General COVID-19 Talk #4 MOD Warning

[Legionnaire]

 

[Bandit]

2.5 billion people are fully vaccinated and assclowns out there are still “doing their own research”. Unreal.

Decorations are brilliant though.

 

[Dooney]

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

Good morning. I want to take a moment to say that I think we both misunderstood each other. I am sorry about that. I didn’t mean to make you think that I thought trauma patients are intubated longer then covid patients. Sometimes they are, but I know they are given the sedation holidays, weaning trials and if that fails usually trached with family consent at 2 weeks.

I also can agree on the modified doses for intubated obese patients fighting the vent. I am sure if we were having the discussion in person it would have come out differently.

PS. I hate pancakes!!!!! More of a waffle person or bagels with lox and cream cheese.

Have a great day.

dooney

XOXO

 

[Dooney]

Legionnaire just stop posting crap about me, referring to me, eluding to me.

 

[Lt Dan]

Legionnaire just stop posting crap about me, referring to me, eluding to me.

please put each other on ignore. This thread is already under threat of being permanently closed because of past political fights and the last thing it needs is more unnecessary crap

 

[Maynard]

please put each other on ignore. This thread is already under threat of being permanently closed because of past political fights and the last thing it needs is more unnecessary crap

Do you really think an “ignore” feature could contain the passion these two have for each other?

 

[Papa Mocha 15]

Good morning. I want to take a moment to say that I think we both misunderstood each other. I am sorry about that. I didn’t mean to make you think that I thought trauma patients are intubated longer then covid patients. Sometimes they are, but I know they are given the sedation holidays, weaning trials and if that fails usually trached with family consent at 2 weeks.

I also can agree on the modified doses for intubated obese patients fighting the vent. I am sure if we were having the discussion in person it would have come out differently.

PS. I hate pancakes!!!!! More of a waffle person or bagels with lox and cream cheese.

Have a great day.

dooney

XOXO

It probably would have in person, online is tough sometimes, especially when no one really knows each other. I'm still shocked re: the amount we're using but had someone try to self extubate the other day when the doc wanted to check the IVC. People go from 0 to 100 fast. Glad the Fellow was there for it holding the arm because then we doubled the sedation so we're not just running into rooms. I didn't have time to get my goggles on but had my shield up so now I"m just watching and waiting. Tube was out about 1/3 of the way. Was just pissed, not even my Pt. Just lunch coverage.

More of a lox and cream cheese person too. Tried to get my kid into it recently, not ready yet so it's just me for now.

Take care!

 

[Lt Dan]

Oh crap I think I forgot to update this yesterday. I think I blew my wad uncovering k17 as Dustin Penner!

Cases look great
Hosp down from Tuesday, twas 288
but ICU up from 72

 

[SmytheKing]

Some information for the "I had it already so therefore natural immunity" statement. It's only data from OK but it's more recent and probably more up to date than the study that gets mentioned in these places frequently.

 

[KingLB]

Some information for the "I had it already so therefore natural immunity" statement. It's only data from OK but it's more recent and probably more up to date than the study that gets mentioned in these places frequently.

Not on YT, don’t believe it.

 

[Dooney]

Not on YT, don’t believe it.

Can I ask what you do believe?

I personally don’t believe in vaccine mandates and people losing their jobs. I tried to post counter information but it was deleted. I have been vaccinated but if I had to make the choice again, I would not.

 

[Raccoon Jesus]

Can I ask what you do believe?

I personally don’t believe in vaccine mandates and people losing their jobs. I tried to post counter information but it was deleted. I have been vaccinated but if I had to make the choice again, I would not.

There have been ZERO deletions since your entry to the thread.

Getting beyond f***ing sick and tired of this "i don't agree so I'm being censored" narrative especially when there's no basis for it. I am 100% out of patience for dramatic martyrdom.

 

[Raccoon Jesus]

Some great news for a home treatment:

 

[Bandit]

Can I ask what you do believe?

I personally don’t believe in vaccine mandates and people losing their jobs. I tried to post counter information but it was deleted. I have been vaccinated but if I had to make the choice again, I would not.

This country wouldn't exist without vaccine mandates:

George Washington and the First Mass Military Inoculation (John W. Kluge Center, Library of Congress)

And a shit ton of us would be paralyzed from polio. Sounds great, glad this country has so many "free thinkers".

 

[Fishhead]

Can I ask what you do believe?

I personally don’t believe in vaccine mandates and people losing their jobs. I tried to post counter information but it was deleted. I have been vaccinated but if I had to make the choice again, I would not.

I agree everyone should have their say on things like vaccines, but this opinion will definitely be in the minority.

We have decades of evidence about how effective vaccines and their mandates are, there is so much data it's overwhelming. It's difficult to even figure out why there is so much push back on this particular vaccine, my own theory is that we are so far removed from the pandemics of the past where people viewed vaccines as their saviors. If you've ever seen a kid with measles, you'll know what I'm talking about. It's terrible to watch a young kid suffer like that.

Older people are far more likely to get vaccinated, not just because of the higher risk, but because they remember what it was like before. People in their 20's through 40's haven't had to get a lot of viruses/illnesses because they've been protected their whole lives. They've never had to deal with Diptheria, tetanus, whooping cough, polio, hep B, measles, mumps, rubella, and now even chickenpox, because it's mandated they get those vaccines. All those vaccines have made the world a much better, safer, and healthier place, but come up with a vaccine for COVID and all of a sudden it's "my body my choice". I can guarantee you that 99% of those that believe that have had many mandatory vaccines in their lives and it's saved them some suffering. People have forgotten the horrors.

