So I did a thing. I just see an N95 mask in my future. So I figured, what the hell?pic.twitter.com/BURWCec2lK
Surgeon/scientist promoting science in medicine and exposing quackery. Editor of Science-Based Medicine. My opinions do NOT represent those of my employers.
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So I did a thing. I just see an N95 mask in my future. So I figured, what the hell?pic.twitter.com/BURWCec2lK
Lord help us when they call up the surgeons from the reserves. 
Well, at least I'm not an ophthalmologist. I did do trauma and critical care back in the 1990s. I have experience as a helicopter flight physician. I can intubate, do lines, and, after a refresher, I'm sure I can run ventilators. I'm just rusty.
Just remember, low stretch, 6-8cc/kg IBW. Covid responds to peep, needing > 12 cm. Keep plateau pressures < 30. Permissive hypercapnea ok if needed to oxygenate. Experiment with modes - not every patient responds the same. Sedate, then paralyze, then prone if needed.
Yep. All of the ARDSNet recommendations.
If you want to prepare for it, take a look at APRV/BiLevel/BiVent, a form of IRV. Very effective for #ARDS ventilation
Love APRV. Just needs closer monitoring because TV isn’t a guarantee on the pressure regulated settings so set the alarms to tell you if they’re pulling large TV and adjust.
Absolutely. There are also some variations to weaning off APRV, potential negatives of increased infra-thoracic pressure (decreased preload, hypotension,etc), which also need monitoring.
Well, fortunately we're not desperate enough here (yet) to call in a subspecialist surgeon. I hope we never get there, but figure I should try to be prepared in case we do get there.
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