10 New Yorkers on Ventilators

That same article says NY has 356 Confirmed Cases and 100 are hospitalized.

2 in NY have already died and 10 out of 356 confirmed cases are already on Ventilators.

This is something to be concerned about.

When the hospitals are full just about everyone that needs a ventilator will not live.

So 12 out of 356 = 3.37%. Thats a 3.37% mortality rate.

When this virus spreads the mortality rate will climb around the 3.37% range. Most likely the confirmed cases are really much higher like 7,000. Helping drop the mortality rate to 1/20 that. If not this virus will be VERY deadly. Latest predictions are that 1/3 of the world will catch it.


The reporting of cases are GROSSLY underestimated or The Mortality rate going to be very high like 3.37% in NY.

Sorry probably put this in the wrong thread accidentally--Littleraven

http://www.nyc.gov/html/doh/downloads/pdf/bhpp/bhpp-focus-bio-vent-results.pdf

here is the breakdown according to NYC.Gov as of 2005 but I can try to find a more recent survey
total by this survey is 2,688 full feature machines and over 1500 portables, anesthesia machines and automatic resucitators

Littleraven wrote: Haven't posted in awhile due to taking care of my Mom who has had bacterial spinal meningitis--got her over most of that with the great help of antibiotics special herbs and some good staff at the hospital where we admitted her after she could not fight it off anymore-- Please watch and be vigilant for secondary infections which can be associated with these viral outbreaks.  Bacterial meningitis can be deadly very quickly and is most notably the illness is often denied by the person who may be infected because it infects the brain.  Many times the one who is infected will deny being sick at all and will fight it and those who may try to help--precious time is wasted and it can result in death very quickly.  We were lucky, so I send out this message.  Be very vigilant and take special care and not be afraid to respond or be insistent.  Take care and be well.

comment:

Good to hear from you again Littleraven and sad to hear about your mom. There is 'something else' that is hooked to encephalitis that has been making the rounds. The irony on this ventilator thing is that most of the cases of flu we are seeing - at least people I know- don't have a lot of respiratory complications and are heavily GI tract with only low grade fever.

Although flu is classically a respiratory virus, as with H5N1- we found increasing GI presence and involvement.  However a classic symptom of this (Swine Flu) is a headache. That must mean there is neural involvement and IMHO inflammation of meninges (not a doctor here.. )  I know at least 6 people who have had subdural hematomas in the family and friends as well as one ex-legislator who eventually was disabled by the disease.

Since there was a lot H3N2 moving with the Swine Flu and there may as yet be a third viral strain- the terms keeps coming up- other complications. We should differentiate between pre-existing other complications- and possible secondary or concurrent other viral and bacterial problems. Significant in terms of the difference between sickness and fatal.

Medclinician

Melody
I looked into it a little more.  A portable ventilator is like a pack that you can carry and seems it would be used out in the field or in areas of hospital outside of ICU where full service vents are housed.  An automatic resuscitator is a much more limited machine that can be hooked up to an oxygen source to help an intubated patient breath.  I think the full service ventilator has many more features and is the best thing if you need one in a hospital setting but the others can be used as backup I suppose. 

hope4bestprep4wrst wrote: Melody I am in mental health so it has been a while since I have seen a vent, but as I recall full feature is the machine you see in ICU's. Portable ventilators and automatic rescucitators-not sure (maybe medclinician or someone else would know?).  Anesthesia machines are  used in operating rooms to keep people unconscious and breathing during surgery. Med-I hate to admit it but I had a blistering headache for 5 days with stiff neck and back pain 2 weeks ago, 2 days after meeting with some folks involved in the Queens outbreak, Thought it was a very bad migraine but the Maxalt didn't help much and I did not have a fever to speak of. Now I am wondering if I had a mild case.  The GI stuff was present but minimal (nausea and loose bm's sorry to get graphic). Maybe not so bad because of the vaccine. Geez.

comment:

When they triaged me, the headache was one of the symptoms they were looking for novel influenza A, Swine Flu. It is possible, but since they only test people who are pretty ill, you may only find out when wave 2 comes through and you do better than those who didn't have it. People have talked about getting it on purpose. I wouldn't do that. But I sure am not sorry I caught it and today has been my best day, fever is gone, and I am recovering.

That's why I have been camped here today. Because I can. Also, this place, if you haven't noticed is really hopping in terms of people posting- especially from infected areas. I worked MH. It is a whole different world. Passing meds is pretty good- your patients come to you.. at least mine did..made a line and I was in an enclosed area- we had some pretty intense cases.

