AI March 2020 Chat Thread

The Something Awful Forums > Discussion > Automotive Insanity > AI March 2020 Chat Thread

tetrapyloctomy: Feb 18, 2003; Okay -- you talk WAY too fast.; Nap Ghost

Beach Bum posted:

First ever dose of Dilaudid... how do people get high on this poo poo? I do NOT like it.

I had a similar experience. I was not a fan of the dissociation involved.

Sucks you have appendicitis, but my cold inner statistician replies that it's so much better for you to get it out when you're relatively young and healthy, as opposed to get appendicitis in your later years when the diagnosis is much more likely to be delayed and recovery is much more likely to be complicated. You should be back up on your feet soon.

# ¿ Mar 8, 2020 11:00

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# ¿ Apr 27, 2024 19:43

tetrapyloctomy: Feb 18, 2003; Okay -- you talk WAY too fast.; Nap Ghost

Yeah, it might be too late to flatten the curve. The US hosed up early and may very well end up like Italy, with more aggressive measures needed that still work less effectively.

# ¿ Mar 12, 2020 02:52

tetrapyloctomy: Feb 18, 2003; Okay -- you talk WAY too fast.; Nap Ghost

I'm part of the Facebook group that provided the crowdsourced recommendations to Jared Kushner vie his brother's father in law. There are so many people in there salivating over the notion of suspending EMTALA that it's seriously disturbing.

# ¿ Mar 13, 2020 19:23

tetrapyloctomy: Feb 18, 2003; Okay -- you talk WAY too fast.; Nap Ghost

Krakkles posted:

I�m pretty sure I�m going to regret asking this, but ... wtf, why?

It's basically been covered, but basically what EMTALA does is ensure that everyone who seeks medical care gets at least a screening examination, regardless of ability to pay. (It also is intended to prevent dumping uninsured patients onto other facilities, and ensure stabilizing measures are undertaken prior to allowable transfers.) The rationale is that suspending EMTALA allows someone at the door to just turn people away for bullshit, as every person presenting with -- for example -- three months of wrist pain represents not only opportunity cost in terms of bed space, nursing care, and physician time, but also potentially exposes that person and all of their subsequent contacts to infectious disease.

That's all well and good, and is both rational as well as ethical from the standpoint of preventing greater harm. But in reality, suspending EMTALA would definitely lead to some facilities pre-screening for capacity to pay and kicking the uninsured out, as well as finding ways to initiate inappropriate transfers also to benefit their bottom lines.

If we see a rapid peak in severe cases, though, suspending EMTALA is not the worst we're going to see from this. The next few weeks will be critical, since two months of potential preparation time was wasted.

# ¿ Mar 14, 2020 19:59

tetrapyloctomy: Feb 18, 2003; Okay -- you talk WAY too fast.; Nap Ghost

rdb posted:

I hope to god that mystery illness that I got is Coronavirus. Just want it to be over with so I have immunity. I am 8 days in, feel ok except for a cough and a tickle in the back of my throat.

It's not certain that infection confers immunity. There have been some cases that may represent re-infection, or possibly the presence of multiple strains.

# ¿ Mar 14, 2020 21:34

tetrapyloctomy: Feb 18, 2003; Okay -- you talk WAY too fast.; Nap Ghost

rdb posted:

Your a doctor, correct?

I had that thought earlier. This isn�t the only Coronavirus that circulates through humans. Most of them just cause colds and immunity only lasts months. Is that generally true?

Yup, Emergency Medicine. There are seven coronavirus species that infect humans, and none confer lifelong immunity after infection. SARS and MERS cause some very severe disease as well, but the four common ones tend to be much milder.

# ¿ Mar 14, 2020 23:33

tetrapyloctomy: Feb 18, 2003; Okay -- you talk WAY too fast.; Nap Ghost

Rhyno posted:

Looks like a fuckload of churches are still holding service today.

Nothing of value will be lost I guess.

