wathe
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Posts posted by wathe
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14 minutes ago, Spy Car said:
Oh, is it "boat?" I was very unsure I hear that correctly.
They are liking the effect of having a zone of dead-air away from their mouths.
Bill
I think so. It's my kid's favourite style for comfort. It's also a very satisfying style to sew (cloth version)
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19 minutes ago, Spy Car said:
This week I sent my wife and son off to school using new KF94 masks. They have a different style from the KN95s we'd had previously (is it called a "bow style?").
They seem to fit both well and no complaints from either.
Bill
I've seen them described as "boat-style", because they look like a little folded paper boat.
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6 hours ago, brehon said:
Yup. I’m on the last few hours of my shift and have transported patients to multiple hospitals in my area. All of them have bed delays for EMS; all of them are full; all have ICU holds; several ERs are having to utilize hall beds (not actually that unusual for ERs here), closets, showers, and - for one ER - the decontamination shower/room. The ERs, having been reminded that diversion is a request, not a mandate, and if two hospitals go on diversion then no one is on diversion, are now rotating 4 hour “full diversions”.
No such thing as diversion here - the next nearest hospital is too far away. We just have to suck it up and cope.
ETA; I wish we could divert. but then we'd be in diversion all the time. We have. permanent "Ambulance Off-Load" nursing assignment.
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9 hours ago, ieta_cassiopeia said:
Does that mean there are 29 non-ICU beds being used as ICU beds, or 29 people who need an ICU bed who cannot get a bed at all?
They are in emergency departments, as per NYT article.
Blocking emergency department beds. Fewer beds available to provide emergency care to incoming patients in the department. Who will then get cared for in "non-traditional patient care spaces", AKA chairs in hallways, waiting rooms, alcoves, closets ,etc, by staff who are run off their feet trying to manage the bed-spaced inpatients as well as the never ending stream of incoming ED patients. This is my life. Working in a bed-blocked ED is very un-fun.
ETA - I'm not in Alabama. I'm in chronically bed-blocked ED elsewhere.
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2 minutes ago, Laura Corin said:
Let's not forget dexamethasone. It's not much touted because .... It's cheap, highly available and well tested?
BBC News - Coronavirus: What is dexamethasone and how does it work?
https://www.bbc.co.uk/news/health-53077879Yes. But only 15% reduction in mortality. Nowhere near as effective as vaccination.
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10 minutes ago, mathnerd said:
@KSera, Thanks for posting this. I always thought that remdesivir helped the survival rates of extremely ill covid patients, especially the elderly. Perhaps, subconsciously, watching Trump walk away from the hospital (after taking that cocktail of drugs including remdesivir) gave me the idea that there are expensive but effective treatments. Reading this is an eye opener for me - that remdesivir might not always work.
Are there any studies about the effectiveness of remdesivir on hospitalized patients?
The Ontario Science Table quotes a 19% reduction in mortality with remdesivir. They do not quote a reference. I think it's safe to assume that that's a relative mortality reduction, not absolute.
UpToDate (expensive professional medical information database) summarizes the evidence for remdesivir, with references, on their "COVID 19: Management in hopistalized adults" page. I believe that they've continued to provide access to their covid pages for free.
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On 8/16/2021 at 7:57 PM, hjffkj said:
wtf is wrong with people. I really wish they would press charges on the parents.
Here recently a parent was fined $880 for sending a child to daycare with covid symptoms:
https://www.cbc.ca/news/canada/toronto/vaughn-parent-fined-covid-19-daycare-1.6142610
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3 minutes ago, mathnerd said:
Cost of a vaccine is cheaper than cost of Regeneron treatment, which antivaxxers don’t seem to understand (not to mention cost of icu admission).
By a lot. $30-40 per dose vs $2000-2500 per dose. Almost a hundred fold difference.
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8 hours ago, SKL said:
Oh well, in the end my kid refused to go. While I feel sorry that she is missing an opportunity to build relationships, I also don't really blame her. I texted that she didn't feel well. Kinda glad it's over for us.