If an adult doesn't want to get a vaccine, that's totally fine, but they can't expect others to want to be around them and they certainly can't expect an employer to assume the risk of them contracting and spreading it. People can fight the mandates all they want, but with literally mountains of evidence to support them and over 100 years of precedence in the supreme court, it's an expensive and losing battle.

 

[Lt Dan]

This country wouldn't exist without vaccine mandates:

George Washington and the First Mass Military Inoculation (John W. Kluge Center, Library of Congress)

Indeed and to add to what Bandit said above

Every public school kid has had to be vaxxed for a long time. We all had to as a kid

Every member of the military must be vaxxed
https://www.cdc.gov/vaccines/schedules/downloads/adult/adult-combined-schedule.pdf


There are liberties and I very much believe in them but one's actions can also have effects on others and that is absolutely one of those instances.

And a shit ton of us would be paralyzed from polio. Sounds great, glad this country has so many "free thinkers".

I have actually met someone who had polio and is still f***ed up from it. He has a lame leg (sorry if I used the wrong term here) , he walks with a cane, and walking has been painful for him since he was a child.

 

[Lt Dan]

They've never had to deal with Diptheria, tetanus, whooping cough, polio, hep B, measles, mumps, rubella, and now even chickenpox, because it's mandated they get those vaccines. All those vaccines have made the world a much better, safer, and healthier place, but come up with a vaccine for COVID and all of a sudden it's "my body my choice". I can guarantee you that 99% of those that believe that have had many mandatory vaccines in their lives and it's saved them some suffering. People have forgotten the horrors.

This is an incredible point. High five yourself Fish

You know how we all had to watch car accidents and shit like Blood Flows Red on the Highway in Drivers Ed?

People should be forced to watch vids like this or someone dying of covid





This poor baby did nothing wrong and got this because someone wasn't vaccinated and is now dead

 

[Lt Dan]

The county hasn't updated the site yet and I need to go see my pimp.

Here is a graph from a data guy I follow He said this is the first time since 7/28 that OC is under 10.0 on the case metrics

 

[Lt Dan]

 

[Lt Dan]

Hospital up slightly today
ICU down from 86

 

[Buddy The Elf]

Can I ask what you do believe?

I personally don’t believe in vaccine mandates and people losing their jobs. I tried to post counter information but it was deleted. I have been vaccinated but if I had to make the choice again, I would not.

I'll speak for myself but I don't agree with a government mandate on vaccinations but fully support private enterprise to operate as they see fit. If you believe in private enterprise then you should agree with that position.

I just find it amusing that the people that feel like their civil liberties are being infringed have no problem walking through airport security and having their body scanned by an agency that's failed every audit that's been conducted.

The list of excuses have no merit. The only valid excuse is that you simply don't want it. That's fine. Don't ask for help when you've been offered it in advance. Live and die by your own devices. I don't think anyone has a problem with that.

 

[KINGS17]

I'll speak for myself but I don't agree with a government mandate on vaccinations but fully support private enterprise to operate as they see fit. If you believe in private enterprise then you should agree with that position.

I just find it amusing that the people that feel like their civil liberties are being infringed have no problem walking through airport security and having their body scanned by an agency that's failed every audit that's been conducted.

The list of excuses have no merit. The only valid excuse is that you simply don't want it. That's fine. Don't ask for help when you've been offered it in advance. Live and die by your own devices. I don't think anyone has a problem with that.

The TSA at the airport...Security Theater.

 

[Dooney]

There have been ZERO deletions since your entry to the thread.

Getting beyond f***ing sick and tired of this "i don't agree so I'm being censored" narrative especially when there's no basis for it. I am 100% out of patience for dramatic martyrdom.

Yes there was. I posted to project Veritas for discussion and within 30 minutes it was gone. I went back and looked at my account. Still adore you though!

 

[Dooney]

Some great news for a home treatment:

This is Ivermectin under a different name you know.

 

[Dooney]

I agree everyone should have their say on things like vaccines, but this opinion will definitely be in the minority.

We have decades of evidence about how effective vaccines and their mandates are, there is so much data it's overwhelming. It's difficult to even figure out why there is so much push back on this particular vaccine, my own theory is that we are so far removed from the pandemics of the past where people viewed vaccines as their saviors. If you've ever seen a kid with measles, you'll know what I'm talking about. It's terrible to watch a young kid suffer like that.

Older people are far more likely to get vaccinated, not just because of the higher risk, but because they remember what it was like before. People in their 20's through 40's haven't had to get a lot of viruses/illnesses because they've been protected their whole lives. They've never had to deal with Diptheria, tetanus, whooping cough, polio, hep B, measles, mumps, rubella, and now even chickenpox, because it's mandated they get those vaccines. All those vaccines have made the world a much better, safer, and healthier place, but come up with a vaccine for COVID and all of a sudden it's "my body my choice". I can guarantee you that 99% of those that believe that have had many mandatory vaccines in their lives and it's saved them some suffering. People have forgotten the horrors.

If an adult doesn't want to get a vaccine, that's totally fine, but they can't expect others to want to be around them and they certainly can't expect an employer to assume the risk of them contracting and spreading it. People can fight the mandates all they want, but with literally mountains of evidence to support them and over 100 years of precedence in the supreme court, it's an expensive and losing battle.

hep b and chicken pox aka shingles are not mandated vaccines. Nor is flu or pneumonia.

Covid is actually a money maker for big pharma and hospitals. Pharma stock has skyrocketed and they are going to follow the money. The hospitals are finally seeing cash flow is federal dollars for every covid related diagnosis they can come up with. It has helped mitigate the horrible contacts they have lost money on with CMS and insurance companies. This I know because it IS my business to know.