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TranceAddict Forums > Main Forums > Chill Out Room > Corona Virus Fears in your area
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72hrpartyanimal
Supreme tranceaddict



Registered: Jan 2007
Location: West LA, California (where retired party people live)

quote:
Originally posted by Ted Promo
Must be doin a bad job.


The worst!


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Jaded, old fart is me.

Old Post Mar-09-2020 21:54  United States
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Dykes_on_Jay
Ape me.



Registered: Aug 2012
Location: Shenzhen LBC

*Wurst


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Old Post Mar-09-2020 22:17  China
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Zoso
Smoke Weed Every Day



Registered: Mar 2006
Location: Dirty South, United States

Excerpt from a post by an ICU doc in the Seattle area:

A common scenario for our patients is, on admission they are put on 1L oxygen by nasal cannula. Next 12hrs, they regress to non-invasive positive pressure ventilation, the blower. Next 12-24hrs, they regress to a ventilator in the prone position with Flolan.

Interestingly, despite some needing Flolan, the hypoxia is not as refractory as with H1N1. Quite different, and quite unique. Odd enough that you’d notice and say hmmm.

Thus far many are dying of cardiac arrest rather than inability to ventilate/oxygenate.

Given the inevitable rapid progression to an endotracheal tube once respiratory decompensation begins, we and other hospitals, including Wuhan, are doing early intubation. Facemask is fine, but if needing a high-flow nasal cannula or non-invasive positive pressure ventilation, just tube them. They definitely will need a tube anyway, & no point risking the aerosols.

Multiple-organ system failure is NOT typically seen. There’s the mild AST/ALT elevation [AST/ALT is an indicator of liver damage or hepatotoxicity], maybe a small Cr bump [Creatinine, indicator of kidney damage], but no florid failure. except cardiomyopathy.

Multiple patients here have had normal cardio Ejection Fraction (EF) on formal Echocardiogram or point-of-care ultrasound (POCUS) at time of admit (or in a couple of cases EF 40ish, chronically [EF 40 or below may be evidence of heart failure or cardiomyopathy, 41-49 is borderline]). Also normal cardiac troponin from EmergencyDepartment[? troponin can be used to diagnose a heart attack, so probably measured on the way in].

Then they get the horrible respiratory failure, without sepsis or shock.
Then they turn the corner, get off Flolan, they are sitting up, weaning off the ventilator, looking good, never any pressor requirement [I think this means no blood pressure drop that would require medication to increase blood pressure].

Then over 12hrs, newly cold, clamped, multiple-pressor shock that looks cardiogenic, EF 10% or less, then either VT [ventricular tachycardia, rapid heartbeat] progressing to VF [ventricular fibrillation, heart quivering or beating erratically] progressing to death
OR, PEA [Pulseless Electrical Activity, got a waveform on ECG–or EKG for you German-loving chemists–but no pulse felt in the body] progressing to asystole [flatline ECG] in less than a day. Needless to say this is awful for families who had started to have hope.

We have actually had more asystole than VT, other facilities report more VT/VF, but same time course, a few days or a week after admit, around the time they’re turning the corner. This occurs on med-surg patients too; one today who is elderly and chronically ill but baseline EF preserved, newly hypoTN overnight, EF<10. Already no escalation, has since passed, So presumably there is a viral CM aspect, which presents later in the course of days.

Of note, no WMAs [left ventricular wall motion abnormalities, commonly seen in coronary artery disease, congestive heart failure, stress-induced cardiomyopathy, etc] on Echo, RV [right ventricular function] is preserved, Tpns [troponins] don't bump. Could be unrelated, but I've never seen anything like it before, esp in a pt who had been HD stable without sepsis.

Old Post Mar-12-2020 12:00  United States
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72hrpartyanimal
Supreme tranceaddict



Registered: Jan 2007
Location: West LA, California (where retired party people live)

You may have already heard about the NBA suspending their season, flights to/from Europe being suspended.

Here in Los Angeles, universities such as UCLA, USC have announced school closures. Some private grade schools (K through 12) have also been suspended but nothing officially from the LAUSD (Los Angeles Unified School District).

Interesting times we're in. I remain positive though and know that we'll all be remembering how crazy of a year 2020 was for us.


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Old Post Mar-12-2020 15:17  United States
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Zoso
Smoke Weed Every Day



Registered: Mar 2006
Location: Dirty South, United States

Governments around the world better get serious and get on top of this shit quick (though many are too late). At this point, our best hope is to "flatten the curve/spike" and by doing so delay infections and cases that require acute care. Politicians needs to be calm, rational, and realistic...not worried about a fucking election cycle. Also, all the "but the economies!" shit needs to thing longer term: dead people cannot buy/consume your product.

Old Post Mar-12-2020 16:28  United States
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Trance-M
Since 1994 tranceaddict



Registered: Oct 2005
Location: Limburg, Netherlands

quote:
Originally posted by 72hrpartyanimal
flights to/from Europe being suspended.


Except UK and Ireland, but why?

https://www.parool.nl/wereld/kaart-...w.google.com%2F


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Old Post Mar-12-2020 17:14  Netherlands
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JEO
Supreme tranceaddict



Registered: Jan 2010
Location: ATH

Working from home for at least the next week. I have to say I kind of enjoy all this. It's exciting, for all the wrong reasons.

Old Post Mar-12-2020 17:40  Finland
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72hrpartyanimal
Supreme tranceaddict



Registered: Jan 2007
Location: West LA, California (where retired party people live)

quote:
Originally posted by Trance-M
Except UK and Ireland, but why?

https://www.parool.nl/wereld/kaart-...w.google.com%2F


I was wondering the same thing. Politics (European Union shit)?


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Old Post Mar-12-2020 17:54  United States
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Swamper
Webmonstah



Registered: Jan 2000
Location: Toronto, Canada

Everyone stay home and post on TA.

c0r resurgence 2020


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Old Post Mar-12-2020 18:06  Canada
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Zoso
Smoke Weed Every Day



Registered: Mar 2006
Location: Dirty South, United States

quote:
Originally posted by Swamper
Everyone stay home and post on TA.

c0r resurgence 2020


+1, would visit/post again!

Old Post Mar-12-2020 18:24  United States
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Zoso
Smoke Weed Every Day



Registered: Mar 2006
Location: Dirty South, United States

quote:
Originally posted by JEO
Working from home for at least the next week. I have to say I kind of enjoy all this. It's exciting, for all the wrong reasons.


I'm fortunate to have both the ability to work from home and do 99% of my job effectively, and I have a boss and employer that are okay with me doing so unless circumstances at the office dictate otherwise.

Given the fact that my wife is immuno-compromised, this is very fortunate for me. I realize I'm in the minority when it comes to this ability, so I feel for all those that have neither the option nor the employer support to do so.

Old Post Mar-12-2020 19:05  United States
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Trance-M
Since 1994 tranceaddict



Registered: Oct 2005
Location: Limburg, Netherlands

quote:
Originally posted by 72hrpartyanimal
I was wondering the same thing. Politics (European Union shit)?


Yes and no, the mentioned countries belong to the free travel Schengen Area of 26 countries. Of those Iceland, Liechtenstein, Norway, and Switzerland are not even member of the EU, while Ireland is a member but not part of the Schengen Area. I bet he doesn't have a clue.
I doesn't make sense in my opinion.


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Old Post Mar-12-2020 21:00  Netherlands
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