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Started By
Message

SARS-CoV-2/COVID-19 medical pro thread...
Posted on 4/8/20 at 9:37 am
Posted on 4/8/20 at 9:37 am
I'm starting this thread for discussion of pathophysiology of SARS-CoV-2 and clinical manifestation and treatment of resultant COVID-19 disease. I want to avoid political discussions, "we're overwhelmed and don't have PPE or vents" discussions, who's to blame etc.
I would very much like to keep this to educated discussion on viral pathophysiology, clinical presentation, and management. It can be drug related, but needs to be based on legitimate clinical experience or perhaps some curated preprints of studies that have not been peer-reviewed yet.
I'm talking about stuff like what type of non-invasive ventilation you're using, when you're intubating (early or later and the debate on the two strategies). ARDSnet protocols and whether for most people this is really behaving like normal ARDS and thus what vent modes and strategies are being used. This is only the tip of the iceberg, I'm just trying to get the ball rolling.
I realize most of us that fit the bill for this thread are busy, but everyone has to have some diversion (see The Shining on that matter).
Would love to here from MD's (espec PCCM, EMcrit, EM, internal medicine, anesthesia, other Primary Care specialists, Ob/Gyn with the pregnancy experience, and any and all), mid-level providers caring for these patients, CCRN's, CRNA's, RT's, and anyone I'm missing taking care of these folks.
Part of the reason I'm starting this is that I miss the normal collegial interaction around the hospital that crosses specialty lines. There is a lot of great info from thought leaders and ground zero stuff on twitter and certain podcasts, and would love to see a thread that is like that here.
Spare me the TLDR responses, because if that's all you have to offer, it doesn't fit the purpose of this thread. DO NOT FEEL OBLIGATED to divulge your specialty or institution or to dox yourself. I hope I get some response and If I don't I only wasted 5 minutest typing this out. Thanks for your interest.
I would very much like to keep this to educated discussion on viral pathophysiology, clinical presentation, and management. It can be drug related, but needs to be based on legitimate clinical experience or perhaps some curated preprints of studies that have not been peer-reviewed yet.
I'm talking about stuff like what type of non-invasive ventilation you're using, when you're intubating (early or later and the debate on the two strategies). ARDSnet protocols and whether for most people this is really behaving like normal ARDS and thus what vent modes and strategies are being used. This is only the tip of the iceberg, I'm just trying to get the ball rolling.
I realize most of us that fit the bill for this thread are busy, but everyone has to have some diversion (see The Shining on that matter).
Would love to here from MD's (espec PCCM, EMcrit, EM, internal medicine, anesthesia, other Primary Care specialists, Ob/Gyn with the pregnancy experience, and any and all), mid-level providers caring for these patients, CCRN's, CRNA's, RT's, and anyone I'm missing taking care of these folks.
Part of the reason I'm starting this is that I miss the normal collegial interaction around the hospital that crosses specialty lines. There is a lot of great info from thought leaders and ground zero stuff on twitter and certain podcasts, and would love to see a thread that is like that here.
Spare me the TLDR responses, because if that's all you have to offer, it doesn't fit the purpose of this thread. DO NOT FEEL OBLIGATED to divulge your specialty or institution or to dox yourself. I hope I get some response and If I don't I only wasted 5 minutest typing this out. Thanks for your interest.
Posted on 4/8/20 at 9:38 am to BigPapiDoesItAgain
quote:
I would very much like to keep this to educated discussion on viral pathophysiology, clinical presentation, and management.

Posted on 4/8/20 at 9:39 am to BigPapiDoesItAgain
Bush did SARS-CoV-2/COVID-19
Posted on 4/8/20 at 9:40 am to BigPapiDoesItAgain
Intubate Deez Nuts
Posted on 4/8/20 at 9:41 am to BigPapiDoesItAgain
Yours is an impossible task...godspeed.
Posted on 4/8/20 at 9:42 am to BigPapiDoesItAgain
Virus is bullshite.
Full disclosure: not a doctor.
Full disclosure: not a doctor.
Posted on 4/8/20 at 9:43 am to BigPapiDoesItAgain
quote:
Ob/Gyn
Such a nasty job.
Posted on 4/8/20 at 9:44 am to BigPapiDoesItAgain
Let’s start with your credentials.
Posted on 4/8/20 at 9:44 am to BigPapiDoesItAgain
The "I'm better than you because I'm 'on the front line' " board is that way
<----
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Posted on 4/8/20 at 9:44 am to BigPapiDoesItAgain
This thread is a hoax
Posted on 4/8/20 at 9:44 am to BigPapiDoesItAgain
quote:
I would very much like to keep this to educated discussion on viral pathophysiology, clinical presentation, and management. It can be drug related, but needs to be based on legitimate clinical experience or perhaps some curated preprints of studies that have not been peer-reviewed yet.
I have smoked a quite a bit of marijuana the past few weeks and haven't gotten the CV. Sooooo, just sayin
This post was edited on 4/8/20 at 9:46 am
Posted on 4/8/20 at 9:51 am to BigPapiDoesItAgain
Lots of thrombotic events with this virus (DVT/stroke). Any benefits of anticoagulation in positive Covid 19 cases beyond prophylactic dose of lovenox/heparin for DVT prophylaxis? Heparin drip, treatment dose lovenox, DOAC/NOAC?
Posted on 4/8/20 at 9:53 am to BigPapiDoesItAgain
quote:
I want to avoid political discussions, "we're overwhelmed and don't have PPE or vents" discussions, who's to blame etc.
You do know you're on the OT right?
Why don't you just ask Jesus to come down and turn off the Whu Flu? It would be more likely to happen than what you want.
Posted on 4/8/20 at 9:54 am to BigPapiDoesItAgain
quote:
I would very much like to keep this to educated discussion on viral pathophysiology, clinical presentation, and management.
Well you surely have come to the right place
Posted on 4/8/20 at 9:55 am to Ric Flair
The thrombotic events may be due to a DIC type picture we see in these patients from the massive inflammatory response. I don’t think anyone has trialed anticoagulants, although Ochsner Nola now gives all of these patients statins, which have some antiplatelet and anti inflammatory effects. Some people have speculated that the sudden crash some of these patients take is due to a pulmonary embolism but I don’t know if that’s been supported by postmortem pathology.
Posted on 4/8/20 at 9:57 am to Snipe
quote:
You do know you're on the OT right?
You may be very surprised to hear this, but the OT actually has some educated people who browse and comment. This includes many on the frontlines of the pandemic who could provide some good insight or information.
Posted on 4/8/20 at 9:58 am to BigPapiDoesItAgain
quote:
I would very much like to keep this to educated discussion on viral pathophysiology, clinical presentation, and management.
Then get off the OT my man.
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