From Heroes to Goats

[alphaholic06]

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Coronavirus patient dead after medical residents set ventilator too high

A New York coronavirus patient died after inexperienced medical residents rushed to the front line of the pandemic set her ventilator too high, according to a report. The patient, who was in her 60…

nypost.com

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[deleted480308]

Coronavirus patient dead after medical residents set ventilator too high

A New York coronavirus patient died after inexperienced medical residents rushed to the front line of the pandemic set her ventilator too high, according to a report. The patient, who was in her 60…

nypost.com

Sent from my Pixel 3 XL using SDN mobile

My first ICU attending talk (them talking to me) about vents was basically...
1) vents are not effective at fixing people
2) vents are sometimes effective at buying time to let someone heal
3) vents are incredibly effective at helping you murder people if you don’t know what you are doing

 

[RustedFox]

My first ICU attending talk about vents was basically...
1) vents are not effective at fixing people
2) vents are sometimes effective at buying time to let someone heal
3) vents are incredibly effective at helping you murder people if you don’t know what you are doing

I want to understand you correctly.
Do you mean you were the one giving the talk, or receiving the talk?

 

[Birdstrike]

My first ICU attending talk about vents was basically...
1) vents are not effective at fixing people
2) vents are sometimes effective at buying time to let someone heal
3) vents are incredibly effective at helping you murder people if you don’t know what you are doing

I remember a thread on here where we were debating back and forth on the decision to intubate someone. In the course of the argument I brought up potential downsides overly aggressive or unnecessary intubation. As I recall, several people jumped down my throat acting as if I had blasphemed the Lord of Oxygen and Life himself. But it's true. Everything you do, or don't do, has potential risks and benefits, however small or large they may be. Mechanical ventilation is no different.

 

[deleted480308]

I want to understand you correctly.
Do you mean you were the one giving the talk, or receiving the talk?

Receiving, they were warning that it was incredibly dangerous to incorrectly assume your level of competence managing vents

 

[Birdstrike]

Coronavirus patient dead after medical residents set ventilator too high

A New York coronavirus patient died after inexperienced medical residents rushed to the front line of the pandemic set her ventilator too high, according to a report. The patient, who was in her 60…

nypost.com

Sent from my Pixel 3 XL using SDN mobile

The media is much more comfortable writing about doctors as either rich and greedy, or incompetent and dangerous, as opposed to "heroes." That's why for every "Doctors are heroes" article you'll read, you'll see another 99 trying to slam doctors for their faults. It's just like the reality that as a doctor you'll be sued. I no longer take it personally, but consider it part of being in the Big Leagues. When you've made it, there's always going to be someone trying to knock you down.

 

[thegenius]

I remember a thread on here where we were debating back and forth on the decision to intubate someone. In the course of the argument I brought up potential downsides overly aggressive or unnecessary intubation. As I recall, several people jumped down my throat acting as if I had blasphemed the Lord of Oxygen and Life himself. But it's true. Everything you do, or don't do, has potential risks and benefits, however small or large they may be. Mechanical ventilation is no different.

But the Lord of Oxygen and Life is all powerful. I have seen numerous people with SpO2 82% RA, and I summon the Lord of Oxygen and Life and, just like that, they are healed. I mean it is amazing. And I'm truly using the word "amazing" properly. I once saw an epic battle between the Lord of Oxygen and Life and a Wizard named Roger. It wasn't even close. Roger threw a knife and it ended up in the Lords hands as a vanilla ice cream cone. The Lord ate it and said "wow that was pretty good." Then he threw the remaining part of the cone back at Roger and it stabbed him in the chest … as a knife.

 

[GeneralVeers]

But the Lord of Oxygen and Life is all powerful. I have seen numerous people with SpO2 82% RA, and I summon the Lord of Oxygen and Life and, just like that, they are healed. I mean it is amazing. And I'm truly using the word "amazing" properly. I once saw an epic battle between the Lord of Oxygen and Life and a Wizard named Roger. It wasn't even close. Roger threw a knife and it ended up in the Lords hands as a vanilla ice cream cone. The Lord ate it and said "wow that was pretty good." Then he threw the remaining part of the cone back at Roger and it stabbed him in the chest … as a knife.

Sometimes I truly don't know what to make of your posts.....

 

[RustedFox]

Sometimes I truly don't know what to make of your posts.....

Made more sense than the new Star Wars movies.

 

[alphaholic06]

Here's another one. Young Doctors Struggle to Treat Coronavirus Patients: ‘We Are Horrified and Scared’

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[BoardingDoc]

Sometimes I truly don't know what to make of your posts.....

