When marketing and profit are disguised as science

[Planktonmd]

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An anesthesiologist sent a letter to the editor of APSF news letter advocating the use of an oxygen mask with a self-healing hole for EGDs and claiming that it minimizes the risk of exposure to droplets.
He did provide a disclaimer that he is a consultant for the manufacturer but provided zero evidence of the validity of his claim that his device is effective in preventing COVID19 in these high risk procedures.
In my opinion this type of cheap marketing is actually harmful because some people might read it as a recommendation of the so called APSF.
Am I the only one who is starting to feel that the APSF has become useless lately and mainly a platform for anecdotes, marketing and CRNAs?
Here is the link:

LETTER TO THE EDITOR: An Approach to Managing COVID-19 During Upper Endoscopy - Anesthesia Patient Safety Foundation

In the midst of the new COVID-19 pandemic, anesthesia personnel find themselves on the front lines, facing and combating the spread of this airborne illness, often with sub-optimal personal...

www.apsf.org

 

[GaseousClay]

yea this is completely self serving. speaking of self serving how about all these medical "heroes" (doctors/nurses) who post non-stop on social media to gain followers by portraying themselves as some kind of superhero (new york people exempt from this). there are way too many docs focused on being instagram/twitter famous rather than actually focusing on patients. Just do your job and stop taking selfies.

 

[AdmiralChz]

I’m a big fan of the POM mask, I do not think scientifically we can say it decreases droplet spread but for high risk endoscopies/TEEs I’ve been utilizing it (along with PPE of course). I’m not going to intubate for a TEE.

That being said I agree it’s completely inappropriate for the ASPF to publish this letter - I know they put that weak disclaimer at the top but this is a tainted opinion from someone with a business interest in getting his product out there. Very disappointing!

 

[AdmiralChz]

yea this is completely self serving. speaking of self serving how about all these medical "heroes" (doctors/nurses) who post non-stop on social media to gain followers by portraying themselves as some kind of superhero (new york people exempt from this). there are way too many docs focused on being instagram/twitter famous rather than actually focusing on patients. Just do your job and stop taking selfies.

If I see another selfie shot of someone with N95 marks on their skin writing a 5 page diatribe about how worried they are for their health and safety (yesterday I saw one by a 23 year old healthy RN) I am going to scream. Do your damn job. I wonder how many of these are actually fake - like the nurse who claimed she quit over lack of PPE but actually had been out of work for a long freakin’ time prior due to mental health issues.

Also - the TikTok nursing dance videos. I thought there was a severe shortage of healthcare providers?? Somehow my state claims they need 30K people, but I guess they still find time to plan and film a coordinated dance routine. I’m all about fun videos, but I honestly feel like dancing around the COVID ward doing the Dougie or the Electric Slide sends the wrong message.

 

[jwk]

I’m a big fan of the POM mask, I do not think scientifically we can say it decreases droplet spread but for high risk endoscopies/TEEs I’ve been utilizing it (along with PPE of course). I’m not going to intubate for a TEE.

That being said I agree it’s completely inappropriate for the ASPF to publish this letter - I know they put that weak disclaimer at the top but this is a tainted opinion from someone with a business interest in getting his product out there. Very disappointing!

I'm really surprised APSF allowed this to go through as a "Letter to the Editor" as it is clearly a commercial endorsement of a product by someone who even states he's a paid consultant. Also - his "bibliography" at the bottom doesn't give any support to the efficacy of his product. We haven't used these masks yet, although I'd like to try them. That being said - we're doing exactly zero MAC/sedation cases for any reason right now except for C-Sections. EGDs, colonoscopies, TEEs, AICD placements - all getting general with RSI and ETT.

 

[deleted697535]

yea this is completely self serving. speaking of self serving how about all these medical "heroes" (doctors/nurses) who post non-stop on social media to gain followers by portraying themselves as some kind of superhero (new york people exempt from this). there are way too many docs focused on being instagram/twitter famous rather than actually focusing on patients. Just do your job and stop taking selfies.

Omg absolutely.
It's absolutely nauseating.
One of my colleagues hasn't worked a day since this started but is daily in the social media. I'd love to call their bs.