Yeah, because none of those people have relatives or go to stores, or coffee shops, or gas stations.

# ¿ Mar 15, 2020 13:19

tetrapyloctomy: Feb 18, 2003; Okay -- you talk WAY too fast.; Nap Ghost

I personally can't wait until ICU beds are nonexistent, ventilators all are in use, and I have a full emergency department without room for other critical illnesses because this dumb loving country took the comedy option vote in 2016.

# ¿ Mar 15, 2020 15:29

tetrapyloctomy: Feb 18, 2003; Okay -- you talk WAY too fast.; Nap Ghost

Seat Safety Switch posted:

Pff, just hook the ventilator up to an air compressor splitter. Now you got multiple people on there. Need more pressure? They make turbochargers.

The emergency physician who had to handle the crushing influx of patients from the Las Vegas did almost exactly that. (Unfortunately, this type of setup doesn't work on the type of lung injury that COVID-19 causes, but 100% an enterprising guy could develop a tree that accounted for differences in lung compliance.)

Applebees Appetizer posted:

Lol it's the US government what difference does it make who's in office we'd be in this exact same situation either way

... you realize that our biodisaster response capacity was gutted by this administration, right? Maybe you realize that response was markedly delayed by disproportionate emphasis on the economic impact as opposed to the epidemiological risk? The "LOL BOTH SIDES ARE THE SAME" response is a few years out of date.

ilkhan posted:

Testing doesn't change the number of hospital beds required, if you need a bed it's because of symptoms (respiratory) that could just as easily be from a non covid-19 flu, which is still around BTW.

Testing can help determine the asymptomatic, mildly-symptomatic, or atypically-symptomatic subgroups who need to self-quarantine rather than maintain normal contact precautions. It's not "just the flu." Data suggests a higher level of precautions -- airborne rather than droplet -- may be necessary. Influenza also does not carry the same sequelae as COVID-19, nor complications in the same proportion. For example, influenza patients whose respiratory function improves don't typically develop a rapidly-progressive cardiomyopathy that leads to fulminant heart failure and cardiac arrest, which has been noted here.

Elviscat posted:

It's been explained in this thread why it's important by an actual no-poo poo ER doctor, how brain poisoned do you have to be to ignore that?

I am actually full of a lot of poo poo, but that's partly because we're already getting crushed at work and I haven't had time to eat my regular food, let alone my fruit.

In other, and more positive news, apparently there's some recent evidence that chloroquine (an antimalarial) shows some benefit. So maybe we'll have something else in our armament other than symptomatic care and possibly remdesivir.

# ¿ Mar 15, 2020 19:19

tetrapyloctomy: Feb 18, 2003; Okay -- you talk WAY too fast.; Nap Ghost

rdb posted:

Serious question: are you seeing cases you suspect could be caused by covid19 that you are not being allowed/dont have the resources to test? Or is the �already getting crushed� just mass hysteria?

If you mean "doctors in general" by "you," then yes. If you mean "tetrapyloctomy" by "you," then ... probably.

The Door Frame posted:

I've been in self quarantine for 2 days because I've got a wicked fever and get tired walking around the house. Are you saying that gin and tonics will help?

Hey, in the early phase if you don't overdo it, it probably won't hurt. (Sadly, in order to get enough quinine in your system you'd have to overdo it.)

Seat Safety Switch posted:

South Korean universal testing is turning up a shitload of asymptomatic carriers in the 20-29 year old range.

Exactly. Here we have no idea who these folks are. Now, the poor sensitivity of the PCR -- 66% to 80% depending -- means we will still miss people, both symptomatic and asymptomatic, but it would still allow us a data-driven possibility in between "let the vast majority of cases run around continuing to infect people" and "literally quarantine everyone" if this thing truly is airborne and not droplet.

# ¿ Mar 15, 2020 20:10

tetrapyloctomy: Feb 18, 2003; Okay -- you talk WAY too fast.; Nap Ghost

sharkytm posted:

So... Plenty of food!