Based on the profile pic, I just assume he's occasionally dropping acid. Keeps things interesting.

 

[turkeyjerky]

I'm confused by the article. What exactly does "setting the ventilatory too high" mean? Any guesses? Like they set the MV too high and the patient was auto-peeping?

 

[SpacemanSpifff]

I'm confused by the article. What exactly does "setting the ventilatory too high" mean? Any guesses? Like they set the MV too high and the patient was auto-peeping?

MV too high leading to critical alkalemia or autoPEEP. PEEP too high leading to critical hypotension. Someone trying to **** around with APRV.... who knows.

 

[thegenius]

My interpretation was they turned up the vent too high and caused both lungs to pop like balloons.

 

[Birdstrike]

Sometimes I truly don't know what to make of your posts.....

Let me translate @thegenius 's post for you.

The "wizard" Roger is an old frequent flyer with COPD, hypoxia and an abusive attitude. The Lord of Oxygen and Life is Dr. @thegenius, armed with an ET tube and "oxygen." Roger suddenly desats to 50% and goes apneic (this is the "knife" being thrown at Dr. genius). But Dr. genius being a genius (and Lord of Oxygen) turns that negative situation (knife) into a positive (ice cream cone) by intubating him and his sats come up to 95% (satisfaction, "eats the ice cream cone" yum). Then, Dr. genius realizes this frequent flyer with a bad attitude probably exposed him to COVID giving a 0.6% chance of dying. So, he doses his sedatives a little lower he normally would (this is the "knife" he throws back at him) but still in a range not to get himself in trouble with his CMG overlords.

See? Easy.

 

[greatnt249]

Let me translate @thegenius 's post for you.

The "wizard" Roger is an old frequent flyer with COPD, hypoxia and an abusive attitude. The Lord of Oxygen and Life is Dr. @thegenius, armed with an ET tube and "oxygen." Roger suddenly desats to 50% and goes apneic (this is the "knife" being thrown at Dr. genius). But Dr. genius being a genius (and Lord of Oxygen) turns that negative situation (knife) into a positive (ice cream cone) by intubating him and his sats come up to 95% (satisfaction, "eats the ice cream cone" yum). Then, Dr. genius realizes this frequent flyer with a bad attitude probably exposed him to COVID giving a 0.6% chance of dying. So, he doses his sedatives a little lower he normally would (this is the "knife" he throws back at him) but still in a range not to get himself in trouble with his CMG overlords.

See? Easy.

 

[gutonc]

Let me translate @thegenius 's post for you.

The "wizard" Roger is an old frequent flyer with COPD, hypoxia and an abusive attitude. The Lord of Oxygen and Life is Dr. @thegenius, armed with an ET tube and "oxygen." Roger suddenly desats to 50% and goes apneic (this is the "knife" being thrown at Dr. genius). But Dr. genius being a genius (and Lord of Oxygen) turns that negative situation (knife) into a positive (ice cream cone) by intubating him and his sats come up to 95% (satisfaction, "eats the ice cream cone" yum). Then, Dr. genius realizes this frequent flyer with a bad attitude probably exposed him to COVID giving a 0.6% chance of dying. So, he doses his sedatives a little lower he normally would (this is the "knife" he throws back at him) but still in a range not to get himself in trouble with his CMG overlords.

See? Easy.

Nope...still not a f***ing clue. But funny for sure.

 

[Groove]

I need glasses, this thread title looked like "From Herpes to Goats" before I squinted.

 

[Hamhock]

I need glasses, this thread title looked like "From Herpes to Goats" before I squinted.

And I read 'Goats' as "greatest of all time" -- only to be disappointed

HH

 

[NYEMMED]

And I read 'Goats' as "greatest of all time" -- only to be disappointed

HH

I was going to make a comment along those lines..

I was thinking GOATs as well

 

[alphaholic06]

And I read 'Goats' as "greatest of all time" -- only to be disappointed

HH

That's G.O.A.T.

"Adversity introduces a man to himself."

 

[FiveIronFrenzy]

This thread went off the rails but Im really enjoying the detour.

 

[jw3600]

And I read 'Goats' as "greatest of all time" -- only to be disappointed

HH

The GOAT is on ESPN tonight at 9 PM.

 

[DeadCactus]

"At Yale New Haven Hospital in Connecticut, anesthesiology residents were sent to work as respiratory therapists — a licensed job that requires at least two years of training — after just one Zoom session and a Google document that instructed them to call an attending physician if they needed help, according to the paper."

Anyone who can write a sentence so comprehensively ignorant has no business reporting on this issue...