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Quick COVID question: average ICU stay?


Quill
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I’m sure this may be in one of these threads, but no time to search for it now. We have a client who was admitted to the ICU on/about 8/10/21; her sister notified us and has received correspondance on her behalf. I have called for an update a few times in the past couple weeks but have not received a call back. (I always frame it as “…how she is recovering…” in my inquiries; I never assume the worst.) But now it’s been almost a month. Is a month still statistically a recoverable amount of time? Is that outside of average? 

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I’m so sorry to hear your client is unwell 😞

One month in the ICU is not unheard of. I wouldn’t say it’s average, but it’s far from unusual. But it usually means there have been complications, and if she makes it, she’s likely facing a very long post-ICU recovery period. Probably will entail rehab, depending on how old the patient is.

Hope she is able to recover

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I just googled.  No recent publications in the USA.  Over a year ago the average stay was 15 days total if you needed ICU.  France averages 27 days in ICU, Wuhan China 7 days in ICU.

I would not necessarily think she won’t survive if she’s lasted this long.  For one I know someone who was in the ICU for 5 weeks.  And I think I saw a news story last month of someone who finally went home after 8 months in the hospital. 

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10 minutes ago, Quill said:

I’m sure this may be in one of these threads, but no time to search for it now. We have a client who was admitted to the ICU on/about 8/10/21; her sister notified us and has received correspondance on her behalf. I have called for an update a few times in the past couple weeks but have not received a call back. (I always frame it as “…how she is recovering…” in my inquiries; I never assume the worst.) But now it’s been almost a month. Is a month still statistically a recoverable amount of time? Is that outside of average? 

I think you should rethink the bolded. Consider how it lands if the true answer would be “she’s not.”

You also might try asking what you need to know: i.e. is sister currently managing the client’s affairs and what would she like you to do regarding the pending legal matter.  Those are things she can answer and are more likely to get a call back.  She probably has dozens of people who want updates on her sister’s condition and she 1) doesn’t know and 2) has no reason to prioritize you on that list.

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8 minutes ago, Danae said:

I think you should rethink the bolded. Consider how it lands if the true answer would be “she’s not.”

You also might try asking what you need to know: i.e. is sister currently managing the client’s affairs and what would she like you to do regarding the pending legal matter.  Those are things she can answer and are more likely to get a call back.  She probably has dozens of people who want updates on her sister’s condition and she 1) doesn’t know and 2) has no reason to prioritize you on that list.

Yeah; that’s why she called in the first place; she’s managing her sister’s affairs and saw legal correspondence. My main communications with her have been regarding the legal matter and postponement, but I want her to know we care about the client and not just her legal issue. 
 

I don’t think she *owes* it too me to report. I’m just trying to communicate: we haven’t forgotten and we care. 
 

I would never want to communicate in a manner that suggests I expect her to die, even if that is a distinct possibility. I mean we never know. 

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If she has been on a ventilator for several weeks, she is unlikely to recover. But, some people crash relatively quickly and others can improve if given enough time, so you never know. Normally, we would try to reduce the settings on a vent to hopefully wean people off for extubation, but the risk of extubation failure is high with Covid. When people have Covid, we have to use very high settings on the ventilator, which makes the risks to the lungs greater (e.g., lung collapse from the ventilator forcing so much air into the lungs). Also, when people are on vents for a long time, we have to keep them paralyzed and sedated for all that time, that also complicates ICU recovery. If you are paralyzed, you cannot use your muscles. You also increase the risk of neuro issues if you cannot easily take so-called sedation vacations without people dying on you. The other issue is that Covid really isn't just a lung issue, it's a blood coagulation and overall perfusion issue. So, you have issues with blood clots and oxygenation to all your other vital organs, so even if your lungs recover, you may still have organ damage in other places.

For all those reasons, it's traditionally been the younger and healthier folks (like two of my friends in NY -- again, in the early days of the pandemic, not with Delta) who have made it off of vents and why you are now seeing more pregnant women passing from Covid. Pregnancy adds tremendous stress to a woman's body -- sometimes, too much stress to handle a serious bout of Covid on top of keeping a fetus alive. It's just too much stress for some bodies to handle. These days, we have more treatments to help us before we get to the point of putting someone on a vent, so it's used more as a last resort than earlier in the pandemic.

I am sorry, Quill.

Edited by SeaConquest
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I have called the hospital and asked to be connected to a particular person to find out if they are still hospitalized. Then you get back things like, "just a minute and I'll connect you"or "they are in ICU and I can connect you to the nurse."

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8 hours ago, Starr said:

I have called the hospital and asked to be connected to a particular person to find out if they are still hospitalized. Then you get back things like, "just a minute and I'll connect you"or "they are in ICU and I can connect you to the nurse."

I really caution about calling ICU nurses right now. So many hospitals are overrun and short-staffed that nurses really shouldn't be answering general inquiry questions. (no offense intended)

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13 minutes ago, Happy2BaMom said:

I really caution about calling ICU nurses right now. So many hospitals are overrun and short-staffed that nurses really shouldn't be answering general inquiry questions. (no offense intended)

Oh sorry, I haven't done it about Covid. I've just checked to see if people were still in the hospital pre covid for the church to arrange visiting. We live in a small community.  I was just thinking she might be able find out from the phone person if covid patient was still in the hospital.

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45 minutes ago, Starr said:

Oh sorry, I haven't done it about Covid. I've just checked to see if people were still in the hospital pre covid for the church to arrange visiting. We live in a small community.  I was just thinking she might be able find out from the phone person if covid patient was still in the hospital.

Unless there is a release of information on file, we are not allowed to even tell you if a patient is in the hospital, nevermind disclose their status, without violating Hipaa. 

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13 minutes ago, SeaConquest said:

Unless there is a release of information on file, we are not allowed to even tell you if a patient is in the hospital, nevermind disclose their status, without violating Hipaa. 

i always wonder about this. But I can call and ask to be connected to so and so s room. I can go into the hospital to visit and the room number will be given. 

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10 minutes ago, Starr said:

i always wonder about this. But I can call and ask to be connected to so and so s room. I can go into the hospital to visit and the room number will be given. 

I can only speak to the hospitals that I have worked at, and the units in which I have worked (mostly ICU and psych), but if it is an emergent situation, then it's a judgment call. If it is clear the people are loved ones, and the patient does not have capacity to give consent, you are going to let them in or connect them to get a status update, etc. But, if the patient has the ability to consent, you need to get consent. You don't just willy nilly give out patient protected information, including whether the patient is there in the first place, without consent. This is especially critical where I currently work in psych. 

Edited by SeaConquest
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I don’t know the average but one of the guys who got it in our first outbreak locally was released months later - I remember the story about him in the news.  He had to learn how to walk again.  He was older so I don’t know how common that scenario is.

I have heard that younger people who survive tend to be in ICU for a lot longer versus older people who tend to go downhill more quickly if that makes sense.

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10 hours ago, Ausmumof3 said:

I don’t know the average but one of the guys who got it in our first outbreak locally was released months later - I remember the story about him in the news.  He had to learn how to walk again.  He was older so I don’t know how common that scenario is.

I have heard that younger people who survive tend to be in ICU for a lot longer versus older people who tend to go downhill more quickly if that makes sense.

It does make sense, sadly. 
 

This client was not elderly, nor visibly in poor health. This was a robust, tall person under 60 years of age. 

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