Re: ECMO - Will We Have Sufficient Capacity for the Fall/Winter Flu Season?

Sorry, hon. I didn't mean to keep you up all night.

I've just scoured the print edition of this paper and the item didn't appear. I was just so coked by this idiocy that I could hardly wait to bang out a letter to the editor asking just those questions. I've already given a heads-up to my union. Did we learn nothing from SARS?

This Bonnie person you mentioned... is that Bonnie Rogers who sat on the OH&S committee examining PPE requirements? *Going into defensive mode* She isn't a Canadian... http://www8.nationalacademies.org/cp...aspx?key=49116

Re: ECMO - Will We Have Sufficient Capacity for the Fall/Winter Flu Season?

Originally Posted by janfrn

Sorry, hon. I didn't mean to keep you up all night.

I've just scoured the print edition of this paper and the item didn't appear. I was just so coked by this idiocy that I could hardly wait to bang out a letter to the editor asking just those questions. I've already given a heads-up to my union. Did we learn nothing from SARS?

This Bonnie person you mentioned... is that Bonnie Rogers who sat on the OH&S committee examining PPE requirements? *Going into defensive mode* She isn't a Canadian... http://www8.nationalacademies.org/cp...aspx?key=49116

I am very sorry about that, janfrn. I probably missed her credentials being announced. It was a sensory overloading experience to listen to two days of testimony and opinions. I got it into my head that she was Canadian for some reason, perhaps because she mentioned colleagues felled by SARS. But, yes, she's the one. I see now that she is in the US.

When I heard her say, matter of factly that the nurses were going to be infected in the community anyway, I wanted to choke her. Come on, Bonnie! Is this any reason to deny them the better protecting mask on the job where they will be in direct contact with confirmed cases? What study did she do or read proving the surgical mask is just as efficacious as the N95?

The Australians at the meeting were openly skeptical of the downplaying of severity of this pandemic. One of them, a Dr McIntyre did two studies on masks that were very interesting, but only her second study, not yet published was directly relevant to HCW using masks in the hospital setting. She said flat out that the surgical masks were not efficacious based on her research comparing both in 24 hospitals in Beijing, China last year. Will the IOM ignore the results of that study, and go with the opinions of experts like Bonnie? Probably so.

Where is your research, Bonnie?

OK, I am calming down, and getting ready for my computer class which will take my mind off of this no win situation...

Re: ECMO - Will We Have Sufficient Capacity for the Fall/Winter Flu Season?

No worries Indigo. I just sometimes feel that Canada and Canadians are vilified when we don't deserve to be. Call me thin-skinned...

I just was reading my work email and we had yet another management clarification of our newly modified contact and droplet precautions (actually it was a verbatim regurg of the one we got last week and the week before...) about aerosolizing procedures yadda yadda. So I replied and asked about my being able to smell soap through my N95, and the lax attention to the CDC recommendations for fit testing. Got an instant reply, "I'm out of the office until September 1. If this is urgent contact the supervisor on call..." (Guess that means I'm not going to get my scheduling problems ironed out either. Sigh.)

Re: ECMO - Will We Have Sufficient Capacity for the Fall/Winter Flu Season?

http://www.bloomberg.com/apps/news?p...d=a9vKlznnyeQ4

Originally Posted by www.bloomberg.com

Last weekend, a quarter of Western Australia’s 105 adult intensive care beds were occupied by swine flu patients who needed ventilators to breathe, according to Towler.

While fewer than 0.5 percent of swine flu sufferers may need hospitalization, those who do can remain in intensive care for up to three weeks, occupying a bed that could be used for 15 heart bypass patients. Christchurch Hospital, the biggest on New Zealand’s South Island, postponed non-emergency procedures requiring an ICU stay such as heart bypass as flu patients -- three-quarters needing mechanical ventilation -- filled up the 12-bed unit and nine other hastily created intensive-care beds, according to Shaw.

What’s more, a 10th of those critically ill patients needed their blood pumped through an artificial lung, a procedure known as extracorporeal membrane oxygenation, or ECMO, that only one hospital in New Zealand offers.

“I’ve seen nothing like this,” said John Beca, head of pediatric intensive care at New Zealand’s national children’s hospital in Auckland. Five of Beca’s six ECMO units have been used simultaneously this winter. He’s ordering three more.

Maquet Cardiopulmonary AG, a subsidiary of Sweden’s Getinge AB, has received a 50 percent jump in orders for the life- support system in Australia, Clinical Director Juergen Boehm said. The German company is doubling production of the units, which cost as much as 60,000 euros ($85,000) apiece, and plans to increase its inventory of tubes, artificial lungs and other disposable ECMO equipment to about 500 sets, from 100 usually.