Plus these idiots are probably the ones to dictate hospital policy despite they've never looked after a sick patient. It's effing insane

 

[GaseousClay]

Omg absolutely.
It's absolutely nauseating.
One of my colleagues hasn't worked a day since this started but is daily in the social media. I'd love to call their bs.

Plus these idiots are probably the ones to dictate hospital policy despite they've never looked after a sick patient. It's effing insane

its like a drug to them once they get into it and their follower count starts going up they won't stop. I work with a few of these front line warriors who actually haven't treated a single covid patient yet if you saw their posts you'd think they went from wuhan to lombardy to nyc.

 

[deleted171991]

its like a drug to them once they get into it and their follower count starts going up they won't stop. I work with a few of these front line warriors who actually haven't treated a single covid patient yet but if you saw their posts you'd think they went from wuhan to lombardy to nyc.

That dopamine in the brain is some seriously addictive stuff (speaking from experience, see message count).

Social media should be part of the tobacco industry.

 

[DrZzZz]

If I see another selfie shot of someone with N95 marks on their skin writing a 5 page diatribe about how worried they are for their health and safety (yesterday I saw one by a 23 year old healthy RN) I am going to scream. Do your damn job. I wonder how many of these are actually fake - like the nurse who claimed she quit over lack of PPE but actually had been out of work for a long freakin’ time prior due to mental health issues.

Also - the TikTok nursing dance videos. I thought there was a severe shortage of healthcare providers?? Somehow my state claims they need 30K people, but I guess they still find time to plan and film a coordinated dance routine. I’m all about fun videos, but I honestly feel like dancing around the COVID ward doing the Dougie or the Electric Slide sends the wrong message.

Another doc in my system (where we have less than 40 positive patients between the local hospitals) in what I would consider a low risk specialty for Covid (ie. not anesthesia, CCM, ER, IM) posts nonstop about how she fears for her and her colleagues safety and is constantly begging people on social media to "thank a doctor or nurse", "pray for us", etc. Asks people to sign some change.org petition to forgive all healthcare workers' student debt (yes the debt is out of control, but give me a break. You signed up for that debt). Posts about crying when she gets home from work after such exhausting shifts. It's a load of BS and if I didn't care about my own professional reputation, I would love to point out the histrionic nature she displays one of these posts.

 

[TheLoneWolf]

An anesthesiologist sent a letter to the editor of APSF news letter advocating the use of an oxygen mask with a self-healing hole for EGDs and claiming that it minimizes the risk of exposure to droplets.
He did provide a disclaimer that he is a consultant for the manufacturer but provided zero evidence of the validity of his claim that his device is effective in preventing COVID19 in these high risk procedures.
In my opinion this type of cheap marketing is actually harmful because some people might read it as a recommendation of the so called APSF.
Am I the only one who is starting to feel that the APSF has become useless lately and mainly a platform for anecdotes, marketing and CRNAs?
Here is the link:

LETTER TO THE EDITOR: An Approach to Managing COVID-19 During Upper Endoscopy - Anesthesia Patient Safety Foundation

In the midst of the new COVID-19 pandemic, anesthesia personnel find themselves on the front lines, facing and combating the spread of this airborne illness, often with sub-optimal personal...

www.apsf.org

As a sidebar to the above:

When marketing and profit are disguised as science-A lot of interventional AND noninterventional chronic pain management.

Very skewed data, heterogenous populations, poor study designs, low n values, inadequate controls of confounding variables, authors in private practice with strong ties to device manufacturers. A lot of "statistical gymnastics" to make the numbers look acceptable. Reputable review groups like cochrane just skewer the research. Does not stop demand or new product releases annually. However, overutilization has lead to insurer scrutiny. sigh.

Our groups | Cochrane

back.cochrane.org

 

[dhb]

its like a drug to them once they get into it and their follower count starts going up they won't stop. I work with a few of these front line warriors who actually haven't treated a single covid patient yet but if you saw their posts you'd think they went from wuhan to lombardy to nyc.

I seriously think a regular surgical mask is enough to prevent infection. I don't know a single MD or nurse that had been infected through patient contact (with a low percentage of use of FFP2 masks). And we are suppose to be in one of the worst countries with 4.5k deaths for 11M habitants.

 

[Mman]

I seriously think a regular surgical mask is enough to prevent infection. I don't know a single MD or nurse that had been infected through patient contact (with a low percentage of use of FFP2 masks). And we are suppose to be in one of the worst countries with 4.5k deaths for 11M habitants.

