Coronavirus thread

[Nephrology]

I wouldn't stress about it too much unless you have very bad peripheral vascular disease. Our employee health department sent me one that is basically the Walgreens version. it does display a waveform and a heart rate alongside a numerical reading.

The key to interpretation of a pulse ox is to ensure the waveform is consistent. It should look like the teeth of a saw and if you were to check your heart rate, the pulse ox heart rate and your manual heart rate should be similar. You should not be getting a reading of 40/min when you check your own pulse and it is 80/min.

I look more for a trend. If my SpO2 is initially 98 and it is down to 94 or 93 a week later that is a less good sign than if it were to stay consistent.

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the AMZN ones seem fine enough. It's not like the hospital is spending much more. Like you point out trend is probably more important than absolute value.

[Crow Hunter]

Back in March CrowHunter suggested an oximeter might not be worth it unless it was “medical grade”. Any guidance on how much one would need to spend to get useful measurements?

I would like to take this opportunity to mention that I am not a Dr. nor have I ever played one on tv or stayed in a Holiday Inn recently. So I would NOT rely on my anecdotal observations of my own situation. 😯

I can tell you that my spo2 level was potentially below 90% but I did not really take notice of the dyspnea until I almost blacked out digging a hole with a pickaxe. I still, very stupidly waited until the next day to go to the ER because I noticed labored breathing while walking across the parking lot at work even though I suspected it might be a PE the night before because of the leg swelling and not feeling "right". It was in the mid 80's by the time I was admitted iirc. That could have killed me.

I might not have waited so long if I had a way to check my sp02 level.

If you have shortness of breath, don't fuck around. My co-worker that died last night waited after he first started having dyspnea for a couple of days to get over it before he went to the ER. He was on a ventilator almost immediately.

[Sensei]

The transplant patient with donor-derived COVID died yesterday from bleeding complications associated with ECMO after more than 2 months in the ICU.

#notcosteffective

#getintubatedandyouarefucked

[Crow Hunter]

Sensei's post reminded me of another anecdote.

My wife is friends with some whose wife had a double lung transplant. She tested positive so he took her immediately to the ER. My wife got a call from her saying that she was fine and had recovered with no problems but he was in ICU and sedated after "going crazy" at the hospital. He apparently caught it from her during the car ride and somehow wound up with viral encephalitis.

This is one strange disease.

[camel]

the AMZN ones seem fine enough. It's not like the hospital is spending much more. Like you point out trend is probably more important than absolute value.

This is what my nurse brother,my doctor,and my mom in 50yrs in the medical field in varying capacities have told me regarding these.

[45dotACP]

I would like to take this opportunity to mention that I am not a Dr. nor have I ever played one on tv or stayed in a Holiday Inn recently. So I would NOT rely on my anecdotal observations of my own situation. [emoji54]

I can tell you that my spo2 level was potentially below 90% but I did not really take notice of the dyspnea until I almost blacked out digging a hole with a pickaxe. I still, very stupidly waited until the next day to go to the ER because I noticed labored breathing while walking across the parking lot at work even though I suspected it might be a PE the night before because of the leg swelling and not feeling "right". It was in the mid 80's by the time I was admitted iirc. That could have killed me.

I might not have waited so long if I had a way to check my sp02 level.

If you have shortness of breath, don't fuck around. My co-worker that died last night waited after he first started having dyspnea for a couple of days to get over it before he went to the ER. He was on a ventilator almost immediately.

Not for nothing but we've seen a lot of patients with what we've come to term "ambulatory hypoxia".

This is a very broad explanation of why and Neph can give the exact specifics (correct me if I'm wrong) but your oxygen levels (PaO2) are low while your pCO2 levels are not high enough to trigger your body to notice that something is quite off.

See your body has chemical receptors for when your carbon dioxide is high. That's why when you hold your breath, your body will freak the fuck out, but if you get carbon monoxide poisoning, you won't notice until you're dead. The CO2 doesn't go up in carbon monoxide poisoning, you just have low oxygen levels.

The lungs are really quite excellent at getting CO2 out of the blood, sometimes even when they can't quite get you enough oxygen.

Because of this, the first place you'll notice profound hypoxemia without hypercarbia (elevated CO2) is going to be the brain, and usually it's because the brain says "I don't have enough oxygen so we're going to stop everything until I do"

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[ccmdfd]

Very little to no relationship between hypoxia and dyspnea(shortness of breath).

That's why airplane decompression kills. Oxygen drops but you don't feel shortness of breath, and thus don't recognize the emergency.

Edited to add:

That's why some people recommend hypoxia as a way for execution of prisoners. No pain or discomfort.

[ccmdfd]

Deleted

[Nephrology]

The transplant patient with donor-derived COVID died yesterday from bleeding complications associated with ECMO after more than 2 months in the ICU.

#notcosteffective

#getintubatedandyouarefucked

That sucks. Not surprising though.

[ccmdfd]

That sucks. Not surprising though.

And had to be hell for both the family as well as the treatment team