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Map of usage of intensive care beds in Germany

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Re: Map of usage of intensive care beds in Germany

#51

Post by m0zg »

DoreenMichele wrote: post #46
hutzlibu wrote: post #43

Earlier quoted context omitted.

How is you experience with oxygen? I can imagine it helps without stress to the lungs, which lung ventilators might introduce?

I've never been put on oxygen. A downside of oxygen is that it's very flammable. Also, to whatever degree it involves a cannula, masks, etc, it has some of the same issues in terms of sterility challenges. I've generally relied on things like airway clearance and dietary intervention in recent years.

> it's very flammable

Nit: oxygen is not flammable. Other things are flammable in its presence. A lump of coal, for example, burns white hot when oxygen is blown on it from a welding torch.

Re: Map of usage of intensive care beds in Germany

#52

Post by Kliment »

DoreenMichele wrote: post #26
cycomanic wrote: post #23

Earlier quoted context omitted.

The thing is generally for lung treatment doctors follow a path of escalation, start with less invasive methods like oxygen and progress to ventilators. With covid 19 there have been several reports from doctors that skipping this and putting the patient directly on ventilators directly significantly improves survival. Doesn't that contradict what you are suggesting.

Source? I cited my source, above. What you're saying is news to me. Without a source, I can only reply based on general life experience that most doctors are lazy and quick to prescribe drugs and surgery (or similar intervention -- in this case, ventilators) in place of trying to insist on educating patients and taking more low tech, often labor-intensive approaches instead. I have seen all the handouts saying if you…

The Chinese recommendations document ( Handbook of COVID-19 Prevention and Treatment available from https://covid-19.alibabacloud.com/ ) suggests oxygen early on, and not keeping patients on noninvasive ventilation for long before moving on to invasive, or skipping noninvasive altogether (intubating earlier rather than later) gives better outcomes. I suspect this is what the parent post is referencing. However, this applies to hospitalized patients in intensive care. High flow oxygen is the best way to prevent them from reaching that stage. What you're talking about is a much earlier stage of treatment, in order to prevent the need for hospitalization. Once a patient has reached the invasive ventilation stage their chances of recovery have already dropped massively, but at that stage the outcomes with invasive ventilation are significantly better than without. That said, all the emergency hospitals with capacities in the thousands being built are designed to get as many patients as possible on oxygen early on, as this definitely prevents many deaths. Their ventilator patient capacity is significantly lower - the bulk of them (as used in China, Spain, Italy) are just endless rows of beds and oxygen plumbing, to relieve the ICUs and isolation wards from people who just need oxygen and isolation and allow them to be used to only treat critical patients.

Re: Map of usage of intensive care beds in Germany

#53

Post by _ph_ »

chvid wrote: post #33

Germany (like a few other countries) is in the situation "too much lockdown, too few sick". So it has to remove those lockdowns. This creates a fun political dynamic where the authorities who just spend a month scaring the population in doors now has to explain and justify why it is ok to go out and get a little sick.

I strongly disagree with the statement, that we have "too few sick" here in Germany. With the lockdown, we managed to just keep the health system from being completely overloaded in the most infected regions. But that already at the price of postponing non-urgent medical procedures. So yes, there are a few free beds in hospitals still, but we might still need them.

What is not accounted for is, that supplies (masks...) are still scarce and more importandly, most medical personal is working at an unsustainable intensity. There is plenty of reason of desiring even less sick people.

The reasons for reducing the lockdown are practical, social and economic. The lockdown is hard on many people, depending on their social and living situation. Especially in dense cities, most people don't have housing which was designed to be confined to it for many weeks. And apart from that, people want to go out, want to meet other people again. Need to do shopping for clothing, get a haircut. Also, we should try to keep the economy from collapsing.

The trick will be to reduce the lockdown while keeping the minimum safety in place and without too many people acting reckless and endangering the population again.

Re: Map of usage of intensive care beds in Germany

#54

Post by DoreenMichele »

m0zg wrote: post #51
DoreenMichele wrote: post #46

Earlier quoted context omitted.

I've never been put on oxygen. A downside of oxygen is that it's very flammable. Also, to whatever degree it involves a cannula, masks, etc, it has some of the same issues in terms of sterility challenges. I've generally relied on things like airway clearance and dietary intervention in recent years.

> it's very flammable Nit: oxygen is not flammable. Other things are flammable in its presence. A lump of coal, for example, burns white hot when oxygen is blown on it from a welding torch.

Touche.

Still, it's a fire hazard.

Re: Map of usage of intensive care beds in Germany

#56

Post by DoreenMichele »

Kliment wrote: post #52
DoreenMichele wrote: post #26

Earlier quoted context omitted.

