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grepmeded's profile
GrepMed
GrepMed
GrepMed
@grepmeded

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GrepMed

@grepmeded

Image Based Medical Reference: Sharing crowd-sourced checklists, algorithms, decision aids, #PhysicalExam #POCUS, and more - by @GeraldMDMD + @k00bideh

Sacramento, CA
grepmed.com
Joined March 2018

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    1. Bob Wachter‏Verified account @Bob_Wachter Apr 15
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      3/ @UCSF rate of positive tests 3.5%. 2nd day in row w/ no pos tests. Now testing all pre-op patients & will start testing all hospitalized pts @ucsfhospitals on Monday. Suspect very few positives but hope it'll reassure pts & workers that it’s safe to be in hospital: it is.pic.twitter.com/va12t5FWWp

      4 replies 44 retweets 282 likes
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    2. Bob Wachter‏Verified account @Bob_Wachter Apr 15
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      4/ SF scrambled to create new capacity (@ucsf, opening Mt Zion; @SaintFrancis_SF opened floor; Cal Pacific opened old hosp). Suspect we won’t need most of it, but won’t be surprised if there is late surge of non-Covid patients who will need care after they feel OK leaving home

      2 replies 19 retweets 170 likes
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    3. Bob Wachter‏Verified account @Bob_Wachter Apr 15
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      5/ Underuse of frantically-built capacity seems universal. Even @ NYC, Javits Ctr & Navy hospital ship mostly empty https://wapo.st/34CYPxk  Why? Combo of “where did all the other pts go?” & hospitals have improvised (2 pts in ICU built for 1; Covid pts in ORs & recovery rooms)...

      7 replies 33 retweets 192 likes
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    4. Elon Musk‏Verified account @elonmusk Apr 15
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      Replying to @Bob_Wachter

      We are hearing almost all hospital ICUs have excess capacity. In some cases, 60% empty.

      65 replies 130 retweets 874 likes
    5. Bob Wachter‏Verified account @Bob_Wachter Apr 15
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      Replying to @elonmusk

      Yes, definitely in California; where we have avoided the worst. Not in NYC, Boston, Detroit, New Orleans, where they truly are overwhelmed.

      9 replies 5 retweets 192 likes
    6. Elon Musk‏Verified account @elonmusk Apr 15
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      Replying to @Bob_Wachter

      They were, but are they currently?

      33 replies 25 retweets 457 likes
    7. Daniel Schlessinger, MD‏ @dschless Apr 15
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      Replying to @elonmusk @Bob_Wachter

      I am a medical resident in Boston and we are still overwhelmed. We have had to significantly expand our ICU capacity across the city and the cases continue to increase. Patients who are mechanically ventilated are often on the ventilator for weeks before being extubated.

      30 replies 25 retweets 377 likes
    8. Ashley Gamblin‏ @gamblin_ashley Apr 15
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      Replying to @dschless @elonmusk @Bob_Wachter

      I had an idea since I was reading about the ventilator debate. Could something similar to dialysis be used to oxygenate the blood instead of cleanse it?

      2 replies 0 retweets 1 like
    9. GrepMed‏ @grepmeded Apr 16
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      Replying to @gamblin_ashley @dschless and

      google “ECMO”

      1 reply 0 retweets 4 likes
    10. Ashley Gamblin‏ @gamblin_ashley Apr 16
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      Replying to @grepmeded @dschless and

      Is that a reasonable alternative to the ventilator?

      1 reply 0 retweets 1 like
      GrepMed‏ @grepmeded Apr 16
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      Replying to @gamblin_ashley @dschless and

      still need a ventilator on top of many other things. it’s certainly not easy and extremely resource intensive. only viable for very select patients in resource rich academic environments and will not scale well in mass casualty / pandemic scenarios.

      12:53 AM - 16 Apr 2020
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      • Obligate Carnivore 🇺🇸🌊 Taylor Nichols, MD Ashley Gamblin
      3 replies 0 retweets 3 likes
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        2. Ashley Gamblin‏ @gamblin_ashley Apr 16
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          Replying to @grepmeded @dschless and

          I think I was looking for something less resource intensive. Something that would directly increase oxygen saturation without messing with lung function. For example, the same experience one would have donating platelets but I guess that doesn’t exist.

          1 reply 0 retweets 1 like
        3. GrepMed‏ @grepmeded Apr 17
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          Replying to @gamblin_ashley @dschless and

          it’s a great thought. In practice you need gardenhose size catheters and lots work to keep the blood from clotting and other complications. need to ventilate lungs to allow recovery, prevent pneumonia etc. much much more more complex than standard hemodialysis.

          1 reply 0 retweets 0 likes
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        1. Ashley Gamblin‏ @gamblin_ashley Apr 17
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          Replying to @grepmeded @dschless and

          So has anyone realized I was speaking about innovating a current practice and less about regurgitating information

          0 replies 0 retweets 1 like
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        1. Ashley Gamblin‏ @gamblin_ashley Apr 16
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          Replying to @grepmeded @dschless and

          That’s a shame...wait. Idk if you have the time. In this particular scenario, why is ventilator needed at least for the ones not showing symptoms of ards? Just low oxygen saturation. Simplicity lies in both sides of complexity. I just feel there is a solution

          0 replies 0 retweets 1 like
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