Coming to a hospital near you - as told by an Italian physician

greg nr

Well-Known Member
Remember that Italy is about 3-4 weeks ahead of us. This is exactly what will be happening at every large hospital before long. Forget about the smaller urban hospitals; they don't have the staff or resources to do this kind of juggling. They will just turn people away to die at home.

Translated account from an Italian surgeon.
The cases multiply, up to a rate of 15-20 hospitalizations a day all for the same reason. The results of the swabs now come one after the other: positive, positive, positive. Suddenly the emergency room is collapsing. Emergency provisions are issued: help is needed in the emergency room. A quick meeting to learn how the to use to emergency room EHR and a few minutes later I'm already downstairs, next to the warriors on the war front. The screen of the PC with the chief complaint is always the same: fever and respiratory difficulty, fever and cough, respiratory insufficiency etc ... Exams, radiology always with the same sentence: bilateral interstitial pneumonia. All needs to be hospitalized.

Some already needs to be intubated, and goes to the ICU. For others, however, it is late. ICU is full, and when ICUs are full, more are created. Each ventilator is like gold: those in the operating rooms that have now suspended their non-urgent activity are used and the OR become a an ICU that did not exist before. I found it amazing, or at least I can speak for Humanitas Gavazzeni (where I work), how it was possible to put in place in such a short time a deployment and a reorganization of resources so finely designed to prepare for a disaster of this magnitude. And every reorganization of beds, wards, staff, work shifts and tasks is constantly reviewed day after day to try to give everything and even more.

Those wards that previously looked like ghosts are now saturated, ready to try to give their best for the sick, but exhausted. The staff is exhausted. I saw fatigue on faces that didn't know what it was despite the already grueling workloads they had. I have seen people still stop beyond the times they used to stop already, for overtime that was now habitual. I saw solidarity from all of us, who never failed to go to our internist colleagues to ask "what can I do for you now?" or "leave that admission to me, i will take care of it." Doctors who move beds and transfer patients, who administer therapies instead of nurses. Nurses with tears in their eyes because we are unable to save everyone and the vital signs of several patients at the same time reveal an already marked destiny. There are no more shifts, schedules.


https://forums.hardwarezone.com.sg/eat-drink-man-woman-16/testimony-italian-surgeon-working-heart-italys-coronavirus-outbreak-6223837.html
 

printer

Well-Known Member
Just retired from a large hospital, talked to one of my buddies last night. They are doing all they can to get rooms to be used for isolation of patients. We had around 60 real iso rooms, a number that can be used as them in a pinch but are not true iso. People will be shifted around with the less contagious being bumped down. The big thing is ventilators, keeping people breathing long enough so they can recover.
 

greg nr

Well-Known Member
Just retired from a large hospital, talked to one of my buddies last night. They are doing all they can to get rooms to be used for isolation of patients. We had around 60 real iso rooms, a number that can be used as them in a pinch but are not true iso. People will be shifted around with the less contagious being bumped down. The big thing is ventilators, keeping people breathing long enough so they can recover.
I heard one nurse say they went to ebay and bought an oxygen concentrator and 2 used cpap units. They can be combined into a makeshift respirator in case he needs one for his family.

Now that's a mcguyver thinking ahead.
 

printer

Well-Known Member
I heard one nurse say they went to ebay and bought an oxygen concentrator and 2 used cpap units. They can be combined into a makeshift respirator in case he needs one for his family.

Now that's a mcguyver thinking ahead.
One of the guys said that our shop will miss a lot of the experience I had, I was good at troubleshooting, getting things up and running with some creative thinking. I hope things do not get that bad.
 

greg nr

Well-Known Member
One of the guys said that our shop will miss a lot of the experience I had, I was good at troubleshooting, getting things up and running with some creative thinking. I hope things do not get that bad.
You may get a call asking you to come back. A lot of staff are going to get sick and drop out; even if all they do is stay home for a few weeks, it will still cause a staffing crisis.
 

lokie

Well-Known Member
Remember that Italy is about 3-4 weeks ahead of us. This is exactly what will be happening at every large hospital before long. Forget about the smaller urban hospitals; they don't have the staff or resources to do this kind of juggling. They will just turn people away to die at home.

Translated account from an Italian surgeon.
The cases multiply, up to a rate of 15-20 hospitalizations a day all for the same reason. The results of the swabs now come one after the other: positive, positive, positive. Suddenly the emergency room is collapsing. Emergency provisions are issued: help is needed in the emergency room. A quick meeting to learn how the to use to emergency room EHR and a few minutes later I'm already downstairs, next to the warriors on the war front. The screen of the PC with the chief complaint is always the same: fever and respiratory difficulty, fever and cough, respiratory insufficiency etc ... Exams, radiology always with the same sentence: bilateral interstitial pneumonia. All needs to be hospitalized.

Some already needs to be intubated, and goes to the ICU. For others, however, it is late. ICU is full, and when ICUs are full, more are created. Each ventilator is like gold: those in the operating rooms that have now suspended their non-urgent activity are used and the OR become a an ICU that did not exist before. I found it amazing, or at least I can speak for Humanitas Gavazzeni (where I work), how it was possible to put in place in such a short time a deployment and a reorganization of resources so finely designed to prepare for a disaster of this magnitude. And every reorganization of beds, wards, staff, work shifts and tasks is constantly reviewed day after day to try to give everything and even more.

Those wards that previously looked like ghosts are now saturated, ready to try to give their best for the sick, but exhausted. The staff is exhausted. I saw fatigue on faces that didn't know what it was despite the already grueling workloads they had. I have seen people still stop beyond the times they used to stop already, for overtime that was now habitual. I saw solidarity from all of us, who never failed to go to our internist colleagues to ask "what can I do for you now?" or "leave that admission to me, i will take care of it." Doctors who move beds and transfer patients, who administer therapies instead of nurses. Nurses with tears in their eyes because we are unable to save everyone and the vital signs of several patients at the same time reveal an already marked destiny. There are no more shifts, schedules.


https://forums.hardwarezone.com.sg/eat-drink-man-woman-16/testimony-italian-surgeon-working-heart-italys-coronavirus-outbreak-6223837.html
Stop harshing my mellow dood.
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This is clearly a hot topic on most if not all media at this time.

It need not take up my time here.
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