For those of us who have treated patients with a variety of respiratory conditions, if you NEVER put an asthma patient on a vent, I wonder how many asthma patients were under your care. Yes, supplemental O2 and steroids, but you also may need a vent or non-invasive ventilator assistance once in a while, also using proper I:E parameters, …
For those of us who have treated patients with a variety of respiratory conditions, if you NEVER put an asthma patient on a vent, I wonder how many asthma patients were under your care. Yes, supplemental O2 and steroids, but you also may need a vent or non-invasive ventilator assistance once in a while, also using proper I:E parameters, even Heliox, to try to save lives. BUT I never gave ANYONE Remdesivir.
I continue to consider mech vent a LAST RESORT, but it is a resort! If weaning is impossible, then make a decision. But to NEVER consider a last resort, seems short-sighted. Just make everyone DNI? You don't intubate unless there is already respiratory failure. If some did, I agree, that's malpractice and could be assault and murder. But don't throw the baby out with the bathwater!
to clarify.... I was trained as a pediatrician and in that population, asthmatics were never put on vents. Be that as it may, my point was the LAST RESORT became FIRST RESORT in the face of 90% mortality and that was done by design for reasons that should be obvious by now.
I was trained Pulmonary - Critical Care, and asthmatics are put on vents, though again as a LAST resort. But I agree the LAST RESORT should never be the first resort. I know what I did. But anyone motivated by anything other than doing their best for patients, God might have mercy on their soul, but I don't know if I would.... Cheers!
For those of us who have treated patients with a variety of respiratory conditions, if you NEVER put an asthma patient on a vent, I wonder how many asthma patients were under your care. Yes, supplemental O2 and steroids, but you also may need a vent or non-invasive ventilator assistance once in a while, also using proper I:E parameters, even Heliox, to try to save lives. BUT I never gave ANYONE Remdesivir.
I continue to consider mech vent a LAST RESORT, but it is a resort! If weaning is impossible, then make a decision. But to NEVER consider a last resort, seems short-sighted. Just make everyone DNI? You don't intubate unless there is already respiratory failure. If some did, I agree, that's malpractice and could be assault and murder. But don't throw the baby out with the bathwater!
to clarify.... I was trained as a pediatrician and in that population, asthmatics were never put on vents. Be that as it may, my point was the LAST RESORT became FIRST RESORT in the face of 90% mortality and that was done by design for reasons that should be obvious by now.
I was trained Pulmonary - Critical Care, and asthmatics are put on vents, though again as a LAST resort. But I agree the LAST RESORT should never be the first resort. I know what I did. But anyone motivated by anything other than doing their best for patients, God might have mercy on their soul, but I don't know if I would.... Cheers!