Source? I cited my source, above. What you're saying is news to me. Without a source, I can only reply based on general life experience that most doctors are lazy and quick to prescribe drugs and surgery (or similar intervention -- in this case, ventilators) in place of trying to insist on educating patients and taking more low tech, often labor-intensive approaches instead. I have seen all the handouts saying if you…

The Chinese recommendations document ( Handbook of COVID-19 Prevention and Treatment available from https://covid-19.alibabacloud.com/ ) suggests oxygen early on, and not keeping patients on noninvasive ventilation for long before moving on to invasive, or skipping noninvasive altogether (intubating earlier rather than later) gives better outcomes. I suspect this is what the parent post is referencing. However, this…

Thanks for that.

I have really serious lung problems and spent years homeless. While homeless, I used to just stand outside my tent and cough up massive amounts of fluid and gunk so I could breathe when I laid down to sleep.

Based on my experiences with my incurable lung disorder, I'm fairly confident we could be doing more with non-invasive techniques even at fairly advanced stages.

Re: Map of usage of intensive care beds in Germany

#57

Post by hutzlibu »

DoreenMichele wrote: post #46
hutzlibu wrote: post #43

Earlier quoted context omitted.

How is you experience with oxygen? I can imagine it helps without stress to the lungs, which lung ventilators might introduce?

I've never been put on oxygen. A downside of oxygen is that it's very flammable. Also, to whatever degree it involves a cannula, masks, etc, it has some of the same issues in terms of sterility challenges. I've generally relied on things like airway clearance and dietary intervention in recent years.

But if you have a personal mask, aren't this then mostly your own microorganism, your body knows how to deal with?

The fire hazard is a real threat, yes, but I imagine, if I ever would have serious trouble breathing, the first thing I would get is a bottle of oxygen to ease it.

Re: Map of usage of intensive care beds in Germany

#58

Post by DoreenMichele »

hutzlibu wrote: post #57
DoreenMichele wrote: post #46

Earlier quoted context omitted.

I've never been put on oxygen. A downside of oxygen is that it's very flammable. Also, to whatever degree it involves a cannula, masks, etc, it has some of the same issues in terms of sterility challenges. I've generally relied on things like airway clearance and dietary intervention in recent years.

But if you have a personal mask, aren't this then mostly your own microorganism, your body knows how to deal with? The fire hazard is a real threat, yes, but I imagine, if I ever would have serious trouble breathing, the first thing I would get is a bottle of oxygen to ease it.

I'm a little uncomfortable with the line of questioning here because it is starting to veer into sounding like asking me for medical advice.

I've left comments previously about airway clearance techniques and home remedies I've used. They probably aren't hard to find if you care to read them.

I have an incurable condition and impaired immune system. I personally don't like dealing with anything like masks. I've done it in the past. I know how hard it is to keep them adequately sterile.

I am not a doctor. I am not here to give medical advice in comments.

Re: Map of usage of intensive care beds in Germany

#59

Post by hutzlibu »

DoreenMichele wrote: post #58
hutzlibu wrote: post #57

Earlier quoted context omitted.

But if you have a personal mask, aren't this then mostly your own microorganism, your body knows how to deal with? The fire hazard is a real threat, yes, but I imagine, if I ever would have serious trouble breathing, the first thing I would get is a bottle of oxygen to ease it.

I'm a little uncomfortable with the line of questioning here because it is starting to veer into sounding like asking me for medical advice. I've left comments previously about airway clearance techniques and home remedies I've used. They probably aren't hard to find if you care to read them. I have an incurable condition and impaired immune system. I personally don't like dealing with anything like masks. I've done…

I know that, I did not really ask for advice, more for your experience. And since you do not have experience with oxygen, I was merely suggesting it, as I heard how it helps people with breathing problems and I do not see the need to have the masks 100% sterile if it is your personal mask. But I am also not a doctor ..

Re: Map of usage of intensive care beds in Germany

#60

Post by DoreenMichele »

hutzlibu wrote: post #59
DoreenMichele wrote: post #58

Earlier quoted context omitted.

I'm a little uncomfortable with the line of questioning here because it is starting to veer into sounding like asking me for medical advice. I've left comments previously about airway clearance techniques and home remedies I've used. They probably aren't hard to find if you care to read them. I have an incurable condition and impaired immune system. I personally don't like dealing with anything like masks. I've done…

I know that, I did not really ask for advice, more for your experience. And since you do not have experience with oxygen, I was merely suggesting it, as I heard how it helps people with breathing problems and I do not see the need to have the masks 100% sterile if it is your personal mask. But I am also not a doctor ..

My personal experience is that you do need to diligently sterilize things like masks that only you use. I spent years boiling medical equipment daily.

I had a nebulizer for a time to administer inhaled treatments. It had to be carefully sterilized.

Failure to adequately sterilize your personal medical equipment is sometimes a source of very nasty antibiotic resistant infections.

Your own germs or not, once they leave your body and grow on a surface and come back in contact with you, you had better take it seriously as a threat to your health.

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