Orders for ECMO accessories are up about 20 percent in Australia and New Zealand, said Joseph McGrath, a spokesman for Minneapolis-based Medtronic Inc., which also makes the devices.

(hat tip PFI/Monotreme)

Re: ECMO - Will We Have Sufficient Capacity for the Fall/Winter Flu Season?

This one's for you, janfrn. Now, don't you feel better about those poor physicians getting megabucks per hour? They are in the frontlines, according this guy. They are self employed after all, and they have to make a living. The nurses and other staff are salaried, so no worries, mate...

Alberta MD group defends $500 per hour to treat H1N1

http://www.dose.ca/news/story.html?id=1912592
(hat tip PFI/snowhound1)

Re: ECMO - Will We Have Sufficient Capacity for the Fall/Winter Flu Season?

So will those physicians also do the nursing care when the nurses stay home in droves so they won't expose there families for their paltry salary.

Hey Doc - empty my bedpan and do it now!

Re: ECMO - Will We Have Sufficient Capacity for the Fall/Winter Flu Season?

Oh it gets better. I just read this morning's paper (this is happening on my doorstep, you know) and am fuming at this statement:
"... the rates of pay are meant to compensate doctors for the risk of exposing themselves and their families to the flu virus."

Even worse is that our union is saying "we" don't care about the money, we just want some guarantees that there will be enough masks for all of us. WRONG!! I don't want to expose my liver-transplant-recipient son or my elderly parents to this potentially fatal virus any more than this legion of physicians wants to expose their families. And really, who is at greater risk? The physician who does a 2 minute physical assessment and then does the rest of his doctoring from the hallway, or the ICU nurse IN THE ROOM for 12 hours? Will they compensate me if my son gets sick and dies from H1N1 after a prolonged ICU stay? Of course not, because, as they said in California, he could have gotten it in the community! I posted a comment on the CBC's website related to this story (didn't use my name but I bet you could ID it...) and am going to see what kind of response it got from the public in just a few minutes.

Our union did make some comments about our staffing issues... you know the magically resolved nursing shortage in Alberta that disappeared because the minister of health and the CEO of Alberta Health Services said there isn't one... Right now on our business-as-usual PICU we're staffing most shifts with anywhere from 20 to 50% overtime. What the heck will we do when the unit is packed to the rafters with sick kids and we haven't been able to hire any new nurses?

Re: ECMO - Will We Have Sufficient Capacity for the Fall/Winter Flu Season?

Originally Posted by CrunchRN

So will those physicians also do the nursing care when the nurses stay home in droves so they won't expose there families for their paltry salary.

Hey Doc - empty my bedpan and do it now!

I have posted on threads where nursing were talking about layoffs. I told them that if I was an experienced nurse that wanted to make some extra money I would be signing up at a couple of agencies. Even though we are in middle of labor glut at the moment, the glut will turn on a dime into a shortage if the flu situation gets dicey in the next few months. Between nurses out sick and new nurses finding out for the first time what working short in a epidemic is like, I think a shortage will rear its head very quickly. Older nurses who have experienced a heavy flu season before will not be shocked by being told they have to take another patient from the ER, then another after that even though they have a heavier patient load than they ever carried in their life. I do believe that a certain portion of nurses will just walk. I say that because half way through the heavy flu season of 1999-2000 I gave my two weeks notice and bolted. I just went "I am to old for this" and retired for the first time. Took three years off but did eventually come back. Now well into my 60s I am really to old to take 12 patients on a med/surg unit during a pandemic. In Pennsylvania we have a "no mandation" law. During a pandemic that goes out the window because there is a clause that allows employers to mandate during an epidemic or other emergency.

Re: ECMO - Will We Have Sufficient Capacity for the Fall/Winter Flu Season?

Some think that because we are nurses, we should, and would take risks that no other profession (including doctors) would take.

It's OK to give us only the surgical masks based on no data, just the opinion of "experts".

Our regular salary is enough while docs get $500/hr for less time with patients than we put in.

Who is more exposed than we are? Our families don't matter? I know of one tech that brought home the virus to her family, but was not offered Tamiflu by the facility. Her entire famly became ill. Her toddler could not eat...Luckilly for all, they recovered. But what if they did not?

Re: ECMO - Will We Have Sufficient Capacity for the Fall/Winter Flu Season?

Maybe this will open some eyes to the value of their nurses. Probably futile hop, but you never know.....