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PANDEMIC ALERT LEVEL
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Tracking the next pandemic: Avian Flu Talk

Hospitals are not the answer: Healers at home are
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abba View Drop Down
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    Posted: August 22 2006 at 11:11pm
Since access to effective medical care at a public hospital is likely to be rationed at best or non existent, what things can be done to care for those striken with BF at home?

Effective BF care at home is likely going to help impact "turning the tide" of BF infection in a greater way than public medicine, simply because:

(A)  Home healers will be available
(B)  Home healers will have the time
(C)  Victims will not have to wait for a bed
(D)  BF victims will not have to travel to obtain their care
(E)  They will be in the devoted care of loved ones

The 67 billion dollar question that this hinges on, however, is:

 >> WHAT KIND OF LIFE SUSTAINING CARE SHUD HOME HEALERS GIVE? <<
 
 
I cant find any comprehensive literature on exactly what kind of care Home Healers should give to the ill:
 
 
** What to do / not do;
** Avoiding infection;
** What to do with soiled bedding;
** What to give to victim to eat / drink (and how often) 
** Whether to isolate victim or not from other family members
 
 
The US government should compile and mail IMMEDIATELY such a document to every household in the USA.
 
 
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: August 23 2006 at 4:40am
The answer to your questions above are available in a new book.  It was written by a physician to answer questions brought up by people within his practice and was so good it bcame a book.  It's SHORT, like 85 pages but concise, only about $4.99.  My husband, who's also a FP doctor, has two copies of it at his office and is showing it to people who are concerned and would want to treat at home.  It will walk any layperson through how to treat a family member with the flu, outlining the necessary medical supplies you should have, even discusses the thing floating around online about how you can recycle Tamiflu from your pee to make a complete regimin from just two pills.  It is THE book to have when the S hits TF and you're caring for someone sick.  Here's a link to the website that sells it: http://search.barnesandnoble.com/booksearch/isbnInquiry.asp?z=y&isbn=0757304982&itm=1
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: August 23 2006 at 9:32am

Abba,

You've come to a conclusion few have the courage to consider.

Because of the numbers of patients, hospitals will close early in the 'wave of infection'. I'll list a few things to get you started and I hope my AFF colleagues will add to the list.

1. As 4abbie mentioned, information is first.

2. Don't panic now and keep your anxiety under control. Don't be imbarrassed to contact your doctor to discuss your anxiety if you can't control through excersise and meditation, etc. Also, use this forum to vent and get support. You are among kindred souls.

3. If you plan to be a caregiver or to receive care from a family member there is a fair amount to know about avoiding contamination of yourself and others. There is personal protective clothing and equipment that is needed. An avian flu patient will be expelling contaminated fluids from every opening. An avian flu patient will be having a great deal of difficulty breathing. The patient's skin may turn dark blue/purple due to a lack of blood platlets.

4. This is not the yearly flu. The patient may die within days of developing symptoms. Currently 66% of patients who test positive die even with the support of a modern intensive care unit. Of course 34% survive. The 34%'s chances of living improve with good 'supportive' care such as fluids, over-the-counter medications and basic good bed-side care.
 
5. The best case is not to be exposed to infective agent.
 
6. The best case is to have enough 'preps' and information to stay away from the general public during an outbreak. The chaos alone will be something you will probably not want to experience.
 
7. See number 2. above.
 
8. For a source of excellent information, see the videos on the forum. They are at: H5N1Avian Flu Forum: Pandemic Flu Preparedness: Video Awareness
 
9. When you see a 'Breaking News Story' on this forum or hear a rumor, please confirm it with at least 2 News Services before even considering it as real.
 
10. See number 2. above.
 
Peace be with you.
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Points: 81 		Post Options Post Options   Thanks (0) Thanks(0)   Quote GreenTeam Quote  Post ReplyReply Direct Link To This Post Posted: August 23 2006 at 8:30pm
I printed this out and have it filed in my "emergency" notebook:
 
 
I too believe we will likely need to take care of our families at home. Personally, I'd rather be cared for at home than to have to go to an overcrowded and chaotic hospital or school gym set up as a bird flu center. Hope this helps!
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Originally posted by Doug Doug wrote:

Because of the numbers of patients, hospitals will close early in the 'wave of infection'.
 
4. This is not the yearly flu. The patient may die within days of developing symptoms. Currently 66% of patients who test positive die even with the support of a modern intensive care unit. Of course 34% survive. The 34%'s chances of living improve with good 'supportive' care such as fluids, over-the-counter medications and basic good bed-side care.
I think these two sections are highly questionable. First of all, when a pandemic starts hospitals will discharge as many of their existing patients as possible, and no new elective surgeries will be scheduled unless the hospital determines it will not interfere with their duties to save pandemic lives.  The hospital plans would either divide the hospital into an infectious zone and a clean zone, or move the infectious respiratory patients off site to the flu care unit in a gym or auditorium somewhere.  You should consult with some public health or hospital officials that are planning.  Granted it is hard to find the planners, as most hospital people are not involved.
 
