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Inside Medicine. What Are You Seeing?

TatinGTatinG 7169 replies118 threads Senior Member
Reports from what is going on inside hospitals are very limited. The big hospitals in New York are shown on the news but I wonder what we all are seeing out there in other places. Those of you with health care workers in the family or with first hand knowledge otherwise, care to comment?

My relative who is a gastroenterologist is working only telemedicine. They have had to lay off much of their staff since routine colonoscopies and endoscopies are not being done.

In a large university hospital for which I have first hand knowledge, pregnant doctors in some specialties which don't have to do with COVID-19 treatment are being told to do telemedicine and not have in person patient contact.

Another relative who is a nurse says that the hydrochloroquine treatment is going well in her hospital in a large metro area that is slammed with cases.

I have no insight into our local hospitals because almost nothing is being reported on the news and I don't know any health care workers here personally.

Are hospitals being slammed? Are things quiet for now?
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Replies to: Inside Medicine. What Are You Seeing?

  • katliamomkatliamom 13865 replies170 threads Student Voice
    Neighbor is a hospitalist, her specialty is internal medicine. She's now being trained for ER and ICU. Her hospital is fairly quiet, only a few CV-19 cases, but they're bracing for patients to start arriving in large numbers - perhaps in a week or two.

    A good friend is a doctor at a Children's hospital here. Because large numbers of children with CV-19 aren't expected, all other hospitals will divert their juvenile patients needing care/surgery here, to make room for CV-patients in their facilities.

    In both hospitals, all non-emergency surgeries/procedures have been rescheduled. Everyone is focused on CV-19 preparation. The virus has not peaked here nor are hospitals swamped with patients, yet.
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  • thumper1thumper1 78032 replies3500 threads Senior Member
    Some hospitals in my state are getting slammed. Others not so much so. But that could change.

    All elective procedures have been ordered cancelled until further notice. This includes screening mammograms, colonoscopies (screening), and all elective surgeries.

    Dental offices are closed except for emergencies.

    Physical therapy offices are closed for in person therapy. Patients can have telepractice if that will work them.

    Doctors offices have at least reduced hours. Many places are seeing only acute issues. All that I know of are separating appointments so folks aren’t in the waiting room at the same time.

    I had a specialty appointment on March 20. The waiting room can seat about 50. I was the only one there. They quickly moved me to an examining room to wait. No one was waiting in the waiting room. Even then, all elective surgeries were not being scheduled until the beginning of June.

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  • yucca10yucca10 1410 replies40 threads Senior Member
    Colorado - just heard from a neighbor that his large hospital in Boulder county has seen very few coronavirus patients, and they have lower than usual ER traffic (as are other hospitals across the country, https://www.insidesources.com/unexpected-consequence-of-covid-19-crisis-empty-emergency-rooms/). They are experiencing PPE shortage. He thinks our governor is doing a great job.
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  • FlyMeToTheMoonFlyMeToTheMoon 3228 replies45 threads Senior Member
    Local hospitals are still keeping up. Several are continuing to do elective surgeries. Dental offices are closed as well as physical therapy. Doctors have switched to doing all appointments via telemed.
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  • 2plustrio2plustrio 305 replies5 threads Member
    I have worked in the ED/Level 1 trauma center for over 20 years. We typically were seeing 200 plus patients each day. Overall numbers are down but acuity is high. Meaning, while some of the frivolous cases are being smart and staying away, the patient who are coming in are very sick.

    PPE is an issue. The ED is now out of N95 masks and although supposedly treating them with "ultraviolet light", it doesn't help those who didn't already have one saved in their little paper bag. Many healthcare employees are testing positive here.
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  • CreeklandCreekland 6611 replies92 threads Senior Member
    Med school lad got an update that his hospital will be building a giant tent hospital and are looking for ways med school students can be used as volunteers if they want to be involved. Expectations are for using it in 2-4 weeks. He'll be volunteering if it's an option.

    I find myself hoping the social distancing and some of these new meds work so they don't end up needing the tent.

    Around here I haven't heard recently. We have an ED nurse who lives next door, but we haven't talked in person lately due to social distancing. I know they were creating their own place to live in the garage. I know the hospital they work at had the county's first death.
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  • CreeklandCreekland 6611 replies92 threads Senior Member
    Local hospitals are still keeping up. Several are continuing to do elective surgeries. Dental offices are closed as well as physical therapy. Doctors have switched to doing all appointments via telemed.

    What state are they still doing elective surgeries in? I thought all of those were cancelled due to needing the PPE for emergencies elsewhere?
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  • HImomHImom 35863 replies396 threads Senior Member
    My allergist said she will do our visit via telemedicine or we can come in, our choice. I think we will try telemedicine. Told S to see if his insurer will pay for telemedicine but not sure he’s checked. Mine WILL pay.

