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Minnesota
In reply to the discussion: (Minn) 3 of 4 border states have much higher per-capita cases than MN, but no stay-at-home orders [View all]progree
(11,463 posts)1. Running out of medications desperately needed for ventilator patients (pain killers, sedatives...)
Last edited Sun Apr 5, 2020, 02:09 PM - Edit history (2)
U.S. may get more ventilators but run out of medicine for COVID-19 patients, MPR News, 4/4/20
... This week, Vizient released data showing dramatic spikes in demand for sedatives, pain medications, paralytics, and other drugs that are crucial for patients who are on ventilators. According to Vizient's study, the rate at which those orders are filled is lagging far behind the demand.
One complicating factor: "Injectable drugs take a long time to make," Kistner says. "For instance, there's a 21-day sterility period needed for all injectable drugs. So it's not something simple that you can do overnight."
... a patient in acute respiratory distress, being put on a ventilator can be life-saving. It's also really unpleasant. ... When patients are intubated, they're given strong sedatives and pain medicine such as propofol and fentanyl, and sometimes paralytic drugs, as well.
Without those medications, Morse says, "Most people will reach for the [breathing] tube and try to grab it and pull it out. They may fight against having it in their mouth. And if they're working against a breathing machine it can actually damage their lungs."
Now, with a surge of COVID-19 patients on ventilators, hospitals are burning through their supplies of those essential drugs.
... "The nightmare really is that I won't have enough ventilators to treat them all at the same time," Akers says. "And even if I get them on a ventilator, I won't be adequately able to sedate them to know that they're safe. And my real worry is that a lot of people will die as a result of that."
More: https://www.mprnews.org/story/2020/04/04/npr-u-s-may-get-more-ventilators-but-run-out-of-medicine-for-covid-19-patients
... This week, Vizient released data showing dramatic spikes in demand for sedatives, pain medications, paralytics, and other drugs that are crucial for patients who are on ventilators. According to Vizient's study, the rate at which those orders are filled is lagging far behind the demand.
One complicating factor: "Injectable drugs take a long time to make," Kistner says. "For instance, there's a 21-day sterility period needed for all injectable drugs. So it's not something simple that you can do overnight."
... a patient in acute respiratory distress, being put on a ventilator can be life-saving. It's also really unpleasant. ... When patients are intubated, they're given strong sedatives and pain medicine such as propofol and fentanyl, and sometimes paralytic drugs, as well.
Without those medications, Morse says, "Most people will reach for the [breathing] tube and try to grab it and pull it out. They may fight against having it in their mouth. And if they're working against a breathing machine it can actually damage their lungs."
Now, with a surge of COVID-19 patients on ventilators, hospitals are burning through their supplies of those essential drugs.
... "The nightmare really is that I won't have enough ventilators to treat them all at the same time," Akers says. "And even if I get them on a ventilator, I won't be adequately able to sedate them to know that they're safe. And my real worry is that a lot of people will die as a result of that."
More: https://www.mprnews.org/story/2020/04/04/npr-u-s-may-get-more-ventilators-but-run-out-of-medicine-for-covid-19-patients
So anyway, for those fuckwad governors who think the Dow and their beach businesses are more important than human lives, well, there's this to also think about.
And regular people too ... do you really want to risk this hell on earth experience? Like being on a ventilator for 2 weeks is what's needed for many Cov-19 patients, where obviously every second is excruciating.
Edited to add - Here is an article from March 21 -- this is how it is like even with all the drugs available, and all the necessary equipment and personnel:
A Medical Worker Describes Terrifying Lung Failure From COVID-19 -- Even in His Young Patients, Propublica, 3/21/20
Patients will be on minimal support, on a little bit of oxygen, and then all of a sudden, they go into complete respiratory arrest, shut down and cant breathe at all.
Its called acute respiratory distress syndrome, ARDS. That means the lungs are filled with fluid. And its notable for the way the X-ray looks: The entire lung is basically whited out from fluid. Patients with ARDS are extremely difficult to oxygenate. It has a really high mortality rate, about 40%. The way to manage it is to put a patient on a ventilator. The additional pressure helps the oxygen go into the bloodstream. Normally, ARDS is something that happens over time as the lungs get more and more inflamed. But with this virus, it seems like it happens overnight
... The ventilator should have been doing the work of breathing but he was still gasping for air, moving his mouth, moving his body, struggling. We had to restrain him. With all the coronavirus patients, weve had to restrain them. They really hyperventilate, really struggle to breathe. When youre in that mindstate of struggling to breathe and delirious with fever, you dont know when someone is trying to help you, so youll try to rip the breathing tube out because you feel it is choking you, but you are drowning.
... Even if you survive ARDS, although some damage can heal, it can also do long-lasting damage to the lungs. They can get filled up with scar tissue. ARDS can lead to cognitive decline. Some peoples muscles waste away, and it takes them a long time to recover once they come off the ventilator.
More: https://www.propublica.org/article/a-medical-worker-describes--terrifying-lung-failure-from-covid19-even-in-his-young-patients
Patients will be on minimal support, on a little bit of oxygen, and then all of a sudden, they go into complete respiratory arrest, shut down and cant breathe at all.
Its called acute respiratory distress syndrome, ARDS. That means the lungs are filled with fluid. And its notable for the way the X-ray looks: The entire lung is basically whited out from fluid. Patients with ARDS are extremely difficult to oxygenate. It has a really high mortality rate, about 40%. The way to manage it is to put a patient on a ventilator. The additional pressure helps the oxygen go into the bloodstream. Normally, ARDS is something that happens over time as the lungs get more and more inflamed. But with this virus, it seems like it happens overnight
... The ventilator should have been doing the work of breathing but he was still gasping for air, moving his mouth, moving his body, struggling. We had to restrain him. With all the coronavirus patients, weve had to restrain them. They really hyperventilate, really struggle to breathe. When youre in that mindstate of struggling to breathe and delirious with fever, you dont know when someone is trying to help you, so youll try to rip the breathing tube out because you feel it is choking you, but you are drowning.
... Even if you survive ARDS, although some damage can heal, it can also do long-lasting damage to the lungs. They can get filled up with scar tissue. ARDS can lead to cognitive decline. Some peoples muscles waste away, and it takes them a long time to recover once they come off the ventilator.
More: https://www.propublica.org/article/a-medical-worker-describes--terrifying-lung-failure-from-covid19-even-in-his-young-patients
Yes, they are struggling to breathe even on ventilators at maximum settings (which at high settings are very damaging to the lungs).
And it happens so quickly like overnight from having mild breathing difficulty to lungs filled with fluid and drowning.
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