I know of ones nearby that have DIED from patient contact, let alone countless infected through it and I'm not even in a very hard hit area.

 

[D P356]

One of the partners is my group did an anesthetic for a known covid pt. I’m sure he wasn’t pleased, but he did his job, didn’t complain and handled it like a boss.
I’m encouraged by the staff and the courage of folks stepping up to take care of these patients.
This forum is the only social media platform I use. However, I photobomb other’s selfies and pictures as much as possible; it’s an underrated hobby

 

[deleted270145]

I seriously think a regular surgical mask is enough to prevent infection. I don't know a single MD or nurse that had been infected through patient contact (with a low percentage of use of FFP2 masks). And we are suppose to be in one of the worst countries with 4.5k deaths for 11M habitants.

I beg to differ. I work in NYC. Even with full PPE, me and several of my colleagues have become infected with COVID (and thankfully survived!) while performing airway management of these patients.

 

[dhb]

I beg to differ. I work in NYC. Even with full PPE, me and several of my colleagues have become infected with COVID (and thankfully survived!) while performing airway management of these patients.

None of the anesthesiologists of our team or ICU docs have been infected though patient contact...
Could you or your collegues have been infected through other sources?

 

[Mman]

None of the anesthesiologists of our team or ICU docs have been infected though patient contact...
Could you or your collegues have been infected through other sources?

we have had healthcare workers get infected from patient contact before there was community spread in our area

 

[dhb]

we have had healthcare workers get infected from patient contact before there was community spread in our area

So if it was before community spread they probably didn't have a protection at the time?

 

[Mman]

So if it was before community spread they probably didn't have a protection at the time?

no, we went bonkers with PPE before we had community spread because we had patients in the hospital that had travelled from hard hit areas. I'm trying to figure out how a physician could think health care workers could not get infected with an extremely infectious disease in the hospital taking care of these patients....

Did you not see the case report of the trans-sphenoidal case in China where all 14 people that entered in the OR contracted it?

 

[dhb]

no, we went bonkers with PPE before we had community spread because we had patients in the hospital that had travelled from hard hit areas. I'm trying to figure out how a physician could think health care workers could not get infected with an extremely infectious disease in the hospital taking care of these patients....

Did you not see the case report of the trans-sphenoidal case in China where all 14 people that entered in the OR contracted it?

I don't know i just surprised that some people are saying they see infections even if you are dressed to go to Mars and we haven't had any infections even without widespread use of FFP2s...

 

[deleted270145]

None of the anesthesiologists of our team or ICU docs have been infected though patient contact...
Could you or your collegues have been infected through other sources?

Totally possible, and impossible to prove where/when/from whom we contracted the virus from.

 

[Sandman192799229]

Just wanted to say something about social media. In general the public opinion of doctors has been waning. That’s the reason the nursing lobby has been able to push independence for NPs CRNAs. It’s all based on politics and who is more likable. While I understand some people’s posts are grating and over the top social media is an important platform. Whether you like it or not social opinion matters. So maybe take it easy on some of the people they might just be doing it to look out for their fellow colleagues.

 

[Mman]

I don't know i just surprised that some people are saying they see infections even if you are dressed to go to Mars and we haven't had any infections even without widespread use of FFP2s...

I think it depends on where you are geographically since there is such drastic difference in prevalence rates right now in various locations. Also worth noting that plenty of people get infected and never have any symptoms or only minor at most. And while we might "get dressed to go to Mars" to intubate somebody, nobody wears that gear every moment in the hospital. I mean you could pick up the virus touching a button on the elevator and then rubbing your eyes.

How many covid+ inpatients does your hospital have right now and how many in ICU?

 

[GaseousClay]

Just wanted to say something about social media. In general the public opinion of doctors has been waning. That’s the reason the nursing lobby has been able to push independence for NPs CRNAs. It’s all based on politics and who is more likable. While I understand some people’s posts are grating and over the top social media is an important platform. Whether you like it or not social opinion matters. So maybe take it easy on some of the people they might just be doing it to look out for their fellow colleagues.

Maybe a few are genuinely looking out for colleagues but no doubt in my mind the majority are doing it for ego stroking and the dopamine release when gaining followers/likes. Nurses way worse than doctors but both are guilty.