You talk as if the avian H5N1 will be the pandemic, killing 66%  It will have mutated further as at present it does not have the capability to sweep through a community.  You can't compare the rare people who catch it from birds and get sick with the larger numbers that will pass a different virus from person to person and get sick.  The mortality rate might be 2% up to 75%
Dlugose RN AAS BA BS Cert. Biotechnology. Respiratory nurse
June 2013: public health nurse volunteer, Asia
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: August 24 2006 at 11:29am
The hospital plans would either divide the hospital into an infectious zone and a clean zone, or move the infectious respiratory patients off site to the flu care unit in a gym or auditorium somewhere.
..................................................................................................................
 
Dlugose, Will many hospitals be able to have a truly
infectious free zone ?  (that is able to accomodate a lot of beds) Are most Hosps equiped with forced air type systems? 
 
I'm just thinking about getting a window fan to pull the bad air out of a sick room.
 
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Guests Quote  Post ReplyReply Direct Link To This Post Posted: August 24 2006 at 12:25pm
To where will the hospitals be discharging these patients? Hospitals don't have patients just laying around reading the paper and asking for more demerol. Hospitals run lean and mean since the medicare gravy train stopped years ago. Even if they discharged a few, there will be hundreds needing a bed.
 
The current H2H mortality is >66%. I can only deal with current facts. I'll leave conjecture to the palm readers.
 
 
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Originally posted by Doug Doug wrote:

To where will the hospitals be discharging these patients? Hospitals don't have patients just laying around reading the paper and asking for more demerol. Hospitals run lean and mean since the medicare gravy train stopped years ago. Even if they discharged a few, there will be hundreds needing a bed.
Let's get more specific and talk about the plan of NYC Department of Health and Mental Hygiene.  http://www.gnyha.org/eprc/general/public_health/influenza/20050613_Berg_GNYHA.pdf#search=%22%22surge%20capacity%22%20hospital%20pandemic%22

To Increase beds:

– Implement rapid patient discharge plans

– Increase % of opened licensed staffed beds

– Convert procedure / PACU areas to pt. care

– Cancel elective admissions, surgeries

– Use halls for non-contagious patients

Possible Alternate Care Locations
• Primary care centers • Procedure care centers • Long term care facilities • Home-based care • Family-based care • Sheltered hospital, hotel, school, convention center
 
My comments on these.  Legal standards will be different.  State legislatures are considering this now.  You don't ask any patient if they are ready to go home.  If the flu patient has pneumonia you admit him so he has a chance to survive.  If some other patient has a 98% chance of survival if you send them home early, you do.

Licensed beds:  hospitals have more bed space than they are using.  Closer to pandemic time they will be allowed to use that space.  Standards will get loose.  Most hospital hallways are wide and have room for a bed along the walls.  Cafeterias may have room, because you are not going to have a lot of employees gather in a cafeteria during a pandemic and share their germs.  A nurse that ordinarily cares for 6 may care for 20 or 30, and she will be told don't worry about your usual standards, whatever you can do for them will be most appreciated.
Dlugose RN AAS BA BS Cert. Biotechnology. Respiratory nurse
June 2013: public health nurse volunteer, Asia
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Dlugose View Drop Down
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Originally posted by Anharra Anharra wrote:

The hospital plans would either divide the hospital into an infectious zone and a clean zone, or move the infectious respiratory patients off site to the flu care unit in a gym or auditorium somewhere.
..................................................................................................................
 
Dlugose, Will many hospitals be able to have a truly
infectious free zone ?  (that is able to accomodate a lot of beds) Are most Hosps equiped with forced air type systems? 
 
I'm just thinking about getting a window fan to pull the bad air out of a sick room.
 
A window fan helps a lot at home.  I went into this in detail many months ago, you can also modify the doorway so every time it opens a lot of germs dont come out of the room.
 
In hospitals I'm no engineer, but the same reference in NYC I quoted above mentions "Identifying non-traditional isolation and patient care areas and auxiliary sites."  Let me speculate.  You have a wing with heating ducts and return air ducts, and some windows that can be opened.  This wing is designated pandemic only.  You screen off the entry hallway so that you go through two sets of plastic doors that are designed to draw air onto the unit and not back out.  On the unit you seal off all return air vents.  Warm relatively clean air blows in, windows are selected to open that are not above a sidewalk, and are facing south so sunlight will kill as many as possible escaping viruses.  You also if possible place UV lights radiation the air leaving through these windows to kill viruses.
Dlugose RN AAS BA BS Cert. Biotechnology. Respiratory nurse
June 2013: public health nurse volunteer, Asia
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