Until someone spreads a Facebook post saying that eating one Tide pod per day can destroy COVID-19.

... brb logging into facebook

# ¿ Mar 15, 2020 20:41

tetrapyloctomy: Feb 18, 2003; Okay -- you talk WAY too fast.; Nap Ghost

MrOnBicycle posted:

Last guidelines we received here in a Swedish ER is that it's likely droplet and our "normal" face masks should protect in most cases (not cpr, procedures in infected patients mouth.

Right now we are testing everyone with any one symtom, and they have to go through special rooms and stay there until negative tests are returned. I heard we are running out of tests soon though. So far no Corvid19 here though.

That's basically how we're operating so far, but not being able to give nebs to asthmatics in allergy season without putting on an N95 and gown is going to suck.

# ¿ Mar 16, 2020 12:24

tetrapyloctomy: Feb 18, 2003; Okay -- you talk WAY too fast.; Nap Ghost

Applebees Appetizer posted:

Funny that no one has mentioned being worried about Bernie getting the virus, that dude is in the prime age to get turbo hosed into the ground by it.

Literally all non-comedy-option candidates are of prime COVID-19-turbofucking age. (I think Tulsi is still technically in, hence the modifier.)

# ¿ Mar 18, 2020 14:55

tetrapyloctomy: Feb 18, 2003; Okay -- you talk WAY too fast.; Nap Ghost

Rhyno posted:

We're all going to die

https://www.propublica.org/article/...lHfw_uBtrn27iZo

Now imagine being a healthcare worker seeing assholes walking around wearing N95s while your director of operations is sending out e-mails that your hospital is running low.

# ¿ Mar 21, 2020 19:59

tetrapyloctomy: Feb 18, 2003; Okay -- you talk WAY too fast.; Nap Ghost

Rhyno posted:

Stay safe man.

I appreciate the sentiment, but it's pretty much literally impossible. The country had months to prepare -- ramp up testing supplies, arrange drive-in and mobile testing centers, stockpile and manufacture PPE, and protect the most vulnerable. Instead, Trump tried to pretend it was a hoax so as not to disturb his precious stock market gains, and politicians sold off stock instead of warn their constituents. So now we enact more severe emergency measures that won't work as well, and in all likelihood a lot of us die. Here's hoping the chloroquine/azithromycin combination works ... and that we can make enough of it to go around.

# ¿ Mar 21, 2020 20:20

tetrapyloctomy: Feb 18, 2003; Okay -- you talk WAY too fast.; Nap Ghost

slidebite posted:

Jesus christ that's one of the most depressing things I've ever read here.

If we don't find a way to recover from Trump's fuckups, that post will pale in comparison to the "my grandparents/parents/siblings/kids just died in their own secretions" comments we'll be seeing.

# ¿ Mar 21, 2020 20:58

tetrapyloctomy: Feb 18, 2003; Okay -- you talk WAY too fast.; Nap Ghost

Maksimus54 posted:

Episode 2, Pretty sure Carole hosed a cat. Dead certain she fed her husband to one. Check out tiger king ya'll

I really feel like I'm missing out on a cultural touchstone. My schedule hasn't changed at all over the last few weeks, unless you count scheduling in about seven hours a day wondering which of my coworkers or friends will die because the nation decided to prioritize temporary stock market stability over disaster preparedness.

# ¿ Mar 30, 2020 11:26

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# ¿ Apr 27, 2024 19:43

tetrapyloctomy: Feb 18, 2003; Okay -- you talk WAY too fast.; Nap Ghost

builds character posted:

Just think, after this is all over you have something to look forward to!

I'm mainly looking forward to seeing my parents again.

I've heard some horror stories out of NYC, and it sounds like Philadelphia is ramping up. Things are about to go crazy, it sounds like.

# ¿ Mar 30, 2020 20:24

The Something Awful Forums > Discussion > Automotive Insanity > AI March 2020 Chat Thread