 

[dhb]

How many covid+ inpatients does your hospital have right now and how many in ICU?

The ICU has had 15 on average (range 12-20) with 5-6 ECMO, there is 3 wards of patients so probably 45-50 inpatients.
We did a trach 12 days ago patient was screened negative, then turned positive 2 days later and nobody in the room got infected w just surgical masks...
Other collegues also took care of patients in the OR that later were tested positive and weren't infected...

 

[Mman]

The ICU has had 15 on average (range 12-20) with 5-6 ECMO, there is 3 wards of patients so probably 45-50 inpatients.
We did a trach 12 days ago patient was screened negative, then turned positive 2 days later and nobody in the room got infected w just surgical masks...
Other collegues also took care of patients in the OR that later were tested positive and weren't infected...

when you say people weren't infected, can I assume they were swabbed several times for the next week or two after exposure?

 

[dhb]

when you say people weren't infected, can I assume they were swabbed several times for the next week or two after exposure?

No i'll rephrase: they didn't develop symptoms

 

[marr65]

I beg to differ. I work in NYC. Even with full PPE, me and several of my colleagues have become infected with COVID (and thankfully survived!) while performing airway management of these patients.

Were you wearing a PAPR or just an N95 when intubating? I feel that N95 masks aren’t that great with making a tight seal and that people should get fit tested.

 

[deleted162650]

people should get fit tested

No sh**.

 

[jeterfan]

yea this is completely self serving. speaking of self serving how about all these medical "heroes" (doctors/nurses) who post non-stop on social media to gain followers by portraying themselves as some kind of superhero (new york people exempt from this). there are way too many docs focused on being instagram/twitter famous rather than actually focusing on patients. Just do your job and stop taking selfies.

Completely agree. I did 18 intubations during a call a week and a half ago. The or staff tried to take a picture of me and I politely declined. Granted I am pretty antisocial to begin with..to each one their own I guess

To me through this experience there have been a few real heroes who have been completely forgotten. Our respiratory techs for one. They have been so overworked. They are all middle age or older.. all high risk. The worry in their faces often can’t be hidden behind all the masks. Protocols regarding bag ventilation have been all over the place at my place. Some were giving push back to even have a bag in the room. one of my early intubations was tough..had to switch to a smaller tube and the guys sat was 76 and going south fast along with his pulse. The therapist without hesitation or me asking started bagging to buy me a few seconds that kept him from certainly coding. Don’t know if it was right or wrong..depends on the protocol that day..but everyone in the room that day put that patient first.

The other heroes have been our hospital cleaning staff. Pretty sure you won’t find any of them on social media. There is no glory in what they do that anyone on Instagram really cares. Going in and out of infected rooms constantly throughput the day to defeat the virus in the most basic way. Cleaning rooms after patients have expired.

Most making minimum wage or a little more. Some would probably make more with all the new benefits if they were just laid off. The few ones I know on a first name basis from the OR who have been floated throughout our hospital have kept showing up each day up despite the risks and minimal rewards or recognition that physicians and nurses have gotten throughout this.. They are my heroes

 

[UscGhost]

The ICU has had 15 on average (range 12-20) with 5-6 ECMO, there is 3 wards of patients so probably 45-50 inpatients.
We did a trach 12 days ago patient was screened negative, then turned positive 2 days later and nobody in the room got infected w just surgical masks...
Other collegues also took care of patients in the OR that later were tested positive and weren't infected...

Basic fundamentals of infectious disease would still logically apply.

It comes down to whether you expose yourself to sufficient viral burden to overwhelm your initial innate immunity. Things like distance from the patient..how much virus they are shedding...ventilation..exposure time and any barriers (hepa vs n95 vs surgical mask) will all come into play.

Using a surgical mask and saying you won't get infected is overestimating its effectiveness. Even an N95 will only filter 95% and can be overwhelmed during certain aersolizing procedures if enough viral particles are released and exposure time is sufficient

 

[CopaceticOne]

The other heroes have been our hospital cleaning staff. Pretty sure you won’t find any of them on social media. There is no glory in what they do that anyone on Instagram really cares. Going in and out of infected rooms constantly throughput the day to defeat the virus in the most basic way. Cleaning rooms after patients have expired.