Before there was the luxury of RT (Repiratory Therapy) which was always STAT to ER- we had to do full vents in ICU and CCU. This may have been the days when we had glass IV bottles that would clink during the earthquakes. For those of you who may not have been in ICU or worked it, a Vent was often a one on one- if the patient was fragile (unstable). Airway is number one and someone on a vent has a tube and that tube has to be kept clear- and even if the machine if puffing away- if it is set to trigger (on demand) breathing, it can get tricky. RT is a whole world and in ER it is really one. In Operating Room you need an airway and general anesthesia. So a most important thing is that airway. Except massive hemorrhage, vtach or arrest, no airway is deadly. 

Bleeding lung diseases or lots of fluid, bad news.  Avian and Influenza are classic fill up the lungs with gunk (like pneumonia) and give us one big problem. You tie up a qualified nurse or RT who could be doing respiratory treatments, bagging (assist breathing) , or something else to a patient(s).  Most of my vents were one on one (they were brittle anyway) and RT would come in and out sometimes draw an arterial blood gas- to see if the vent was getting enough oxygen into the patient.

point here- big point for the laymen readers- high care patients would be triaged out in a real emergency. They are not going to tie up nurses, RTs, and doctors running 20 vents when they may  have 1000 sick people to deal with. All these how many vents do we have things, or in consideration of a really atypical situation. An ICU full of vents before they call it a day.

The whole concept of vent supply and even hospitalizing that many people is impractical. You can afford TLC when you have the staff- if you are looking at 350 real sick people in ER or tons more- we aren't going to see lines of vents. if they are doing this I can't see how they are pulling if off. The 10 people on Vents must be at different hospitals. 10 vents in one ICU would be a nightmare. We might be staffed on a good day with 4-5 - often 3 nurses or RT.

Don't worry about having enough ventilators. Worry about having enough people to run them.

Often these "plans" look good on paper- but if you will look at Katrina- they evaced the well people first (I think) and then came back for the worst case.

here's a book http://books.google.com/books?id=FX999MWvlhcC&pg=PA14&lpg=PA14&dq=nerc+disaster&source=bl&ots=Q0rmuuC_po&sig=_AD9ecuViJQesttyok1zwgpZ4sY&hl=en&ei=qJMhSo2oGZqqtgf89sXFBg&sa=X&oi=book_result&ct=result&resnum=5#PPA19,M1

http://tinyurl.com/nbth3y

This will give you a feel for disaster scene compared to rush hour medicine.

Hospitals probably will be shut down rather quickly. End of vents.

Automatic Resucitator- this is a gem. Wish we had these when we used to go with paramedics in training on the ambulance.

http://www.floteco2.com/htm/Products/B-VOR_Automatic_Resuscitator.htm

You would need to intubate- http://en.wikipedia.org/wiki/Intubation RTs and anesthesiolgists could comment more on this. We all had to do it and fast when we got our ACLS as opposed to standard CPR.

These are probably pretty pricey.

Don't try this at home. We learned to do it. You find a spot anatomical, cut, and use an old style pen or straw (worse case- hard to keep open) to create an airway.

http://www.medstudents.com.br/proced/cricotir.htm

John (the MD one on here) - who can do these nowadays. We used to do them on the troops.. can a layman do this one.. or only medical people?

Thought this post might be informative though a little lengthy since this is a vent thread. We nurses used to love to see RT not swamped. Made our double shift when someone didn't show, a lot less double.

Medclinician

" Don't worry about having enough ventilators. Worry about having people to run them"

As far as creating a tracheostomy-stoma as  the risk for infection alone  makes me cringe, not to mention the lack of equipment to care for such needs unavailable at home, and then what if the caretaker became ill ?  Not to mention the risk of bleeding to death or immediate shock.  

Ok seriously, Jesus up in Heaven just take me home !

02 concentrators could in theory ease the efforts of someone having difficulties but they would have to be breathing on their own, ventilators are for those who cannot physiologically move air effectively or at all through the respiratory system ( alot of involuntary  muscle movement )  I am not a RT but have cared for those on a few different types of vents.

I also wonder how many of the ventilators in existance are in good working condition. As you know many times any type of equipment ends up breaking down and maybe not fixed because of money contraints or cutbacks. I hope there will be enough for all who may need them. If not, how do they choose who gets the ventilator? First come first serve or who's more important??