ICU COVID-19 census went to 20 from 4.

9,063 Views | 56 Replies | Last: 5 yr ago by SoulSlaveAG2005
Marcus Aurelius
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2:08a, 5/27/20
AG
In our ICU. Discouraging. In a week or so. From SNFs and a meat packing plant. Controlling these epicenters is main battle now. Though I am concerned about next week after Memorial Day weekend.

Our designated COVID-19 unit is full, so now having to open up other ICU space. Blow to hospital as we are now full with "normal diseases."
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cc_ag92
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In reply to Marcus Aurelius • 7:04a, 5/27/20
AG
I understand why the SNFs are filling beds. Why the meat-packing plant workers? Are they 75 and older? What's causing them to be so sick that they need ICU if you can share?

Thank you for your work, both AT work, and on this forum, by the way. I appreciate your posts and insight.
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Duncan Idaho
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In reply to Marcus Aurelius • 8:22a, 5/27/20
From what I am seeing around greystone, you should be worried about next week.
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SkiMo
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8:25a, 5/27/20
AG
Sorry but can someone tell me what the SNF acronym means?
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Duncan Idaho
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In reply to SkiMo • 8:26a, 5/27/20
Skilled nursing facility
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Dad
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In reply to SkiMo • 8:28a, 5/27/20
AG
SkiMo said:
Sorry but can someone tell me what the SNF acronym means?
I googled it and it said Skilled Nursing Facility.
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SkiMo
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In reply to Duncan Idaho • 8:28a, 5/27/20
AG
Duncan Idaho said:
Skilled nursing facility
Ah... I assume this is another way to say "nursing home" or "long term care facility"?

Thanks!
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BigOil
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8:36a, 5/27/20
AG
I would imagine working long hours in a meat packing plant would lead to weakened immunity systems... long hours, probably poor diet, poor fitness, poor sleep quality.
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Aust Ag
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8:51a, 5/27/20
AG
Though I am concerned about next week after Memorial Day weekend

I think if anything is certain, it's that we'll know one way or another in about 5-7 days if we're somewhat "done" with this thing, or Memorial Day behavior got us headed down the crooked path again. And I can't wait. Ready for definitive answers, one way or another.
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Aggie95
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8:53a, 5/27/20
AG
local hospital here in GA is up as well.
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One Eyed Reveille
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9:13a, 5/27/20
AG
Does that acronym imply there is such a thing as an unskilled nursing facility?


And I think Meat Packing Plants are the NYC Subway viral loaders of the rest of the country.
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gigemhilo
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In reply to Marcus Aurelius • 9:16a, 5/27/20
AG
Where are you located? This sounds almost exactly like the status of our local hospital.
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Marcus Aurelius
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9:18a, 5/27/20
AG
Bham metro
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gigemhilo
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In reply to Marcus Aurelius • 9:19a, 5/27/20
AG
ok - Im in rural East Texas.

But ours went from 4 to 19 overnight because of an outbreak in a chicken plant.
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Carnwellag2
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In reply to Aust Ag • 9:28a, 5/27/20
Aust Ag said:
Though I am concerned about next week after Memorial Day weekend

I think if anything is certain, it's that we'll know one way or another in about 5-7 days if we're somewhat "done" with this thing, or Memorial Day behavior got us headed down the crooked path again. And I can't wait. Ready for definitive answers, one way or another.
YOU really think that if there is "not a large surge" that will provide enough information to people stop the madness
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Fitch
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9:33a, 5/27/20
AG
SNF's and ALF's ("Sniffs and Alfs") are common industry acronyms for skilled nursing facilities and assisted living facilities.

SNF's involve more or less constant care.

ALF residents don't necessarily require constant care, but help with daily activities.
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Duncan Idaho
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In reply to Carnwellag2 • 9:39a, 5/27/20
Carnwellag2 said:
Aust Ag said:
Though I am concerned about next week after Memorial Day weekend

I think if anything is certain, it's that we'll know one way or another in about 5-7 days if we're somewhat "done" with this thing, or Memorial Day behavior got us headed down the crooked path again. And I can't wait. Ready for definitive answers, one way or another.
YOU really think that if there is "not a large surge" that will provide enough information to people stop the madness

What are you defining as madness?

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Duncan Idaho
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In reply to Marcus Aurelius • 9:41a, 5/27/20
Marcus Aurelius said:
Bham metro

Can you give some general demographics on the icu patients? Just general age ranges.
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Marcus Aurelius
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In reply to Duncan Idaho • 9:44a, 5/27/20
AG
Elderly. Dementia. Ill. Factory pts younger.
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KlinkerAg11
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In reply to Marcus Aurelius • 9:52a, 5/27/20
AG
Why are meat packing plants getting hit so hard?

