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[COVID-19] CPAP use for Coronavirus mitigation & severe pneumonia
RE: CPAP use for Coronavirus mitigation & severe pneumonia
One other observation in all this: countries like Japan, Singapore, Hong Kong, South Korea, all had SARS-COV-2 well before the US started ticking up cases.  Yet, these Asian countries stopped or dramatically slowed the spread.  Besides a fast response and quarantine of the affected regions, another thing Asian countries have that most western countries don't is 1) a healthy supply of masks; 2) the innate ability to use them in public without stigma. 

I wonder what would happen if we all had an adequate supply of masks and the desire to wear them as we go about our normal business.   I haven't seen anything like this written up in any of the journals, but masks must be playing a measurable part in reducing R0.
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RE: CPAP use for Coronavirus mitigation & severe pneumonia
I bought a supply of N95 masks several years back after I got sick flying somewhere for Christmas.  The illness ruined my Christmas vacation and I vowed to wear the mask on every flight thereafter.  

I did it for 3 flights and then stopped, primarily due to embarassment.  Never again.  Never.  You can laugh at me all you want.

I wear one every time I go out now.  Once this is over, I may continue to do it during flu season.
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RE: CPAP use for Coronavirus mitigation & severe pneumonia
(03-20-2020, 08:47 PM)SuperSleeper Wrote:
(03-20-2020, 08:40 PM)Reznik Wrote: Well, if CPAP won't help when there's fluid, how would a ventilator help?  Neither actively remove fluids.


Bingo.  Both CPAP use and ventilator use needs to be supplemented with methods to help remove fluid in the lungs.  We're not talking about using CPAP alone in this thread.  We need a complete protocol for emergency use only, and that protocol would likely include a variety of pneumonia-fighting tools, including possible CPAP usage.

Coffee

There is already a protocol that's used in the ICU's, I posted about it on page 9. I dont think 'brainstorming' from regular folk is gonna be any better then years of research by 'non-regular' folks.
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RE: CPAP use for Coronavirus mitigation & severe pneumonia
Hi
I've been reading through this long thread and think it would be good before looking at this stuff to understand a bit more about COVID-19, how it's acting on the lungs and
about dealing with the pneumonia that it creates, which is different in characteristic than that of a 'normal' pneumonia.

I'd suggest if you haven't checked this out already the YouTube videos put on by Med Cram.
They have a series of vids on COVID-19 that come out most every day but more importantly they have videos that
go over pneumonia, ventilators and all the parameters, what they are and how it all works. All the videos are designed to teach
medical information to people who have an interest or background but are not necessarily medical professionals. They do have some
videos that provide CE credits too.
anyway.. here's the link. The videos are on YouTube so you can just search there too.
I found the COVID-19 video that talks about pneumonia very good. These videos are created by an ER Doctor in Los Angeles.

https://www.MedCram.com

Also, this virus reportedly colonizes in the nasal passages before 'leaking' down into the lungs. If that's the case, nasal flush with Neti pot and hot saline is probably a good thing to do, especially after being in areas frequented by others.

I have a respirator mask (AO Safety) and that takes two MSA type threaded filters. I've got R53e filters which are a combo filter that has P100 rating. I'm thinking I'll get some clip covers and thin n95 filters to put over the top to protect the P100 from getting clogged. They don't last long if you get into any kind of dust.
Unfortunately, my GF and I cannot find even a N95 disposable mask for her, or my 90 year old father. Those masks do help protect the wearer from others if well fitted and you are careful when putting them on and taking them off not to contaminate your face.
FWIW, as times are tough, if you have a mask.. you can disinfect with STEAM. It'll kill all the virus, and if you go easy won't distroy the mask right away.
Nothing left in the stores .. they show stock at many places then are not available when you go to place the order.
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RE: CPAP use for Coronavirus mitigation & severe pneumonia
Western nations are going to get hit so much harder because of the stigma to wearing masks.

Wearing a mask is not to prevent catching the disease, but primarily to prevent spreading the disease.

Granted, there is a shortage of masks, but even if there was not, I’m not sure people have the mindset to wear one to protect someone else.

John
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RE: CPAP use for Coronavirus mitigation & severe pneumonia
There are things to do on the diet as well. The Corona virus attacks cells in the lungs in a certain way.

This might explain some.

https://threadreaderapp.com/thread/12389...48960.html
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RE: CPAP use for Coronavirus mitigation & severe pneumonia
I use a DreamStation ASV machine and have used a System One 960 ASV machine.
If anyone needs help in understanding the interaction between parameters on either of these machine, I can help.

The parameter settings are very different from those on ResMed ASV machines.

As usual, please keep your apnea physician informed if you intend to make changes.
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RE: CPAP use for Coronavirus mitigation & severe pneumonia
Hospitals need masks more than we as individuals largely inside do. If they get sick and can no longer work, that's one less people treating the sick and only adds to the collapse of the hospital itself. Not a situation you want to be in if you end up getting sick yourself and need medical attention. Setting up, monitoring and adjusting a vent is something that even most physicians can't do well. There aren't enough respiratory therapists to go around. If you can, stay home and do your part.
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RE: CPAP use for Coronavirus mitigation & severe pneumonia
Hello. My apologies if I’m asking something previously discussed. 
My work involves the daily driving of hospital ventilators and I’ve had some education on the ventilation requirements of SARS a couple of years back. 
Is this thread looking more toward patients who don’t given get in through the hospital doors or those that get assessed, provisionally treated and then turned away based on “ventilator triage”?

The reason I ask is regarding the airway management side of utilizing an apnea board style machine. Given the potential multi thousands of patients requiring ventilatory support outside of ICU the questions for me are:
- can an advanced airway such as ET tube or tracheostomy (inc makeshift trachy) be utilized with our machines, having the constant nursing care being given by family members at home?
- can our bipap machines be retasked/reprogrammed to provide the “on-the-fly” adjustments likely required? (Those assessments could feasibly be made via video chat with professionals)
 From memory the patients need a short inspiratory time with a long expiratory time, with low tidal volumes. I:E ratios of 1:4 or 5 sort of thing. *** i’m in no way sure of this, it’s been a while *** has this sort of thing been discussed already? 

Oxygenation is less of an issue I think, there are many ways to MacGyver supplemental O2 to a machine. There will be be far more portable sat probes out their than people requiring ventilators. Not as nice as a blood gas machine but desperate times ... 

Love the thread. A lot of health care workers would start screeching at the mention of this topic, I like to think outside the box and the scenario mentioned in post 6 is quite reasonable. 

Cheers
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RE: CPAP use for Coronavirus mitigation & severe pneumonia
(03-21-2020, 05:45 AM)70sSanO Wrote: Western nations are going to get hit so much harder because of the stigma to wearing masks.

Wearing a mask is not to prevent catching the disease, but primarily to prevent spreading the disease.

Granted, there is a shortage of masks, but even if there was not, I’m not sure people have the mindset to wear one to protect someone else.

John

What a mask also does is keep you from touching your face with your hands.  You don't need N95 to mitigate that risk significantly, either. You can hack up a vacuum cleaner bag to achieve that.
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