回复 27楼Stromboli的帖子 6,211 cases in New York City. Last night was insane; high volume and high acuity. Sick patients lie on stretchers hooked up to cardiac monitors that beep endlessly throughout the night. At one point I just stood at the nursing station and looked around. I guess this is what the pandemic will look like. There were at least 80 positive coronavirus virus patients in all 4 bays that required admission. Their age ranged from 20-90s, but each age group was represented equally. I’ve never seen so many people with pneumonias with rapid progressions. I try to discharge the younger patients with pneumonias, but when I walked them and check vital signs, their oxygen drops down to 85% and heartrate increases to the 140s. They are so fragile. A few of these patients were otherwise healthy, yet still stricken with pneumonia. A lot of patients had to be intubated for respiratory distress – they crash so quickly. I’m really happy with the way leadership has responded to the crisis. Last night they deployed an anesthesia intubation team to help us with the vast amount of people being intubated and placed on ventilators. I intubated the prior two nights, so it was great to have others help, because aside from coronavirus patients, we still manage other emergencies such as strokes, brain bleeds, seizures, heart attacks, appendicitis, GI bleeds etc. There are still a lot of people that come to the emergency room and want coronavirus testing, but we cannot test everyone, because there are not a lot tests. The coronavirus test is limited for patients being admitted because patients have to be cohorted with patients that have or don’t have coronavirus. Our main criteria for admission are shortness of breath and hypoxia, which have to be monitored closely. What is shortness of breath? Imagine running full speed on a treadmill at an incline of 8 then stopping immediately and trying to speak to someone. That is what respiratory distress from coronavirus does to you. Patients cannot breathe at a rate of 40 times per minute for too long before they tire out. Young patients usually do well on supplemental oxygen, but a portion of them desaturate on the floor and ultimately end up intubated. I was fortunate to spend the night with our ED director Dr. Betty Chang, and residents Taylor Walsh and Marc Tarsillo (pictured below). Till next time. #CleavonMDjournal
纽约订阅短信692-692每天会收到几条消息，今天早上的是 Notify NYC: If you have mild COVID-19 symptoms, stay home & isolate. Only go to the Emergency Dept if you are severely ill. Protect yourself & others.
纽约订阅短信692-692每天会收到几条消息，今天早上的是 Notify NYC: If you have mild COVID-19 symptoms, stay home & isolate. Only go to the Emergency Dept if you are severely ill. Protect yourself & others.
说一下我身边人的经历吧，坐标也是纽约市。老公的现同事一周前跑去跟佛罗里达的前同事玩儿，回来两天后得知佛罗里达的前同事确诊了新冠。这个现同事和他老婆得知消息后就约到了drive through test并测了，老婆是阴性，同事本人还没出结果。我当时还想看来纽约还真是test aggressively。 当然了这只是我身边的一个例子。还有我老公的一个前同事的老板确诊了自己也开始有症状，但那人因为是轻症就没想要去测。
那些说我制造恐慌的，我只是以我今天早上打的电话给大家如实汇报，大数据我是不知道，但就我今天的经验，发烧，胸闷，干咳，接触史，基础病史都有了，一句话，重症觉得自己坚持不下去的，电话建议想测去Ed急症室，给不给测他们管不到，但是去急诊室有个很大的弊端，就是如果你只是其他的病毒感染，很有可能感染到covid 19.所以不到万不得已，急症室是last option。
大部分发烧，肌肉疼，呼吸急促，接触史，基础病都算上了，都不给测，一句话，如果你觉得是快死了，打911。。。。。。
最重要的指标是看多少需要住院 需要住院的都是重症
楼主你是纽约市还是纽约上州阿？这个还是挺不一样的
纽约现在的上升模式，并没有算上很多想测没的测的人但又有症状的。
所以这个病现在在纽约，只能从在家发现症状，坚持到快死时打911，直接进ICU? 就这两个阶段？WTF
那上升的都是测的什么人？
纽约昨天3/23，一万多测试 negative，五千多测试 positive。难道这一万多阴性都是重症？？？
不要制造恐慌！
那建好了javis方舱，有多少医生护士资源可以派过去？现在都已经人手不够了
原来是给测的，只要符合他们的check sheet，电话里面有医生给order,然后去指定的地方测，现在统一打过去都说我们没有测试的了
该怎么联系啊
纽约总共就3000多住院的。
能不能发取样kit让病人自己取样啊？不就是捅捅鼻孔喉咙的事情吗。
病人根本不懂得怎么取样，棉签要茶很深很深的。取样不准，测试就不准
没那么容易，要捅的很深很深
应该是人力物力都不够，测试也要人操作的，即使试剂盒够，人员和设备也未必够。现在感染人数井喷，只好只测更有可能是阳性且急需救治的重症。
而且没病的可能也染病了。测试是多难的事情，搞不懂。
欧美防疫最愚蠢的就在于不把精力花在检测， 追踪隔离感染者上。 不检测轻症和密切接触者， community spread根本无法阻挡， 就依靠松散无比的social distancing? 自由散漫了几百年的美国人会乖乖待在家里？ 不把感染的基数降下去， 医院准备再多呼吸机都不够用。 美国就是朝意大利， 西班牙同一个方向奔去了。 在检测人数这么少的情况下， 纽约阳性病例还在飞速增长。 加州一样的政测， 只测住院病人。
那是什么？至少给测一下，很多应该不是，自己在家养病，总比疑神疑鬼的挤爆er好。
韩国怎么做到测试能力这么强的？也没有测试盒或人手不够的问题。
那签子的长度有时10几厘米， 自己根本做不了
自己根本做不了
Seattle Flu Study这种取样的kit能不能推广一下？
https://scanpublichealth.org/
人人都可以自己取样的，就算是结果不能用临床诊断，只能做“研究”用，也是好的
看电视，他们都带那种象太空服的头罩，应该是不用每次都换的
天哪，那得有多少轻症
CO觉得美国处理的太TNND的不给力了。
原来看武汉的悲剧，有些已经在伟大的美国重演。太魔幻了。这些本来是可以避免的。