Most making minimum wage or a little more. Some would probably make more with all the new benefits if they were just laid off. The few ones I know on a first name basis from the OR who have been floated throughout our hospital have kept showing up each day up despite the risks and minimal rewards or recognition that physicians and nurses have gotten throughout this.. They are my heroes

I 100% concur with this.

 

[cchoukal]

I 100% concur with this.

Likewise. NONE of this stuff works if the garbage can is full. It seems trite or basic, but the reality is, we can’t do any of the things we do if the supplies aren’t brought in and the garbage isn’t brought out, and the people who do both of those jobs are paid very little. There was a meme going around about how we’ve learned from this that half of the jobs out there can aparrently be done without showing up, and the people with jobs that require showing up are sorely underpaid.

 

[Pharmado]

Were you wearing a PAPR or just an N95 when intubating? I feel that N95 masks aren’t that great with making a tight seal and that people should get fit tested.

I keep wondering if anyone would pass the fit test with the same N95 they’ve been wearing for a week (or two or three...). Sure the mask fits ok when you test it right out of the pack, but people are being forced to use and reuse them. I doubt many people would pass the fit test with an old mask and that’s what people are wearing.

 

[jwk]

The ICU has had 15 on average (range 12-20) with 5-6 ECMO, there is 3 wards of patients so probably 45-50 inpatients.
We did a trach 12 days ago patient was screened negative, then turned positive 2 days later and nobody in the room got infected w just surgical masks...
Other collegues also took care of patients in the OR that later were tested positive and weren't infected...

Nobody in our department does ANY cases with "just surgical masks" period. Minimum is an N95 with a level 3 mask covering it plus goggles or faceshield. That's for any case, negative, positive, or PUI.

I listened to a great presentation on Covid 19 and ICU patients yesterday during the AAAA virtual meeting by an anesthesiologist in Houston. The takeaway was that most of us have long careers still ahead of us and will have thousands of patients to deal with down the line. Jeopardizing that by not using appropriate PPE is just not smart.

 

[deleted697535]

I seriously think a regular surgical mask is enough to prevent infection. I don't know a single MD or nurse that had been infected through patient contact (with a low percentage of use of FFP2 masks). And we are suppose to be in one of the worst countries with 4.5k deaths for 11M habitants.

1 - you're insane
2 - send us your PPE supply if you believe that seriously

 

[chocomorsel]

I seriously think a regular surgical mask is enough to prevent infection. I don't know a single MD or nurse that had been infected through patient contact (with a low percentage of use of FFP2 masks). And we are suppose to be in one of the worst countries with 4.5k deaths for 11M habitants.

I do. But I am currently in NY.

 

[deleted87051]

I do. But I am currently in NY.

How is it?

 

[chocomorsel]

How is it?

See the life after Covid thread.

 

[Foodie]

An anesthesiologist sent a letter to the editor of APSF news letter advocating the use of an oxygen mask with a self-healing hole for EGDs and claiming that it minimizes the risk of exposure to droplets.
He did provide a disclaimer that he is a consultant for the manufacturer but provided zero evidence of the validity of his claim that his device is effective in preventing COVID19 in these high risk procedures.
In my opinion this type of cheap marketing is actually harmful because some people might read it as a recommendation of the so called APSF.
Am I the only one who is starting to feel that the APSF has become useless lately and mainly a platform for anecdotes, marketing and CRNAs?
Here is the link:

LETTER TO THE EDITOR: An Approach to Managing COVID-19 During Upper Endoscopy - Anesthesia Patient Safety Foundation

In the midst of the new COVID-19 pandemic, anesthesia personnel find themselves on the front lines, facing and combating the spread of this airborne illness, often with sub-optimal personal...

www.apsf.org

I agree 100%. This Rene’ Miguel Gonzalez is the clown who kept promoting POM throughout the first two ASA Covid-19 Townhall zoom meetings. His repetitive interjections were like spam mail -- copied and pasted every 5 min. He finally got called out and was asked if he was being paid to advertise. That shut him up.

I like POM. But APSF's publishing of biased, self-promoting garbage articles like this in time of crisis and uncertainty:
1) distracts us from obtaining critical info,
2) keeps us from having meaningful, educational, constructive discussion, and
3) devalues the educational worth of the panel/source.