Are Ventilators Killing Patients to "Protect" Healthcare Workers?

The title pretty much sums up my conclusions -- a resounding "yes". How we got here -- all the whys and wherefores -- is a little murkier.

We've been told that ventilators are the go-to treatment in hospital, and we all heard the screaming from Cuomo that they "need 30,000 more ventilators!!!" What we have not heard is that ventilators became the default treatment due to FEAR... because the less expensive, less risky, non-invasive treatment devices such as cannulas, CPAPs and BiPaps may aerosolize the virus -- in other words, the virus may become air borne -- infecting healthcare workers with their use. This is also true for ventilators initially during intubation, but it then becomes self-contained and the chance of aerosolization is minimized/eliminated.

So, in an effort to avoid healthcare providers being exposed to the virus, these non-invasive treatments are not recommended, while ventilator treatments are recommended.... with a notable "rare exception":

Patients with a DNI order who have an acute indication for NIPPV.

"DNI" is short for "do not intubate," and a "DNI order" refers to a patient's specific order not to be intubated... and therefore not put on a ventilator. YES. Patients can refuse to be intubated and placed on a ventilator.

Note that this recommendation for ventilators is NOT because the non-invasive methods don't work... they do work!!! And their early use could/would prevent many (most?) patients conditions from deteriorating further. But the patient's needs -- the patient's very life! -- is sacrificed to protect the very people who are supposed to be helping them.

This became an issue in the nursing home in Seattle -- "Ground Zero" so to speak. This is how NPR reports it:

First responders called to the Life Care Center of Kirkland starting Feb. 24 initially used positive airway pressure machines, often known as CPAPs, to treat residents before it was known the patients were infected with COVID-19.

"It's best practice for us for people with respiratory illnesses," said Jim Whitney, medical services administrator for the Redmond Fire Department, whose crews responded to the nursing home's 911 calls.

It was only later that King County public health officials advised Redmond Fire and other first responders in the region not to use those machines for patients suspected of having COVID-19 infections. Whitney said responders were using the machines with specialized filters, which can reduce the amount of virus released. But county public health authorities recommend that first responders avoid using CPAP machines altogether. Redmond Fire has now discontinued use of CPAPs for COVID patients.

"Best practice" -- not ventilators -- until CoVid. And they make it very clear that it is to protect the healthcare workers, NOT the patient:

"It's truly out of an abundance of caution for our people and for the community that we put it on the back shelf, unless we can confirm it was the best use for our patient," Whitney said.

Gee... think they're doing anything to try to "confirm" that? I don't. It has not even been confirmed that these methods do aerosolize viruses.

The American Society of Anesthesiologists issued guidance on Feb. 23 discouraging CPAP use in COVID-19 patients — advice largely informed by experience with the SARS epidemic in 2003. Studies dating to 2003 suggest that such devices can pump viruses into the air, potentially increasing the spread of a contagious disease.

No one has tried to confirm or refute either in the last 17 years... and not in last three months.

This is happening despite the healthcare industry being well aware of potential ventilator problems, starting with Ventilator-Associated Pneumonia (VAP), the result of a bacterial infection contaminating a ventilating machine and transmitted to the patients. According to one clinical study:

Eighty-six percent of nosocomial pneumonias are associated with mechanical ventilation and are termed ventilator-associated pneumonia (VAP). Between 250,000 and 300,000 cases per year occur in the United States alone, which is an incidence rate of 5 to 10 cases per 1,000 hospital admissions (134, 170)

But it gets worse. Others are saying (and have been saying) that mechanical ventilation itself is a problem and not a safe and effective treatment for CoVid and its complications:

With ventilators running out, doctors say the machines are overused for Covid-19

As virus advances, doctors rethink rush to ventilate

Doctors think ventilators might harm some COVID-19 patients

Yet another emerging problem is that many healthcare workers are not trained in the use of ventilators, or they are poorly trained, with little to no proper supervision; here's one example that ended in tragedy -- Corona virus patient in New York died because her ventilator was turned up too high by trainee doctors who did not know how to work it, medic claims

Many (most) patients would not get to the point of needing hospitalization if they could be treated sooner and more effectively with these non-invasive methods. By the time someone is accepted to the hospital, they are in critical condition, and even if they are one of the lucky 20% who survive, they will have further complications and side effects to overcome.

This is yet one more unintended consequence with tragic results for many to protect others. These health workers shouldn't be held liable for this travesty, and they won't be -- Cuomo Executive Order Grants Immunity to Healthcare Providers During COVID-19 Emergency -- but those at the top making the decisions and giving these healthcare workers their marching orders sure as hell need to be held to account.

(continued...)

(continued)

We've heard much about the skyrocketing death rate in New York, and it's not just a coincidence. How much can we really know with hospitals on lockdown and patients on their own without their families to advocate for them or tell the tale? I will post a video of a woman who does try to tell that tale, and links to a few more videos for those who prefer to watch than to read. And, as always, my source links will follow.


Doctors Face Troubling Question: Are They Treating Coronavirus Correctly? (video)

Do CoVid-19 Vent Protocols Need a Second Look?

(I wanted to post the video that inspired this ATS thread, but it's been removed by YouTube for violating "community standards": Nurse Labels Virus as a Lie)

Cuomo says NY needs 30,000 ventilators, pleads with feds for help

Hierarchy of O2 Delivery (ventilation, nasal cannula, cpap, bipap and more)

CPAP Machines Were Seen As Ventilator Alternatives, But Could Spread COVID-19

Ventilator-associated pneumonia

Ventilator-Associated Pneumonia: Diagnosis, Treatment, and Prevention

DoD COVID-19 PRACTICE MANAGEMENT GUIDE (pdf)

Cuomo Executive Order Grants Immunity to Healthcare Providers During COVID-19 Emergency

My girlfriend works at Danbury hospital n Connecticut, she is coved nurse. The last think they want is the ventilator, most don’t survive it. Protocol now is heavy O2, anti AIDS & that quinine drug the Democrats criticized Trump on. Turns out it’s working great with high success rates. Ventilators damage the lungs!!

a reply to: Boadicea

This is an incredible amount of work you've put in. Thank you for gathering all this research!

I'm trying to dig it back up, but I recently watched a video seminar where a Chinese doctor, who treated patients during the 2003 SARS outbreak, mentioned that healthcare workers were most often exposed during the intubation process -- not via NIV. He felt with HEPA filters, there was little to no chance of exposure.

When I find it, I'll post it.

S&F for you!

a reply to: Boadicea

From the UChicago article:

“The proning and the high-flow nasal cannulas combined have brought patient oxygen levels from around 40% to 80% and 90%, so it’s been fascinating and wonderful to see,” Spiegel said.

^^^Wow.

Normally, those patients would go right onto a ventilator and there is an 80%+ death rate.

The prone position seems to also have a dramatic effect from what I've been reading.

So, if you do not want to be pushed onto a ventilator, you need to have a 'Do Not Intubate' order and you need to decide what course of treatment you'd like to try...and on your belly.

originally posted by: WUNK22
My girlfriend works at Danbury hospital n Connecticut, she is coved nurse....Protocol now is heavy O2, anti AIDS & that quinine drug the Democrats criticized Trump on. Turns out it’s working great with high success rates.

This is really great to hear. I've been encouraged by the reports of doctors noticing a problem and identifying the problem, because that's when they start finding better answers. Hopefully this also means that with better treatments, we will have better outcomes, hospitals and healthcare won't be overwhelmed, and we can be proactive instead of reactive.

Fear is a great motivator, but never a great master.

And that would take away the greatest weapon being wielded against us by the political critters. Everything is politicized and propagandized beyond all proportion to reality.

originally posted by: MotherMayEye
a reply to: Boadicea

This is an incredible amount of work you've put in. Thank you for gathering all this research!

Well, thank YOU -- you helped point me in the right direction with links you posted in a previous thread -- and I very much appreciate it! That got me going...

I'm trying to dig it back up, but I recently watched a video seminar where a Chinese doctor, who treated patients during the 2003 SARS outbreak, mentioned that healthcare workers were most often exposed during the intubation process -- not via NIV. He felt with HEPA filters, there was little to no chance of exposure.

When I find it, I'll post it.

Thank you -- I'd like to see that.

originally posted by: MotherMayEye
a reply to: Boadicea

From the UChicago article:

“The proning and the high-flow nasal cannulas combined have brought patient oxygen levels from around 40% to 80% and 90%, so it’s been fascinating and wonderful to see,” Spiegel said.

^^^Wow.

Pretty amazing, isn't it? I knew not to lay flat on your back, but I hadn't ever heard or read about laying on the belly. Thank Heaven for whoever thought of trying that! I never cease to be amazed at how effective the simplest remedies can be.

Normally, those patients would go right onto a ventilator and there is an 80%+ death rate.

That's just terrifying and horrifying. My heart goes out to the loved ones left behind who will have to wonder if these simpler measures could have saved them, especially if they could have received treatment sooner.

So, if you do not want to be pushed onto a ventilator, you need to have a 'Do Not Intubate' order and you need to decide what course of treatment you'd like to try...and on your belly.

That's about it. At least for now. I hope and pray that more and better treatments are found and that won't be the status quo.

So wise words for now.

originally posted by: Boadicea
"I'm trying to dig it back up, but I recently watched a video seminar where a Chinese doctor, who treated patients during the 2003 SARS outbreak, mentioned that healthcare workers were most often exposed during the intubation process -- not via NIV. He felt with HEPA filters, there was little to no chance of exposure."

When I find it, I'll post it."

Thank you -- I'd like to see that.

Hopefully it starts where he beings talking about that...if not, it begins about 4:52 in.

a reply to: Boadicea

Yes, and it is known. Here is an updated EMS notification.


URGENT! Please circulate as widely as possible. It is crucial that every pulmonologist, every critical care doctor
and nurse, every hospital administrator, every public health official receive this information immediately.

“We have zero success for patients who were intubated.
Our thinking is changing to postpone intubation to as
long as possible, to prevent mechanical injury from the
ventilator. These patients tolerate arterial hypoxia
surprisingly well. Natural course seems to be the best.”

www.evms.edu...

originally posted by: infolurker
a reply to: Boadicea

Yes, and it is known. Here is an updated EMS notification.


URGENT! Please circulate as widely as possible. It is crucial that every pulmonologist, every critical care doctor
and nurse, every hospital administrator, every public health official receive this information immediately.

“We have zero success for patients who were intubated.
Our thinking is changing to postpone intubation to as
long as possible, to prevent mechanical injury from the
ventilator. These patients tolerate arterial hypoxia
surprisingly well. Natural course seems to be the best.”

www.evms.edu...

Very good info. Thanks!

I've also been reading there are two phenotypes, one kind of patient that continues to do well with severe hypoxia and ones that do not tolerate it well, at all. But there's only been one protocol for all severely hypoxic patients: Ventilators.

It's been reported by some physicians, the ones that do well with the severe hypoxia should not be rushed onto a ventilator, and the other phenotype is just very hard to treat, period. But the ventilators are destroying their lung tissue, too. As one doctor said, if he ends up with it and falls in the second category, he would just sign a DNR. That said, he is an octogenarian.

originally posted by: infolurker
a reply to: Boadicea

Yes, and it is known. Here is an updated EMS notification.

Very very good to hear! And thank you for posting the link. I haven't finished reading it yet, but I'm already impressed with their initial treatment protocols and "cocktails", including Vitamin C & D supplements, and high dose IV Vitamin C for more serious cases. (It's worth a read folks!)

This is very good to hear and to know. Thank you!

originally posted by: MotherMayEye

I've also been reading there are two phenotypes, one kind of patient that continues to do well with severe hypoxia and ones that do not tolerate it well, at all. But there's only been one protocol for all severely hypoxic patients: Ventilators.

It's been reported by some physicians, the ones that do well with the severe hypoxia should not be rushed onto a ventilator, and the other phenotype is just very hard to treat, period. But the ventilators are destroying their lung tissue, too. As one doctor said, if he ends up with it and falls in the second category, he would just sign a DNR. That said, he is an octogenarian.

I've read a little bit about this -- not nearly enough yet. But that might explain much if understood better. Reading some accounts, it seems many people can go from zero to death in a matter of hours. It might explain the increased at home deaths.

a reply to: Boadicea

I should rephrase, the info is out there but most hospitals probably are unaware since their primary median of communication is 1990's fax machines!

a reply to: MotherMayEye

Dr Yadegar here:



Seems to have made some kind of progress with the different presentations in patients.
Keep waiting to hear more, Im very interested in what hes doing..

Good thread Bo.. It seems that protocol may be one of the biggest determining factors for a regions success (or failure). Seems obvious, but being able to shift isnt always easy when there is a Plan.

It's a death sentence. Virus or no virus. Most do not survive being put on one. If they are put on one odds are another organ or organs are failing. They might be breathing but there is no fixing organs. Maybe they go on dialysis and recover. Maybe they get a transplant. Odds of that working out are extremely low. Maybe one lives a week longer. I'm not a doctor but watched it first hand a couple times.

Coronavirus: Hundreds of ‘potentially deadly’ Chinese ventilators bought by UK government ditched


Here is another problem

Hundreds of Chinese ventilators bought by the UK government to help the NHS treat critically ill coronavirus patients have been ditched because they were unsuitable, unreliable and potentially dangerous, it has emerged.

Every device in a shipment delivered from China earlier this month has been rejected by clinicians amid serious concerns that “significant patient harm, including death” would be likely if they were put to use.

We have to accept that technology is great but not perfect.

Medical science is good but not perfect and human beings administer it.

And all those deaths in China you'd never hear them telling us about these bad ventilators

link

a reply to: Boadicea

This is like a horror movie , no wonder New York have so much deaths..good thread Boadicea

Hospitals should have those UV lamps in use do disinfect the air ?

This is something i would maybe suspect to happen in China, and not in New York.......what's the world coming to? The people who murder patients should be lock up in prison


I seen reports that molecular hydrogen could be helpfull, they used it in china for covid-19 ....i wonder if could hydrogen water that could help....it`s easy to use as just need to put the tablets to water and drink after dissolved, anti-inflammatory etc benefits

originally posted by: Boadicea
(continued)

We've heard much about the skyrocketing death rate in New York, and it's not just a coincidence. How much can we really know with hospitals on lockdown and patients on their own without their families to advocate for them or tell the tale? I will post a video of a woman who does try to tell that tale, and links to a few more videos for those who prefer to watch than to read. And, as always, my source links will follow.

[...]

Thanks for the post and this video. I watched the video and it was very informative, eye-opening. What a brave girl and nurse! I shared this video on my facebook page.

The standard cpap mask raises pressure and can be used with added O2.

But it vents to the outside through vent ports.

I believe the cpap machines are useful with a modified mask that vents through a N100 filter.

I have been on a Cpap machine since 2006 for sleep apnea and at full pressure they put a lot of pressure into your lungs.

Something like this.
www.resmed.co.uk...