Refusing to intubate/extubate without PPE?

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Were approaching this all wrong. I've heard ppl putting clear plastic bags over patients heads etc

Screw that. Put the bag over your own head and get a venti mask for yourself with a C cylinder. you're golden!!
 
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Newtwo said:
Were approaching this all wrong. I've heard ppl putting clear plastic bags over patients heads etc

Screw that. Put the bag over your own head and get a venti mask for yourself with a C cylinder. you're golden!!
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nimbus said:
Our senior trauma surgeon said trauma service would run the COVID19 vents if the pulm/icu team gets overwhelmed since we anesthesiologists are not used to APRV ventilation. We said all yours baby!!
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A missed opportunity for your dept to demonstrate worth. But then again, at least y’all will survive
 
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BLADEMDA said:
I can get elastic straps from a regular non rebreather O2 mask in the O.R.? I can build one of these respirators but need elastic straps. All I can think of is the straps we have on our O2 masks.

Can you re-use a typical N100 respirator? What about a N95 mask? This stuff has very limited availability.
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The manual on the masks we use say they can be used indefinitely as long as they don't get soiled or "contaminated". IMO it's absurd how we're being denied masks in the OR and to our RRT. I don't feel like taking chances because the administrators are not willing to spend a few bucks on masks that don't even need to be replaced that often. This is in addition to support staff vanishing and leaving us doing turnovers on call without any former instructions on where to find stuff and what to do with everything. Should I report this to ACGME?
 
parcus said:
The manual on the masks we use say they can be used indefinitely as long as they don't get soiled or "contaminated". IMO it's absurd how we're being denied masks in the OR and to our RRT. I don't feel like taking chances because the administrators are not willing to spend a few bucks on masks that don't even need to be replaced that often. This is in addition to support staff vanishing and leaving us doing turnovers on call without any former instructions on where to find stuff and what to do with everything. Should I report this to ACGME?
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One should be able to reuse an n95 if desperate. The virus doesn’t live that long on surfaces, 10 days would likely be safe. I know people using UV-c lights on masks after use and saving...
However, your machine is out for 21-28 days if a drager and it gets contaminated. Bet they re-engineer that in future models. Gives GE a big advantage with parts you can autoclave.
 
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pjl said:
One should be able to reuse an n95 if desperate. The virus doesn’t live that long on surfaces, 10 days would likely be safe. I know people using UV-c lights on masks after use and saving...
However, your machine is out for 21-28 days if a drager and it gets contaminated. Bet they re-engineer that in future models. Gives GE a big advantage with parts you can autoclave.
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Actually it does. Up to 1-2 weeks, if I remember correctly. But one can wipe the mask with alcohol every day, I guess.

I loved how British doctors called themselves "cannon fodder" in a letter to Boris Johnson.
 
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FFP said:
Actually it does. Up to 1-2 weeks, if I remember correctly. But one can wipe the mask with alcohol every day, I guess.

I loved how British doctors called themselves "cannon fodder" in a letter to Boris Johnson.
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2 weeks isn’t that long, you can isolate the masks and rotate. I think the data would show ~5 days, but I am more careful than that.
There are some good papers about duration it lives.

I plan to save masks used that are not for intubation of covid people, just in case. But then again, I like the overall protection of a PAPR for those intubations better.
 
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does anyone know the exact difference between Bacteria viral filter vs HEPA filter?
THe video shows BV filter, which is on our circuits, but we also have HEPA filters separately. Debating which one to use. We have more BV filters since we have more circuits lying around. but we'd have to open individual circuits to take them out.

But i hear BV filter is supposed to be superior to hepa?? could be mistaken
 
anbuitachi said:
not really surprised . these people making the rules, such as administrators are not the ones on the front lines. their #1 priority is themselves.
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that's why its important to meet with them regularly, face to face.
 
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Healthcare workers with a high degree of exposure are being denied tests and proper safety equipment. Healthcare workers are being told to continue working until a fever develops. Meanwhile stories of asymptomatic politicians and celebrities getting tested accumulate daily.

The response to this situation has been a train wreck.

Everyone who has been exposed should start demanding tests. Accumulated viral load probably plays a role in illness severity. Everyone should also refuse to work without proper PPE.
 
