Just rounded on our LTAC...

Marcus Aurelius

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1:46p, 7/25/20

AG

Very interesting. 30 pts. 15 of which are "COVID Recovery" diagnosis. A new term. 15/15 African American. The majority of these pts are on vents. Moderate to high O2 requirements. CXRs patchy inflitrates - but more fibrotic pattern. Majority renal failure requiring dialysis. And majority with some degree of encephalopathy. Several who have had trachs decannulated but still fairly high O2 requirements. Weak. Malnourished.

All of these pts COVID neg x 2 prior to admit. Most in acute ICU for weeks prior to transfer.

I think the majority of these pts will have long term significant organ dysfunction - especially pulmonary. The long term ramifications are real for those who survive the severe illness.

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Dr. Not Yet Dr. Ag

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2:37p, 7/25/20

Been seeing about one patient a shift for the last 2 weeks with complications from COVID after their initial hospitalizations. Most are just chronic dyspnea related to what appears to be fibrotic lung disease secondary to COVID. I actually had two patients with fibrotic lung disease status post COVID who developed a pneumothorax.

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bigtruckguy3500

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3:15p, 7/25/20

What kind of ages are we looking at? And what vent mode and pressures are the go to these days?

Marcus Aurelius

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In reply to bigtruckguy3500 • 3:22p, 7/25/20

AG

Older. At LTACs, by definition, most of these pts are on weaning modes, such as SIMV/PSV. There are a few on more demanding acute modes such as AC and PC with high minute ventilation demands. Weeks in those pts are not going to fare well. Sad.

cone

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In reply to Marcus Aurelius • 3:24p, 7/25/20

AG

just the flu, bro

were these people who were admitted with covid, "recovered" in the hospital from the infection, and have never left?

or did they catch the bug, get over it either inside or outside the hospital, go home, and then had to be readmitted?

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OKC~Ag

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In reply to Marcus Aurelius • 3:25p, 7/25/20

Marcus Aurelius said:
Very interesting. 30 pts. 15 of which are "COVID Recovery" diagnosis. A new term. 15/15 African American. The majority of these pts are on vents. Moderate to high O2 requirements. CXRs patchy inflitrates - but more fibrotic pattern. Majority renal failure requiring dialysis. And majority with some degree of encephalopathy. Several who have had trachs decannulated but still fairly high O2 requirements. Weak. Malnourished.

All of these pts COVID neg x 2 prior to admit. Most in acute ICU for weeks prior to transfer.

I think the majority of these pts will have long term significant organ dysfunction - especially pulmonary. The long term ramifications are real for those who survive the severe illness.

so, soon as you suspect Covid, should all patients be anticoagulated? should that prevent organ dysfunction?

Marcus Aurelius

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In reply to cone • 3:34p, 7/25/20

AG

cone said:
just the flu, bro

were these people who were admitted with covid, "recovered" in the hospital from the infection, and have never left?

or did they catch the bug, get over it either inside or outside the hospital, go home, and then had to be readmitted?

They were admitted and treated for severe covid-19, intubated with severe multi organ dysfxn. They survived the acute illness, after weeks, but can't extubate. They are covid neg swabbed x 2, trached (and many dialysis), and then transferred to LTAC (located at another location.)

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plain_o_llama

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4:44p, 7/25/20

Wasn't sure how this compared to rehabilitation facilities. Here is a description.

https://www.dekalbmedical.org/long-term-acute-care/about-us/long-term-acute-care

WHAT IS LONG-TERM ACUTE CARE?

A long-term acute care facility is a specialty-care hospital designed for patients with serious medical problems that require intense, special treatment for an extended period of timeusually 20 to 30 days.

Long term acute care facilities offer more individualized and resource-intensive care than a skilled nursing facility, nursing home or acute rehabilitation facility. Patients are typically transferred to a long term acute care hospital from the intensive care unit of a traditional hospital because they no longer require intensive diagnostic procedures offered by a traditional facility.

While a traditional hospital provides several general medical specialties, such as emergency care, maternity care, etc., a long term acute care hospital has the focused resources to apply very high standards to a relatively small list of ailments. View Emory Long-Term Acute Care's Patient & Family Guide, which will give you a wide range of information about our care and services.

Click on any of the services listed below for a printable copy detailing that Emory Long-Term Acute Care Clinical Service. We offer: