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What exactly is Government of India doing?
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<blockquote data-quote="red dragon" data-source="post: 2200544" data-attributes="member: 34839"><p>That was my biggest fear. Think I have mentioned repeatedly, a physician ( no matter how knowledgeable he/she is) needs training and real life exposure to tackle these situations. It is not only the physical stress ( mostly caused by the PPE) it is the mental one that kills a person.</p><p>Their demand for shorter shifts will increase the chance of spread. The protocol for wartime and epidemic is to work for 7 days at a stretch ( 4 hours of sleep, if you are lucky) and rest for 36 hours. As a member of doctor family I feel deeply for them. But this job is at times tougher than soldiers in war and they will eventually harden up and take up the challenge head on. A physically strong leader can help a lot in this situation. There must be some doctors with such strength ( not bulging muscles, those are the first to break down), it is usually some thin, tall guy who does not show any emotion.</p><p>We had a simplified protocol in Spain.</p><p>Sick patient with positive RT-PCR </p><p>1. Check serum ferritin level</p><p>if high or very low (with hemoglobin above 12, 11 for females)- tell the family family member that the patient may not survive with our best efforts. I will never give Tocilizumab to them (as cytokine storm will occur irrespective of TCZ) If required, will put on ventilator but no escalation. 90 PERCENT CHANCE THAT WE WILL LOOSE THE PATIENT.</p><p>2. If ferritin within normal range, I will go all out, TCZventilator, IABP ( if the heart gives up pumping function), ECMO ( if both heart and lung is failing simultaneously) and ventilator is not oxygenating enough. This approach saved about 70 percent of very sick patient.</p><p>No ****ing around with HCQS/ Azithral/ Remdesivir.</p><p>All my team member doctors/nurses can use their own judgement regarding investigations etc. but CAN NOT change this ferritin based protocol. If you break it, no one will complain against you. But I may break your jaw after the shift in my chamber, and you are free to sue me ( nobody did, in fact kissed by some emotional Spanish and British doctors who understood the logic and my ultimate intention, save maximum life with available resources)</p><p>My Indian friends should try some simple protocol to triage patients as this thing will shoot straight up and remain for 6-8 weeks.</p></blockquote><p></p>
[QUOTE="red dragon, post: 2200544, member: 34839"] That was my biggest fear. Think I have mentioned repeatedly, a physician ( no matter how knowledgeable he/she is) needs training and real life exposure to tackle these situations. It is not only the physical stress ( mostly caused by the PPE) it is the mental one that kills a person. Their demand for shorter shifts will increase the chance of spread. The protocol for wartime and epidemic is to work for 7 days at a stretch ( 4 hours of sleep, if you are lucky) and rest for 36 hours. As a member of doctor family I feel deeply for them. But this job is at times tougher than soldiers in war and they will eventually harden up and take up the challenge head on. A physically strong leader can help a lot in this situation. There must be some doctors with such strength ( not bulging muscles, those are the first to break down), it is usually some thin, tall guy who does not show any emotion. We had a simplified protocol in Spain. Sick patient with positive RT-PCR 1. Check serum ferritin level if high or very low (with hemoglobin above 12, 11 for females)- tell the family family member that the patient may not survive with our best efforts. I will never give Tocilizumab to them (as cytokine storm will occur irrespective of TCZ) If required, will put on ventilator but no escalation. 90 PERCENT CHANCE THAT WE WILL LOOSE THE PATIENT. 2. If ferritin within normal range, I will go all out, TCZventilator, IABP ( if the heart gives up pumping function), ECMO ( if both heart and lung is failing simultaneously) and ventilator is not oxygenating enough. This approach saved about 70 percent of very sick patient. No ****ing around with HCQS/ Azithral/ Remdesivir. All my team member doctors/nurses can use their own judgement regarding investigations etc. but CAN NOT change this ferritin based protocol. If you break it, no one will complain against you. But I may break your jaw after the shift in my chamber, and you are free to sue me ( nobody did, in fact kissed by some emotional Spanish and British doctors who understood the logic and my ultimate intention, save maximum life with available resources) My Indian friends should try some simple protocol to triage patients as this thing will shoot straight up and remain for 6-8 weeks. [/QUOTE]
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