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GravelRider said:
Healthcare workers with a high degree of exposure are being denied tests and proper safety equipment. Healthcare workers are being told to continue working until a fever develops. Meanwhile stories of asymptomatic politicians and celebrities getting tested accumulate daily.

The response to this situation has been a train wreck.

Everyone who has been exposed should start demanding tests. Accumulated viral load probably plays a role in illness severity. Everyone should also refuse to work without proper PPE.
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These healthcare workers, if they are really worried, can quit. Hopefully they have enough savings. I wouldn't keep exposing myself once I test positive. Hell no. Rather end up begging for handouts for a while and possibly recover than continue exposing myself.
 
chocomorsel said:
These healthcare workers, if they are really worried, can quit. Hopefully they have enough savings. I wouldn't keep exposing myself once I test positive. Hell no. Rather end up begging for handouts for a while and possibly recover than continue exposing myself.
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how do you do that? here if we resign we need to give a several month advanced notice
 
anbuitachi said:
how do you do that? here if we resign we need to give a several month advanced notice
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In a time of crisis, all rules are out the window. Protect yourself. These suits and sellout docs who are CMO's and don't do any clinical work don't give a **** about you. No need to follow the rules. Take care of you. If you fall ill from exposure, you've done your part. I doubt you would have a difficult time explaining this to your next employer.
Cumulative exposure probably isn't good for you. You will likely end up with a high viral load and more likely to die. I think @FFP put up a link to that somewhere.
YOU have to decide what's good for you. Not some suit who's sitting comfortably at home. Screw that.

AND unless you are walking around the whole hospital in full PPE during the duration of your shift, you are exposing others and and possibly that **** everywhere.
 
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anbuitachi said:
how do you do that? here if we resign we need to give a several month advanced notice
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If you are truly concerned about you and your family’s safety due to careless management of this crisis by administrators and politicians then you can claim you have a fever and go on medical leave. We should have a reasonable expectation of certain safety standards in any environment we work in. If that is not being provided then stop working there. Believe me, if a certain threshold of workers stopped showing up then there would be supply of masks and tests that would magically appear.

Do not trust the party line coming out of official communications from hospitals. Protect yourself first. They are still responding to this crisis while keeping an eye on the hospital’s bottom line. They don’t care about you or your family.
 
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GravelRider said:
If you are truly concerned about you and your family’s safety due to careless management of this crisis by administrators and politicians then you can claim you have a fever and go on medical leave. We should have a reasonable expectation of certain safety standards in any environment we work in. If that is not being provided then stop working there. Believe me, if a certain threshold of workers stopped showing up then there would be supply of masks and tests that would magically appear.

Do not trust the party line coming out of official communications from hospitals. Protect yourself first. They are still responding to this crisis while keeping an eye on the hospital’s bottom line. They don’t care about you or your family.
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100% agree. We got an email yesterday telling us to keep using the same N95 mask until it starts showing signs of wear. Before the crisis started we were having DOH on site visits and the hospital had the biggest hard on in the world for telling us to immediately trash masks the nanosecond we pull it off our face. WTF is going through their heads I’ll never know.
 
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Wonder what you all think about this- our dept is recommending full PPE (N95/face shield) for anesthesiologists doing procedures w high risk exposure, and predictably there is already some backlash from circulators who see one team member with better protection than everyone else. Wouldn’t it be better to have one anesthesiologist go room to room tubing/extubating with full PPE and the rest of us can stay on w surgical masks? Helps solve the social issue at least.


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Spacedman said:
Wonder what you all think about this- our dept is recommending full PPE (N95/face shield) for anesthesiologists doing procedures w high risk exposure, and predictably there is already some backlash from circulators who see one team member with better protection than everyone else. Wouldn’t it be better to have one anesthesiologist go room to room tubing/extubating with full PPE and the rest of us can stay on w surgical masks? Helps solve the social issue at least.


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This is what they have recently implemented at Memorial Hermann in Houston. One intubating/extubating team with proper PPE, everyone else leaves the room. RSI, video, no BMV. They've notified surgeons to expect delays. I hope others follow their lead.

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Currently we were issued an n95, told to reuse until soiled or obviously non serviceable or used on covid patient. Use during every intubation/extubation. On a side note, correct me if I'm wrong but doesnt the n95 not work if its place OVER a standard facemask? Like shouldn't it be in direct contact with the skin?
 
