From Aesop: Math Update And Ventilator Numbers #covid19 #coronavirus

The ventilator is out of sight, attached to the tubing

I have tremendous respect for respiratory therapists (RTs) like Dave, Sean, Walter, and the others I work with daily. I’m always having to remind the medical Residents I supervise that RTs know more than the Residents do regarding respiration, oxygen delivery, and ventilation.

Raconteur Report is right:

Nurses don’t run ventilators.

Respiratory therapists do that.

It takes 2 years to train one, and another year of OJT [on the job training] to get them good at it.

Each RT can manage 4 vents, if you want it done right.

If you don’t care about killing people, maybe you can surge that, short-term, to 6 or 8.

***

And if somebody, anybody, thinks we’re good if we just crank out 100,000 or 1,000,000 ventilators, because “‘Murica!”, then please, tell me how you plan to squat, grunt, and shit out the 25,000 to 250,000 trained respiratory therapists you’ll need to run that many vents, which you don’t have now just sitting around playing cards and waiting to come to your Pandemic Party in ICU or the ER.

You’re not hearing that from Dr Fauci and President Trump, are you?

But it’s true.

Source: Raconteur Report: Math Update And Ventilator Numbers

From another Aesop post:

Nawlins ER Doc’s laxative-substitute (because it’ll make you sh*t yourself) field clinical report is pointing towards what I’m afraid will become standard protocol: no one’s worried about 100,000 ventilators, or any such nonsense, because the survival rate once you’re intubated (for the 3-5% of everyone who get that sick) is from 30-14%. From about 1 chance in 3, to 1 chance in 7. Which, I suspect, is going to lead to standard of care to become “If they need intubation, don’t bother. Medicate for pain, and move to hospice tent.” It’s a futile intervention, and it generates more aerosol viral load, so it isn’t worth the risk to practitioners to intubate, and we cannot justify the effort and expenditure of staff time and resources, for something that’s 70-86% fatal anyways. In short, practice will be to let you die, because you’re going to anyways. If possible, in a narcotic haze to ease the pain of the transition.

Steve Parker, M.D.

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