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Thread: Covid 19 Sci/med discussions only

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    Covid 19 Sci/med discussions only

    Other thread is closed, this one intended strictly discussion and dissemination of sci/med info for med pros and or those involved/interested, and might also pass info along. This thread is for medical info of value only:

    What continues to rise to the top is that what they see is not classic ARDs, and intubation may cause more harm than good in some patients. There may be two distinct phenotypes that dictate different approaches. Please view this vid, and following vid linked. Doc posted below that has similar details and a recommended protocol.

    Kyle-Sidell, ER and Critical Care MD working in NYC on the front lines:



    Great interview with Dr Kyle-Sidell via Web MD with specific details:

    "Do COVID-19 Vent Protocols Need a Second Look?"

    https://www.youtube.com/watch?v=Elgct0nOcKY

    Best document I have seen to date that it's not classic ARDS for many and recommended treatment protocol: EVMS CRITICAL CARECOVID-19 MANAGEMENT PROTOCOL by Paul Marik, MD Chief of Pulmonary and Critical Care Medicine Eastern Virginia Medical School. Med pros need to read this and pass it around!

    https://www.evms.edu/media/evms_publ...9_Protocol.pdf

    My model and suggestions for adjuvant treatment of serious complications:

    https://brinkzone.com/life-saving-st...complications/
    Last edited by WillBrink; 11-23-20 at 13:03.
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    I think the most important update is how we treat the H vs L phenotyopes:

    https://www.esicm.org/wp-content/upl...thor-proof.pdf

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    Quote Originally Posted by scooter22 View Post
    I think the most important update is how we treat the H vs L phenotyopes:

    https://www.esicm.org/wp-content/upl...thor-proof.pdf
    Good read. Outside my lane but I'd only add that note transitioning from type L to type H appears to have inflammation (cytokine storm?), and that aspect needs to be addressed asap in the type L person to prevent their transition to type H, and where perhaps a serious treatment gap exists and opportunity lost.

    That's my non medical opinion. These are my thoughts on cytokine storm and inflammation due to possible massive release of iron ions and other factors:

    https://brinkzone.com/life-saving-st...complications/
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    “Those who do not view armed self defense as a basic human right, ignore the mass graves of those who died on their knees at the hands of tyrants.”

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    Quote Originally Posted by scooter22 View Post
    I think the most important update is how we treat the H vs L phenotyopes:

    https://www.esicm.org/wp-content/upl...thor-proof.pdf
    And does one confer immunity to the other? For that matter, since COVID-19 is relatively new do we really know about long-term immunity? I keep hearing (paraphrasing here) that once you get it and survive you're GTG. That may not be the case, especially for the longer term when it could appear next year or for several years.
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    Quote Originally Posted by scooter22 View Post
    I think the most important update is how we treat the H vs L phenotyopes:

    https://www.esicm.org/wp-content/upl...thor-proof.pdf
    From the article you linked:

    "These severely hypoxemic patients despite sharing a single
    etiology (SARS-CoV-2) may present quite differently from one another: normally breathing (“silent”
    hypoxemia) or remarkably dyspneic; quite responsive to nitric oxide or not; deeply hypocapnic or
    normo/ hypercapnic; and either responsive to prone position or not. Therefore, the same disease
    actually presents itself with impressive non-uniformity.
    "


    Kind of scary how it manifests itself at this stage, not to mention the weird symptoms that can indicate COVID-19 infection that normally wouldn't be associated with a predominantly respiratory illness. Like nailing jello to the wall.
    11C2P '83-'87
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    Quote Originally Posted by ABNAK View Post
    And does one confer immunity to the other? For that matter, since COVID-19 is relatively new do we really know about long-term immunity? I keep hearing (paraphrasing here) that once you get it and survive you're GTG. That may not be the case, especially for the longer term when it could appear next year or for several years.
    We also keep hearing consistently or some getting re infected, but what % and how reliable that is, is unclear.

    https://www.reuters.com/article/us-c...-idUSKCN20M124
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    “Those who do not view armed self defense as a basic human right, ignore the mass graves of those who died on their knees at the hands of tyrants.”

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    Quote Originally Posted by WillBrink View Post
    We also keep hearing consistently or some getting re infected, but what % and how reliable that is, is unclear.

    https://www.reuters.com/article/us-c...-idUSKCN20M124
    From that article:

    "The virus also could be “biphasic”, meaning it lies dormant before creating new symptoms."

    Lovely.....
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    Quote Originally Posted by ABNAK View Post
    From that article:

    "The virus also could be “biphasic”, meaning it lies dormant before creating new symptoms."

    Lovely.....
    It's the gift that keeps on giving. Let's hope that's not the case.
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    “Those who do not view armed self defense as a basic human right, ignore the mass graves of those who died on their knees at the hands of tyrants.”

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    Reuter’s article was from February 28. Any new medical intel on this from those with the knowledge and expertise?


    Sent from my iPhone using Tapatalk

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    From what I have seen and heard (at least at our facility) the Hydroxychloroquine and Z-pack isn't given until someone is hospitalized, i.e. the 15-20% that end up requiring hospitalization. If you are positive you are told to go home and self-isolate.....and that's about it. So my question is why wouldn't an earlier intervention be prudent? Obviously it would but from my view it comes down to a couple things: first off, they still don't test everyone with symptoms. Secondly, the ready availability of those drugs is questionable.

    I had a telehealth "virtual visit" with my PCP today for the semi-annual renewal of my meds. He has known me for close to 20 years (his wife, him, and my wife and I took Karate together years ago). I asked him that if I had symptoms would he approve a test, and he said yes (he knows I'm an RT) since my hospital will not test employees....go figure. I then asked if he would prescribe the Hydroxy/Z-pack combo if I was positive but not sick enough yet to be hospitalized. He said "We can't get it. Besides, the efficacy is still up in the air. They're having problems getting it for the lupus and RA patients". I smelled bullshit, but let it be.

    If you are fortunate enough to have a PCP who would prescribe those drugs for you then you are fortunate indeed. I don't really care if they haven't been through the FDA testing protocol or not. If I got this shit I would take my chances and take them early on, instead of waiting to circle the drain. As it is now it doesn't look like I have that option.
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