I'm sorry.
She's an indirect victim of hazing. It's really not OK. I'm angry on her behalf.
An inclusive, respectful, welcome to the team event would have been so much better.
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@ktgrok, @Pawz4me Yes, the dose itself is free of cost to the patient, but the administration may not be (and given what I think I know about US healthcare, I'm guessing that administration almost certainly will not be free of cost to the patient.)
From NYT:
Looks like the total number of doses purchases=d by the US government 1.5 million. That's not going to be enough to ensure free and timely access for all.
Also, this is an expensive drug. $2000-$2500 per treatment. Someone (your government, your tax dollars) is paying for that.
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19 minutes ago, Seasider too said:
I am struggling to understand this. In your work with ER staff, have you heard anyone give actual logical reasons for not accepting a vaccination?
We have some in our department. None of the reasons are logical to me. All the same reasons for vaccine hesitancy as in the general population (HCW, of course, are regular people too).. Mostly fear: fear of something new, fear based on misinformation (including conspiracy types), fear based on ignorance (of how vaccines work, ie worried about their DNA). A few crunchy types who don't believe in vaccines at all. Some head-in-the-sand believing that they won't get sick because they're young and healthy and don't have risk factors. Some worried about vaccine complications or side effects.
Vaccine uptake definitely correlates with level of education here: All MD's in my group are vaxed, at the earliest possible opportunity.
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6 minutes ago, Katy said:
I agree if this is hazing it is problematic, but that seems more like a worry than a surety, especially because the first thing communicated was that it wasn't hazing.
All that tells us is that the coach doesn't understand what hazing is.
Which in of itself is problematic.
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12 minutes ago, SKL said:
Nobody said "kidnap" as far as I know. But they did say they want to wake the girls up, and they want it to be a surprise.
I don't really think my kid would believe she's being kidnapped, but it would annoy her intensely to have her privacy invaded like that, and to be unable to decide for herself how she wanted to prepare for a social outing. It would start out so badly that I don't know if it would ever switch to "fun" in her mind.
Exactly. That's hazing - purposely making her uncomfortable without her consent or foreknowledge, by a group with social power. It's not OK
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13 minutes ago, SKL said:
The driving part isn't legal.
I thought about just having her ready by the door when they come, but the illegal driving thing in the middle of the night with a car full of teens ... I chose to be the adult in this situation.
I
You know, I think that your school admin needs to know about this.
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45 minutes ago, EKS said:
Maybe this was already mentioned, but does anyone else think that the kidnapping aspect of this takes it into hazing territory?
43 minutes ago, SKL said:The upperclassmen are also going to give the underclassmen costumes to wear. Supposedly holiday oriented, e.g. Santa / Easter Bunny themes. Sounds benign, but I could still see it getting uncomfortable.
14 minutes ago, Ivey said:Absolutely. I would consider any type of "initiation" event where there is a power differential between the participants to be a form of hazing. The kidnapping aspect only serves to give power to the older girls and embarrass the younger ones. These types of events were the norm when I was a teen, but none of my kids' schools, sports clubs, etc. have allowed them.
This is hazing. Purposely causing discomfort (sleep deprivation), embarrassment (being given costumes to wear), harrassment (surprised awake at night in own home, kidnapped), regardless of member's willingness to participate, in a group context with a power differential.
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42 minutes ago, lewelma said:
I've shared the research with her and she is thinking that she lectures with only a mask, but then puts on the face shield with the mask when she is stopping at desks and leaning over to help students with their work.
This seems a reasonable strategy.
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Faceshields protect eyes and face against droplets. They also decrease surface contamination of the mask.
Covid is spread by both droplets and aerosols. It's true that face shields don't protect against aerosols, but protection from droplets remains important.
IPAC wisdom is that glasses are not adequate to protect against droplets and/or splash. Standard safety glasses (with side shields) are also inadequate - they are meant to protect against impact. To protect against droplets and splash, you really need either goggles with indirect vents, or a faceshield.
