Alberta emergency doctor says major parts of health triage have begun

[chuckChuck]

Moe recently criticized first nations for low vaccination rates but said nothing about low vaccination rates in some mostly rural southern farming regions. Its pretty obvious why he wants to blame first nations and not rural southerners.

More obvious disconnect and bias from Curly, Larry and Moe

[agstar77]

What nurse where? The same one that believes in Martians? I think you can find almost all that think covid is the problem not the vaccine.

[sumdumguy]

Picture this chart in your head - more vaccinations but more cases. hmm

[dmlfarmer]

A twitter thread from an ICU doctor in Edmonton describing the treatments administered in ICU for Covid patients. For those who have no idea of what is done for a covid patient in ICU, and why simply adding beds will not solve the problem. It is a trained staff shortage, more than bed or ventilator shortage.


Darren Markland
@drdagly
So, we’ve reached 34 deaths per day from COVID. It’s a shocking number that really gets swamped over by all the other numbers. I’m going to describe the usual dying process in the ICU from this disease. I’m wearing my clinical hat, be warned.
8:03 AM · Sep 30, 2021·Twitter for iPhone
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Darren Markland
@drdagly
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4h
Replying to
@drdagly
The trip through the ICU is serpentine. We admit patients now who not only have low oxygen levels, but are in distress. Prior to that internal medicine physicians have been providing ICU level care on the floors.
Darren Markland
@drdagly
·
4h
They treat potential coinfections, mange noncovid aspects of patient health and importantly try to turn the course of the disease with steroids and monoclonal antibody therapy. If the trajectory is set, they come to the unit to be placed on a ventilator.
Darren Markland
@drdagly
·
2h
This is where we are learning as we go. First you must understand that we are usually 14 days away from the initial infection. The virus is long gone by now. If coronavirus was the lightning storm than what we are dealing with is the wild fire that got out of control.
Darren Markland
@drdagly
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2h
That is why none of the antiviral therapies work in the ICU. We are battling uncontrolled inflammation. You know when you bang your arm and it hurts way more the next day? Like that, but because COVID targets blood vessels it’s like banging every part of your body.
Darren Markland
@drdagly
·
2h
Just like you putting an ice pack on that bruise, we are using dexamethasone, a steroid, Tocilizumab, an interlukin blocker, and COV-REGEN2 in those who are late antibody formers. All the while we are waiting for the fire to go out, so we can see what happens next.

Darren Markland
@drdagly
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2h
It’s what we like to call the, “do no harm phase.” This is where we try to find the balance of getting enough air in the patient so they don’t suffocate while trying not to tear up their stiff lungs and start the inflammation up again. If this were a joint you wouldn’t move it.
Darren Markland
@drdagly
·
2h
But that’s not an option, unless your a candidate for ECMO, which is where we put the patient on a lung bypass circuit. Oxygen and CO2 exchange outside the body via garden hose size cannula placed in the neck and groin. It’s pretty exceptional, & we can only do about 12 @ a time.
Darren Markland
@drdagly
·
2h
In the non ECMO pathway, we take it day by day. Our job is to protect the vulnerable patient from other things. Blood clots, bacterial infections, skin break down, kidney failure, malnutrition while we wait for the lungs to heal. It can take weeks.
Darren Markland
@drdagly
·
2h
Ok, now take a deep breath, all the way. Trust me. Just do it. Now hold it. That’s your new starting point. I want you to take your next breath from there. And your next. Don’t cheat. Pretty anxiety provoking, right?
Darren Markland
@drdagly
·
2h
To keep people with this lung disease (it’s call ARDS) from ripping their lungs apart we need to sedate them very heavily. Sometimes even paralyze them. It can make people incredibly weak, but there are no other options.
Darren Markland
@drdagly
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2h
No for weeks we wait. Waiting for the lungs to heal. To relax. There is no clear way to predict who will get better and when. It’s an unclear pathway dictated by genetics and immunity. It’s heralded by the ventilators silence as it can relax and not push the air so hard.
Darren Markland
@drdagly
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2h
At that point we can start to wake our patients up. There emergence is often dramatic, like coming up from deep water. We need to be gentle. Too much struggling and we can lose all of our gains.
Darren Markland
@drdagly
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2h
I’ve seen some get better quickly. They act like good old bacterial pneumonia. Others take longer. We talk to families about tracheostomies and long term ventilation. They make progress but they will have long term complications from their journey.
Darren Markland
@drdagly
·
1h
There is however a subset. They seem to improve initially, but despite everything we do they deteriorate after a week on the ventilator. No matter what we do their lungs get stiffer and stiffer. Instead of healing, their lungs are replaced be scar tissue.
Darren Markland
@drdagly
·
1h
We search for hidden infections, scan them for blood clots, look for strange drug reactions and autoimmune disease. Over the ensuing weeks, their hearts start to fail from the tremendous work of pushing blood through fibrous lungs.
Darren Markland
@drdagly
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1h
Deprived of blood the kidneys fail first. Dialysis will keep them going forward a while longer, but without lung transplantation the heart eventually stops. Often we sit down with families before these final things happen to let them know the path their loved ones are on.
Darren Markland
@drdagly
·
1h
We seek out there values and goals. We let them know what we can accomplish and what we can’t. It’s often choosing between the lesser of two evils, and often I am conflicted about putting people in such difficult positions.
Darren Markland
@drdagly
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1h
The journey of dying in the ICU from #COVID19 takes on average about a 6 weeks. I have seen what that does to families.

Despite our resources and technology we can do little but support our patients and their families through the process waiting for them to heal.
Darren Markland
@drdagly
·
1h
And though most who read this thread know that vaccination can prevent almost all of this, it is why those of us in healthcare struggle knowing this is now preventable. It’s a thought that torments us through every day of those 6 weeks.

[Guest]

$20.25 canola targets picked up here today

[AlbertaFarmer5]

$20.25 canola targets picked up here today

Quite a roller coaster ride on futures today too. Up Almost $15 a ton to over 900 again, before the USDA report then down 10 to finish up almost even.

[chuckChuck]

DML posted a very interesting opportunity to hear from a doctor on the frontlines of covid in an Edmonton hospital and some of the usual suspects ignore it and try to change the subject. Ok that's fine. Its not everybody's cup of tea.

But I suspect both of the previous posters have received their vaccinations. Case wants to travel and A5 probably wants to avoid a career ending serious health issue or worse.

But both have been very critical of covid threads and seemingly unconcerned about the human impact. Not sure why this is the case, but I doubt many people would be so nonchalant if it happened to somebody they knew. And I doubt after a death or severe illness from covid of someone they knew, that many people would say vaccines are a bad idea.

In my experience people with chronic illness, a terminal disease or cancer will try just about anything to try and stay alive. Radiation and chemotherapy both have serious side effects that make vaccine risk look like a picnic.

The campaign against vaccines by a few privileged and misguided individuals is hard to understand. What maybe they need is a trip through an ICU full of unvaccinated covid patients and some connection to the reasons why many of them thought vaccinations were not a good idea.

Yeah and there are fully vaccinated people in the ICU you say. Yes and most of them are people with chronic diseases and weak immune systems. Often the elderly.

[chuckChuck]

So JWAB what planet are you fighting this war on? I won't waste my time watching anything you post so give us the gist of this intergalactic good vs evil story. On second thought don't bother, we already know its science fiction and is not set in any kind of reality that matters here on earth. LOL