    My niece is podiatrist. She can only get paid for telemedicine visits if she goes to the clinic, not when she works at home. Her H is pathologist, with same rules. My lung md has offered to have phone visit with me—he’s in SF and I’m unlikely to travel anywhere in near future.

    Our cases keep climbing about 30 or so every day. We are now over 300 cases in our small state and 3 deaths. The ICUs are getting very crowded. One of the patients is a 90 year old and has been kept alive.

    My relative is very busy and stressed at Kaiser Honolulu. Many of the cases are Kaiser patients and very ill.

    Our local hospital has asked sewers to make 500 masks for their wound care unit—for patients and providers. My relative who is a urologist has had to continue seeing urgent cases and procedures, making his family stressed. My relative who is a dermatologist does telemedicine from home exclusively. Our med school cancelled it’s rotations and my relative is studying at home—hopes to graduate from med school on schedule this year.

    The ICU nurse my relative knows says the ICU at her hospital is full of COVID-19 patients and we are so far lucky that most HI patients have not needed hospitalization.
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  • romanigypsyeyesromanigypsyeyes 34203 replies770 threads Senior Member
    Things I learned from my week in L&D this week (all pertain to UMich hospital):

    -They're taking beds from places like L&D to add capacity to the ICU unit.
    -They're also taking volunteers to move from their current department to ICU & ER.
    -The sports fields are being turned into field hospitals.
    -Most COVID patients are still in Detroit hospitals, not around the state.
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  • carlson2carlson2 490 replies2 threads Member
    At my system (i’m in administration), all elective surgeries have been postponed until June. We just made our medical school building (across from our main campus) a Covid-19 Hospital and it will be a 1,000 bed Hospital when it’s ready in about two weeks.
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  • 2plustrio2plustrio 305 replies5 threads Member
    edited April 4
    @CottonTake wrote:
    The good news for her is that if there is a procedure that requires a N95, attendings are doing it themselves, no resident in the room.

    D1 said this her process also. Doing intubations are such high risk that she send everyone out of the room except for herself, one volunteer nurse who administers medications for the procedure and monitors the patient's vitals (patients being intubated are given sedatives, paralytics and pain killers to prevent them from struggling during what is a very unpleasant and painful procedure), and one volunteer RT who sets up ventilator and operates it once the patient has been intubated.

    She always asks for volunteers and never shames anyone who doesn't want to participate in the procedure. Because of the high risk of infection, she believes it's unethical to force anyone to participate.

    Besides having extra bodies in the room just increases the odds of those people becoming infection vectors and wastes PPEs.

    Same here. Anyone in the room where intubation is happening must have very high level of protective gear.

    We have a nurse stationed by the front entrance (all patients/family walking in must go through a metal detector) and are taking temps and asking exposure questions. Most visitors are turned away due to non necessity. We also have a nurse sitting by our ambulance bay again taking temps of every patient just outside of the ambulance bay doors before they enter the department. Pts oxygen levels are checked through a small opening in our otherwise bullet proof glass that triage staff sit behind.

    We have converted what was an outpatient observation unit off our ED to a respiratory care unit. All lower acuity stable patients with any possible symptoms are sent there. We are trying to keep as many rule out COVID patients as possible out of our trauma/resuscitation bay as those are the only beds without glass sliding doors.

    I worked as this was just starting and I did have PPE available. I get daily emails and updates and now they dont have N95's and are working on how to keep their staff safe. I am scheduled to work coming up but I will be checking in first to ensure they have what I need or as sad as it is, I wont go into work.
    edited April 4
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  • momofsenior1momofsenior1 9851 replies110 threads Senior Member
    I have a close friend who is a cardiac nurse in an outpatient clinic who is on standby for being called up for COVID shifts if their hospital system gets overwhelmed.

    Same with an MD friend in another state. They had a lottery system and she was pulled for Phase I.

    So far neither has been called as both states are not yet overrun with cases. We'll see what happens.

    All elective stuff cancelled here too. Emergencies only.
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  • toledotoledo 4859 replies290 threads Senior Member
    My S is a neurosurgery PA in NC. His practice is really slow. Most of his appointments are no-shows, so he started calling patients the day before to see if they were coming. He was recently fitted for an N95 mask, so I wonder if he will be moved to another area. His wife is a gastroenterology PA, and because she is pregnant, has been working from home. She couldn't figure out how to set up videoconferencing, so is only doing phone visits with the few patients that agree.

    I have no idea what is going on in my own city, but no news is good news.....I think.
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