Faces shield plus mask studies (both with simulators)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7922468/
https://pubmed.ncbi.nlm.nih.gov/24467190/
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You need the perfect balance of fit, filtration and comfort.
n95 have great filtration, but often too uncomfortable to wear properly for very long
pleated disposable ear loop masks have great filtration and comfort, but sloppy fit
Cloth masks are comfy, can have great fit, but filtration seems to be poor
A really good and inexpensive solution is p disposable pleated earloop mask under well fitting cloth mask. Disposable mask provides the filtration, cloth mask fixes the fit, and the combination is comfortable enough to wear properly
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2 hours ago, Jean in Newcastle said:
Just picking one quote out of the many because I don't want to multi-quote: in local hospitals there are signs up saying that care will be refused to violent patients or they will be prosecuted (I assume based on the need for care and the extent of violence - if it's just verbal or physical etc. Is this not the case everywhere?
We supposedly have zero tolerance for violence and harassment, and abuse complete with signs. It’s bull.
1). You don’t know it’s going to happen until it happens
2). Violence and harassment and abuse are part some patients’ presentations : intoxication, dementia, psychosis, even personality disorders, and just the stress of being in an overcrowded emergency department. Nobody is at their best. We can’t refuse care to people who are medically unstable, and to evaluate medical stability, you have to assess the patient.
zero tolerance policies look good on paper, but are actually impossible in EDs.
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2 hours ago, SeaConquest said:
Appalling is right. Here is another I just read:
Getting spit on at work is unpleasant. So is getting screamed at, sworn at, cat-called, pinched, hit, slapped, swatted at, scratched, bitten, licked, kicked, bodychecked, having a book thrown at your head from behind, and having a chair thrown at you. Ask me how I know. #EmergLife.
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15 minutes ago, brehon said:
I’ve worked in emergency medicine for almost a quarter century. I’m not sure how the health care system will survive or what it will look like if this keeps up.
— signed one exhausted HCW to another
I'm 20+ years in as well.
We aren't allowed to go on diversion or bypass. The next nearest hospital is too far away. We just have to suck it up and cope.
I'm sure that you are right. The fall-out from this pandemic in health care systems is going to last for years and years.
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1 hour ago, RootAnn said:
I usually do absolutely nothing except put on sunscreen when I'm going to the pool or going to be in the sun a lot.
Not what you were looking for, but I couldn't resist chiming in a contrarian perspective.
I'm on team do pretty much nothing: Wash in the morning while showering with whatever bar of soap is in the shower (usually a no name version of Ivory or Dove). Sunscreen on days that I will be out in the sun, especially early in the season - but I am not consistent, especially later in the season. Weeks that I'm camping I do even less - just wipe with a wet wash cloth at the end of the day, skip the soap.
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I am glad to see a bigger effort to move toward gender parity this year. It's unbelievable to me that women's sprint canoe is in the Olympics for the first time this year (previously is was only men). There is nothing particularly male about canoe!
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2 hours ago, TCB said:
I can’t remember where I heard it, but I’m sure I heard recently that doubling up a surgical mask with a cloth one, like @Melissa Louisedoes is very effective.
1 hour ago, Melissa Louise said:I do a tie and fold of my surgical mask too, before I put it on, so it forms a seal and doesn't gape at the sides. The cloth mask over the top adds additional layers, but also helps seal pretty tight. I know it's better than either on their own b/c breathing is harder, lol.
Yes, disposable pleated surgical mask under well-fitting cloth mask is a really great quick and easy solution. Disposable surgical masks are made from melt blown polypro with excellent filtration, but have a sloppy fit. The cloth mask serves to fix the fit, so has to be well-fitting, but its filtration doesn't really matter; even a thin, single layer, cheapie one is fine, so long as it fits well.
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The Vaccine Thread
in The Chat Board
Posted
Some provinces have been doing that all along. Ontario decided to follow suit this week.
Health care is a provincial responsibility in Canada. It's administered and funded by the provinces, but must be within the framework of the federal Canada Health Act. Provinces all interpret the CHA a little differently.