MirrorTodd said:
Currently we were issued an n95, told to reuse until soiled or obviously non serviceable or used on covid patient. Use during every intubation/extubation. On a side note, correct me if I'm wrong but doesnt the n95 not work if its place OVER a standard facemask? Like shouldn't it be in direct contact with the skin?
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Of course it should. One can place the FM over the N95, not the other way round. And the N95 should be pressed in on the sides and over the nose, for perfect isolation, so I doubt it's functional for more than a day. N95s cut 95% of 0.3 nm particles, IF properly worn.

Cannon fodder...
 
chocomorsel said:
So what? Get unemployment and get a new job. Better that getting sick and possibly dying.
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So what? I mean I wouldn’t want to work in a place like that, but if true, she was fired for alerting employees their workplace was not giving them appropriate ppe. You don’t see a problem with that?
 
Matthew9Thirtyfive said:
So what? I mean I wouldn’t want to work in a place like that, but if true, she was fired for alerting employees their workplace was not giving them appropriate ppe. You don’t see a problem with that?
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It's called at-will employment. Welcome to America!

That's why we need unions, and that's why corporations have been working hard at destroying them, for the last few decades. I mean Walmart would rather close down an entire store forever than allow them to unionize; they are treating it like melanoma.
 
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FFP said:
It's called at-will employment. Welcome to America!

That's why we need unions, and that's why corporations have been working hard at destroying them, for the last few decades. I mean Walmart would rather close down an entire store forever than allow them to unionize; they are treating it like melanoma.
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Not sure about her state, but nurses have unions. In some states they would go berserk over this. But yes, I agree. Again, we don’t have the whole story, but if it’s true I hope she wins her suit.
 
Matthew9Thirtyfive said:
Not sure about her state, but nurses have unions. In some states they would go berserk over this. But yes, I agree. Again, we don’t have the whole story, but if it’s true I hope she wins her suit.
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She won't. They wouldn't have fired her if they hadn't collected dirt on her already. She's probably a straight shooter, so they made sure they can shut her up when the time comes.

These people do this every day; they know the game. When I was a resident in a big academic place, the arsehole running the floor would document every single more serious mistake we made, in his little notebook, "just in case". And we were still in training.
 
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Matthew9Thirtyfive said:
So what? I mean I wouldn’t want to work in a place like that, but if true, she was fired for alerting employees their workplace was not giving them appropriate ppe. You don’t see a problem with that?
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You hit the nail on the head. They did her a favor. Sounds like a crappy place to work.
She's a nurse. She can walk across the street and start working at the across the street hospital tomorrow. People get fired all the time. If she's telling the truth, which I believe she is, then good for her for trying to do what's right. But good guys/gals often get shafted. Such is life.
I see the problem, but the solution is convoluted, expensive, and not worth the heartache in my opinion unless she sues along with other nurses. Not just her against the big bad medical machine, because they will try to bury her. Probably not worth the headache. She won't be the only one.
 
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chocomorsel said:
You hit the nail on the head. They did her a favor. Sounds like a crappy place to work.
She's a nurse. She can walk across the street and start working at the across the street hospital tomorrow. People get fired all the time. If she's telling the truth, which I believe she is, then good for her for trying to do what's right. But good guys/gals often get shafted. Such is life.
I see the problem, but the solution is convoluted, expensive, and not worth the heartache in my opinion unless she sues along with other nurses. Not just her against the big bad medical machine, because they will try to bury her. Probably not worth the headache. She won't be the only one.
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Yeah it’s just unfortunate. She’s definitely better off, it just sucks that there are such ****ty places out there.
 
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nimbus said:
I made one while I was at work today.
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Not being satisfied with the level of protection of the original, I made this modified/improved version version:

25A4A599-D2A4-4EA6-A0D3-CBA448396024.jpeg
 
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In case you missed this:
forums.studentdoctor.net

ER doctor fired for criticizing hospital's preparedness

https://www.seattletimes.com/seattle-news/health/er-doctor-who-criticized-bellingham-hospitals-coronavirus-protections-has-been-fired/ Just shut up and do your job while risking your and your family's health. Unbelievable times we are living in.
forums.studentdoctor.net forums.studentdoctor.net
 
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