Lack of PPE and work environment?
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Duncan Idaho
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9:52a, 5/27/20
Younger being under 65? Or younger being under 40?
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RandyAg98
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In reply to Marcus Aurelius • 9:59a, 5/27/20
AG
Marcus, what is the latest on Toci?
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Marcus Aurelius
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In reply to RandyAg98 • 10:03a, 5/27/20
AG
It's working. And I think remdesivir is too. Anecdote but papers are coming out that have been discussed on here.
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Marcus Aurelius
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In reply to Duncan Idaho • 10:03a, 5/27/20
AG
Duncan Idaho said:
Younger being under 65? Or younger being under 40?
< 65
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Duncan Idaho
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In reply to Marcus Aurelius • 10:08a, 5/27/20
Marcus Aurelius said:
It's working. And I think remdesivir is too. Anecdote but papers are coming out that have been discussed on here.

Just out of curiosity, why werent these drugs tried in the countries that were hit easier?
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Bruce Almighty
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10:25a, 5/27/20
AG
We knew this was going to happen once we lifted restrictions. Spikes are likely happening everywhere. My wife's hospital went from having less than 5 Covid patients and zero in the ICU to over 20 Covid in one week. She hasn't had a death in almost a month, but she said that is likely to change quickly. When we opened back up, our mayor said that a rise in cases and deaths were to be expected.
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Marcus Aurelius
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In reply to Duncan Idaho • 10:29a, 5/27/20
AG
Duncan Idaho said:
Marcus Aurelius said:
It's working. And I think remdesivir is too. Anecdote but papers are coming out that have been discussed on here.

Just out of curiosity, why werent these drugs tried in the countries that were hit easier?
No clue. Think they were to some degree. Both American pharma cos (Genentech and gilead). Not sure if that has a role (easier access - like the local Genentech rep who I got setup with and we had Toci in 10 days).
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VKint
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11:23a, 5/27/20
AG
We need to become more aggressive in getting NH residents to be DNR. If I was demented and in a NH no way in hell I would want to be intubated or even put in ICU. Hospice care and morphine. When my patients go to a home their care is often taken over by the "house" Dr. Not sure how much effort is put into the DNR discussion with family and residents at admission.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
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Marcus Aurelius
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In reply to VKint • 11:50a, 5/27/20
AG
Agreed 100%. It's a very tough situation. Major legal implications right now. About half our COVID-19 unit is elderly chronically ill SNF patients lingering on vent for weeks. Remdesvir, toci and plasma prevents their demise early on. But now more "stuck on vents." If I was one of these patients or they were family - I/they would have been DNR. I even have a poor demented hospice COVID-19 patient, DNR, but brought to ICU. Think those should he handled differently. No one wants the exposure. Not sure the hospital is the answer. But can see some hospital ICUs actually getting overwhelmed if this continues.
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VKint
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12:02p, 5/27/20
AG
Hospice patient to ICU?? Incredible, what a total system failure. So many places that should have been stopped, had to have a DNR on file since they were in hospice. Unbelievable and tragic.

From my perspective I can see where I am part of the problem. Those of us that are strictly that know the family and pt best lose track of them. No one is left that has either the time or inclination to have that DNR talk. Sometimes it is done but the paperwork may not follow from office to hospital to SNF or NH.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
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Capitol Ag
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12:23p, 5/27/20
AG
Is DNR do not resuscitate?
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Reveille
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In reply to Marcus Aurelius • 12:26p, 5/27/20
AG
Marcus Aurelius said:
Agreed 100%. It's a very tough situation. Major legal implications right now. About half our COVID-19 unit is elderly chronically ill SNF patients lingering on vent for weeks. Remdesvir, toci and plasma prevents their demise early on. But now more "stuck on vents." If I was one of these patients or they were family - I/they would have been DNR. I even have a poor demented hospice COVID-19 patient, DNR, but brought to ICU. Think those should he handled differently. No one wants the exposure. Not sure the hospital is the answer. But can see some hospital ICUs actually getting overwhelmed if this continues.
This is terrible! How is a patient on hospice with dementia and a DNR even getting to the ICU? Is the person with the power of attorney pushing to do this? I would think that if they are on hospice that they would just keep them comfortable and allow them to die at home if they got sick. I usually discuss all the possibilities with the family and patient prior to putting a patient on hospice to avoid this type of issue. If they are in a nursing home I can understand transferring them out for the safety of other patients but a floor bed should be more than sufficient unless someone with power of attorney is wanting more done. If this is the case maybe having them call the primary doctor and discussing it might be an option to avoid this unnecessary use of ICU resources.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
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Marcus Aurelius
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In reply to Reveille • 12:30p, 5/27/20
AG
Families / at home hospice staff don't want to be exposed or don't have PPE to safely care for them.
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Marcus Aurelius
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In reply to Capitol Ag • 12:30p, 5/27/20
AG
Capitol Ag said:
Is DNR do not resuscitate?
Yes
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Capitol Ag
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In reply to Marcus Aurelius • 12:45p, 5/27/20
AG
Thank you. Ya, that absolutely makes 0 sense in terms of putting them in ICU. Exact opposite of what they should do.
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