If you will be caring for critically ill COVID-19 patient in the near future, you’ll want to watch this interview by ZDoggMD of Barbara McLean, RN, NP. Sounds like she’s knee-deep in **** right now in an Atlanta ICU.
If you’re not a physician, nurse, hospital PCT, or respiratory therapist, this is not for you. Even I had never heard of a few of the therapies and concepts mentioned.
Here’s their current progression to being on a ventilator: nasal cannula oxygen up to 6-7 liter/minute, non-rebreather mask, then if still not adequate oxygenation, to to mechanical ventilation. No fooling around with CPAP or BIPAP.
I also agree fully with limiting the number of folks in the room handling a code blue (cardiac or pulmonary arrest) in a COVID-19 patient, or even COVID-19 PUI (person under investigation, not definite yet).
All their COVID-19 patients in the ICU get arterial and central lines.
Thank you so much for posting this video. I’m a respiratory therapist currently sidelined from a complete white out of PNA, Flu A (despite getting my flu shot), septic shock, and ARDS a year ago. I’m still in pulmonary rehab still recovering from all of the treatments discussed here: APRV, 100% FiO2, and paralyzed for 10 days. This is a very serious virus we’re dealing with and there are going to be a lot of people in the same boat I’ve been rowing in, with a long, very difficult recovery. If I can do it, they can do it, but I’m not going to pretend recovery is easy. While I will not be on the frontlines fighting the good fight, I have passed the video and your post on to all my medical friends through FB. Thank you for posting!
Glennamarie, I really appreciate your comments!
Sending best wishes to you for ongoing recovery.
I wouldn’t be surprised if the intensivists, pulmonologists, and hospitalists who treated you have no idea what your life has been like after hospital discharge.
You know, it’s very sharp of you to pick up on that. I’ve been posting my rehab updates to Facebook since my husband brought my Kindle up to the in-patient rehab and one of the things my fellow RT’s and ICU RN’s have talked about for the last year is how little any of us knew what recovery looked like in the real world. I’ve been working in the hospital (acute) setting for 15 years, many of my friends for double that; Our part of our patients’ story ends when we extubate them and ship them off to rehab. We had no idea what comes after or how long it can take to rebuild muscle and regain function. It’s been a huge learning experience for all of us. I tease them that they got to practice those vent modes, proning, paralyzation, and roto-bed modalities on me but they don’t find that nearly as humorous as I do considering they sweated, worked, and prayed over me for at least the first four days when my SpO2 was in the low 80’s and I refused to oxygenate like a normal person. But again, if I can do it, there is hope for everyone who gets knocked down by this terrible virus!
Many need to hear your message of hope, glennamarie. Thank you for that!
Powerful, educational video Steve–thank you.
We are a week behind ATL,and will be prepared because of this woman.