Conavirus......

[sweetana3]

That is pure triage. The ethical issues it raises is who do you save? The discussion in NY was when all else failed, toss a coin. This was told on a video grand rounds discussion on what happened in NY. It was by the doctor who figured out how to use a ventilator for two carefully matched patients. Never been done before and many issues were discussed. They used informed consent.

: the sorting of and allocation of treatment to patients and especially battle and disaster victims according to a system of priorities designed to maximize the number of survivors. 2 : the sorting of patients (as in an emergency room) according to the urgency of their need for care.

The issues raised are what sorting decisions are used and who decides. Age, disability, comorbidity, race, gender, income, insurance, etc.

[Teacher Terry]

CL, you are right. If you cannot save everyone you save the most likely to make it. I totally agree.

[sweetana3]

Tradd, i am a senior and was happy to be back at my exercise class. We wear a mask unless we are actively doing the class (although we can wear one the whole time). We are well distanced and disinfect anything we touch before and after. I dont stay and socialize or we just talk to one another from 6 feet or more away. We are not in a state with huge hot spots and I stay away from activities that involve people with the exception of my class.

[Tradd]

Tradd, i am a senior and was happy to be back at my exercise class. We wear a mask unless we are actively doing the class (although we can wear one the whole time). We are well distanced and disinfect anything we touch before and after. I dont stay and socialize or we just talk to one another from 6 feet or more away. We are not in a state with huge hot spots and I stay away from activities that involve people with the exception of my class.

These folks also use the bikes, like I do. Only every other machine is in use. I'm just surprised that so many really ill looking seniors are actually going to the gym.

[Tammy]

Triage actually has a component where you don’t helo those that are certain to die. You also don’t help those that just need stitches. You help those who are in deep trouble but are probably able to be saved.

[Tybee]

Triage actually has a component where you don’t helo those that are certain to die. You also don’t help those that just need stitches. You help those who are in deep trouble but are probably able to be saved.

Yes, I understand. I did not coin the term "reverse" but that is what it has been called. I think we all understand the point about saving those who are most likely to make it, which is certainly like battle triage, of course.

So I get it, but if you are over 60, as I am, and have co-existing conditions, as I do, it certainly changes what I a likely to encounter at an ER. I think that is what folks who called it "reverse triage" intended, but again, I understand completely what you are all saying and have no comment on whether it is right or wrong or ethical or anything else.

[Tammy]

With simply not enough beds and ventilators to go around, our only choice is to triage. I often wonder what else people would have us do? We can’t pull ventilators out of thin air. We are doing the best with what we have. All broader discussions of ethics just becomes a moot point when you’re on the front lines.

In other news I was tested for Covid yesterday because I have a few symptoms. It feels pretty much like an upper respiratory infection that I’ve had many times before, but following our hospital guidelines I got tested and I’m home until the test results and my symptoms clear.

The one big take away from the last four months for me, is the acceptance of uncertainty and the acceptance that we all die sometime.

Arizona is now the epicenter of this thing globally, and I live in our largest city, Phoenix, and I work at our large public safety net hospital. So I’m at the center of the center. Other than I don’t work In ICUs, as I work in behavioral health. However we have two units full of Covid positive behavioral health patients and I’m the manager of one of them.

[Tybee]

With simply not enough beds and ventilators to go around, our only choice is to triage. I often wonder what else people would have us do? We can’t pull ventilators out of thin air. We are doing the best with what we have. All broader discussions of ethics just becomes a moot point when you’re on the front lines.

As I said, I was not discussing ethics or morality, just discussing the terms and concepts that were being explored in the discussion. I do think that is a very legitimate undertaking, to understand what people are saying and to shine light on what is happening.

Hoping your test comes back fine, and that you feel better soon!

[early morning]

To Tammy and everyone else involved in first response, elder, medical and psychiatric care in today's world - THANK YOU, and take care of yourselves as best you can.

[iris lilies]

Tammy, wishing you well.
Tybee, I see nothing wrong in talking about the harsh realities of medical care resources. I am on record for advocating for death panels in the event we go fullbore public health care.

I don’t understand people who Wring their hands and pretend that there are unlimited resources for everything. There are not. But I’m also not sure sure that human lives over the economy and the general welfare of the population is the way we should be looking at this whole deal.

But as usual I’m glad I’m not in charge of much of anything anymore. All the gubmnt officials are earning their salaries these days.