in. However, I'll watch the content from the sidelines on the big screen. #medporn

Mental note to self: I recognize that may have gone too far but oh well.

Well I want to feel it when you hit the prostate other wise the sodomy will have been in big waste.

 

[Lt Dan]

I'll put you in a roofie like trance and you'll never feel it when the Dr. goes in. However, I'll watch the content from the sidelines on the big screen. #medporn

Mental note to self: I recognize that may have gone too far but oh well.

There is no such thing as going too far

 

[Lt Dan]

This thread is now about blueberry pancakes.

Oh wait, we don't do that here?

Holy shit! K17 is Dustin Penner!

 

[Bandit]

Holy shit! K17 is Dustin Penner!

Explains a lot.

 

[Rumpelstiltskin]

Not sure of the actual "impact" of this (given that I haven't heard much about this drug during most of this year), but nonetheless, a bit of bad news:

Remdesivir and Lessons in Pandemic Drug Approvals – AIER

All of which would be just swell except for one problem: Studies keep showing [remdesivir] doesn’t work. In fact, they were showing that before the FDA approval.​

 

[KINGS17]

Explains a lot.

Don't even try. You're not in my class.

 

[KINGS17]

Holy shit! K17 is Dustin Penner!

That's right, MF'er.

 

[Bandit]

Don't even try. You're not in my class.

Sure thing tough guy. You got the second part right at least, I'm definitely not in "your class".

 

[KINGS17]

Sure thing tough guy. You got the second part right at least, I'm definitely not in "your class".

Nah, you are just a little b who likes to make snarky posts. You aren't funny. You aren't cool.

 

[Bandit]

Nah, you are just a little b who likes to make snarky posts. You aren't funny. You aren't cool.

You forgot "and nobody likes you".

 

[KingLB]

One good thing about preseason hockey, the FIGHTS! First the nurses! Now the geriatrics!

 

[Bandit]

One good thing about preseason hockey, the FIGHTS! First the nurses! Now the geriatrics!

Damn dude, I'm not THAT old.

 

[Papa Mocha 15]