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  • I have enlisted.

    A little sobering info from a major hospital in a major city from my brother (a surgeon) this AM. I am not divulging details but wow, lots of ecmo. Sounds bad. Full ICU. Previously healthy people on ecmo.
    I live in a big city in north east (not NY) and I was just asked to be a voluntary member of our hospitals intubation team. I am a mid 40's doc with experience intubating children and adults for over 15 years.

    There will be 17 of us. The intubation team. All experienced docs with lots of training who intubate folks almost every day. So makes sense. I agreed, of course, but I am worried because my mother-in-law lives with me and she has multiple myeloma and no immune system. She is 80.

    So, I am going to live in the basement (has a shower etc.). She (moma) lives on main level master bedroom (has kitchen etc.). I ordered a microwave and I have a freezer and a Yeti cooler in the garage/basement with me. I also ordered a bunch of canned goods to eat etc. So I should be OK.

    I Plan to go to work then back to my basement command center and avoid my wife, dogs, and mother in law until this thing slows down. We have not gotten hammered yet, but it is coming in the next few days. I actually have a "cold" so I go tested on monday and have been isolated since (I am pretty sure I am negative but just being careful here). If I have it, I will be out of the fight for a few weeks, but that seems unlikely.

    Anyway, my Grand Dad (we called him Gand Daddy Joe) was in the battle of the bulge in WWII. This is obviously less intense and less dangerous (I think) but it is about as close as I will get to enlisting. To be honest, I'm pretty dang scared, but proud to do the right thing.
    Anyone else scared? I think I will feel better when I am actually back at work (with a negative test) and treating folks.
    Take care
    Tangler!

  • #2
    I’m sure you already know this, intubation is considered high risk procedure due to likely aerosolization of droplets.

    Comment


    • #3
      TY.

      Doing the next right thing - https://www.youtube.com/watch?v=w6g1yQV0dIY

      edit: make sure that N95 is fitted right.

      Comment


      • #4
        Originally posted by fatlittlepig View Post
        I’m sure you already know this, intubation is considered high risk procedure due to likely aerosolization of droplets.
        Yep.

        Comment


        • #5
          Originally posted by Tangler View Post
          A little sobering info from a major hospital in a major city from my brother (a surgeon) this AM. I am not divulging details but wow, lots of ecmo. Sounds bad. Full ICU. Previously healthy people on ecmo.
          I live in a big city in north east (not NY) and I was just asked to be a voluntary member of our hospitals intubation team. I am a mid 40's doc with experience intubating children and adults for over 15 years.

          There will be 17 of us. The intubation team. All experienced docs with lots of training who intubate folks almost every day. So makes sense. I agreed, of course, but I am worried because my mother-in-law lives with me and she has multiple myeloma and no immune system. She is 80.

          So, I am going to live in the basement (has a shower etc.). She (moma) lives on main level master bedroom (has kitchen etc.). I ordered a microwave and I have a freezer and a Yeti cooler in the garage/basement with me. I also ordered a bunch of canned goods to eat etc. So I should be OK.

          I Plan to go to work then back to my basement command center and avoid my wife, dogs, and mother in law until this thing slows down. We have not gotten hammered yet, but it is coming in the next few days. I actually have a "cold" so I go tested on monday and have been isolated since (I am pretty sure I am negative but just being careful here). If I have it, I will be out of the fight for a few weeks, but that seems unlikely.

          Anyway, my Grand Dad (we called him Gand Daddy Joe) was in the battle of the bulge in WWII. This is obviously less intense and less dangerous (I think) but it is about as close as I will get to enlisting. To be honest, I'm pretty dang scared, but proud to do the right thing.
          Anyone else scared? I think I will feel better when I am actually back at work (with a negative test) and treating folks.
          Take care
          Tangler!
          Is the intubation team needed for the sheer number of patients requiring intubation, or they want the best and most skilled people to limit aerosilization and increase first pass success? Can you comment on this further?

          Comment


          • #6
            Originally posted by FunkDoc83 View Post

            Is the intubation team needed for the sheer number of patients requiring intubation, or they want the best and most skilled people to limit aerosilization and increase first pass success? Can you comment on this further?
            Both / ALL. They don't want more that one try. They don't want people "learning" how to intubate and spreading this. They don't want patients who are really sick to be harmed because it "took too long". They don't want you to mask ventilate a lot and spread droplets all over. There is also only so much PPE to go around and we cannot waste it and at the same time expose some poor person in training who really cannot say no if asked to get involved.
            At least that is my understanding, but I am a private in this army.

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            • #7
              most large systems have emergency pandemic plans to reassign anesthes into intubation teams
              It's psychosomatic. You need a lobotomy, I'll get a saw.

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              • #8
                Grand Dad’s advice? Don’t forget to duck!
                You got this!

                Comment


                • #9
                  You can’t have courage without fear.

                  You can’t be brave without being scared.

                  As far as I am concerned, You are a hero in my book. As well as all the rest of you on the front lines.

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                  • #10
                    I admire your courage and the fact you volunteered. Something would be wrong if you were not a little scared.

                    Comment


                    • #11
                      Awesome. Just think of all the help you will provide. I just tubed my first pt who I am pretty sure has it last night. We will see....unfortunately, it's just me and 2 other pulm-CC covering 2 hospitals. So we are it. I hope and pray none of us get it.
                      Lots of good stuff online/podcasts/guidelines about it-in addition to PPE/N95s, use VL instead of direct laryngoscopy, paralzye them so as to limit coughing, use a viral filter on your Ambu Bag, and even don't bag at all if you can get away with it.
                      You got this.

                      Comment


                      • #12
                        Originally posted by pulmccMD View Post
                        Awesome. Just think of all the help you will provide. I just tubed my first pt who I am pretty sure has it last night. We will see....unfortunately, it's just me and 2 other pulm-CC covering 2 hospitals. So we are it. I hope and pray none of us get it.
                        Lots of good stuff online/podcasts/guidelines about it-in addition to PPE/N95s, use VL instead of direct laryngoscopy, paralzye them so as to limit coughing, use a viral filter on your Ambu Bag, and even don't bag at all if you can get away with it.
                        You got this.
                        Yes I am thinking 100% VL, proxygenate as much as possible, small hypnotic (I prefer ketamine or prop with phenylephrine ) large dose of roc, tube quickly with no bag mask ventilation unless essential. Get tube in fast after RSI but prepare Slow and careful with emergency drugs and equipment ready. Some might need norepi infusion started prior etc etc
                        Will also need to be careful to decontaminate after. keep fighting the good fight!

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                        • #13
                          God bless you and you will be in our prayers!

                          Comment


                          • #14
                            From a civilian, I salute you, sir/ma'am! Thank you for enlisting and God bless.
                            Our passion is protecting clients and others from predatory and ignorant advisors. Fox & Co CPAs, Fox & Co Wealth Mgmt. 270-247-6087

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                            • #15
                              I wish you the best.

                              Our local academic institution has 2 anesthesiologists on call in house round the clock to do all intubations. My next door neighbor was on the rotation last night, it is quiet so far. It's a good plan, but scary. I appreciate your sacrifices.

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