RN Advice

[Cjr777]

I reached out to an old friend of mine who is an ICU RN and working on her PHD..... Below is what she sent back, its all stuff that I belive has already been said but still might help.

I mean... people are dying so it's bad. I think if we weren't quarantining we would be worse off. Young people (30-50) are getting it and needing ventilator support, a few dying. Older people definitely have higher chance of dying, but we're not completely safe. I haven't personally taken care of a covid pt yet but they're saying antimalarial drugs are working. Things I've been doing are drinking lots of water, one cup or orange juice a day, and still getting exercise-don't lay on the couch all day and let your lungs get "lazy." And do everything you can to keep your family safe. You don't want to be in there for a broken arm and get exposed to covid. Don't take any NSAIDs (aspirin, ibuprofen/Motrin, naproxen/aleve) they're saying it makes the virus worse. Take Tylenol if you need pain relief. Don't smoke if any of you do. You don't want to make your respiratory system compromised. I think another big problem is people being without cash and potentially hurting/stealing/killing people do get things sooner or later.


Sent from my LGL84VL using Tapatalk

 

[Brent S]

I reached out to an old friend of mine who is an ICU RN and working on her PHD..... Below is what she sent back, its all stuff that I belive has already been said but still might help.

I mean... people are dying so it's bad. I think if we weren't quarantining we would be worse off. Young people (30-50) are getting it and needing ventilator support, a few dying. Older people definitely have higher chance of dying, but we're not completely safe. I haven't personally taken care of a covid pt yet but they're saying antimalarial drugs are working. Things I've been doing are drinking lots of water, one cup or orange juice a day, and still getting exercise-don't lay on the couch all day and let your lungs get "lazy." And do everything you can to keep your family safe. You don't want to be in there for a broken arm and get exposed to covid. Don't take any NSAIDs (aspirin, ibuprofen/Motrin, naproxen/aleve) they're saying it makes the virus worse. Take Tylenol if you need pain relief. Don't smoke if any of you do. You don't want to make your respiratory system compromised. I think another big problem is people being without cash and potentially hurting/stealing/killing people do get things sooner or later.


Sent from my LGL84VL using Tapatalk

I’ve been reading that the pain/fever reducing products don’t seem to be bad as initially reported. I couldn’t agree more with everything else. Especially the stop smoking or vaping. This is not a bug you want with weak or damaged lungs to begin with.

 

[DrHenley]

A lot of media reports about ibuprofen and COVID-19 are flat out wrong (big surprise, eh?)

Several organizations have looked into it and found no evidence to support that. In fact it seems to have originated with a HYPOTHETICAL article about how ibuprofen MIGHT POSSIBLY cause problems.

https://www.npr.org/sections/health...ibuprofen-for-covid-19-leaves-experts-baffled

The questions about ibuprofen's safety for COVID-19 patients seem to have stemmed, in part, from a letter published in The Lancet last week hypothesizing the ways various medications could, perhaps, increase the risk of infection with the coronavirus. Research has shown that the virus attaches itself to cells in the lungs by way of an enzyme — angiotensin-converting enzyme 2 (ACE2). The Lancet commentary suggested that taking ibuprofen might increase the number of ACE2 receptors on a cell, which could make someone taking the drug more vulnerable to infection.
But just because you have more ACE2 receptors doesn't mean you're more susceptible to infection, says Rachel Graham, a virologist at the University of North Carolina Gillings School of Global Public Health. She's one of the researchers who discovered how the coronavirus binds to cells.​

 

[dirtdiva]

I reached out to an old friend of mine who is an ICU RN and working on her PHD..... Below is what she sent back, its all stuff that I belive has already been said but still might help.

I mean... people are dying so it's bad. I think if we weren't quarantining we would be worse off. Young people (30-50) are getting it and needing ventilator support, a few dying. Older people definitely have higher chance of dying, but we're not completely safe. I haven't personally taken care of a covid pt yet but they're saying antimalarial drugs are working. Things I've been doing are drinking lots of water, one cup or orange juice a day, and still getting exercise-don't lay on the couch all day and let your lungs get "lazy." And do everything you can to keep your family safe. You don't want to be in there for a broken arm and get exposed to covid. Don't take any NSAIDs (aspirin, ibuprofen/Motrin, naproxen/aleve) they're saying it makes the virus worse. Take Tylenol if you need pain relief. Don't smoke if any of you do. You don't want to make your respiratory system compromised. I think another big problem is people being without cash and potentially hurting/stealing/killing people do get things sooner or later.


Sent from my LGL84VL using Tapatalk

Thank you so much for sharing. All good sources of accurate information are so helpful.

 

[Kevin L]

I second the point about lying down when you're sick.

I have about 30 years of experience dealing with pneumonia patients (I started working in healthcare shortly after the AIDS epidemic was recognized, and pneumocystis cariini pneumonia occurred in a very high percentage of these AIDS patients).

When people lie around without moving when they have pneumonia, the lungs can fill up with fluid (this is called "pulmonary edema"), and this puts a hurtin' on the heart and cardiovascular system.

This is why it's very, very, very important that pneumonia patients and bronchitis patients spend a certian amount of time walking. These illnesses take a lot out of people, so they may need to be pushed, cajoled, or even blackmailed to get up and walk.

As to how much time to spend upright and walking . . . I'll leave that to a nurse.

A good guideline is, however, to take short walks frequently through the day, rather than one really long walk once or twice a day.

The patient may need to be closely followed by a caregiver to make sure that there are no slips and falls, which are likely in a weakened pneumonia patient.

I would advise against using welder's oxygen for pneumonia patients (or any other patient), as is suggested on some other forums, as welder's oxygen can be obtained without a perscription.

Atmospheric oxygen is 02, while welder's oxygen may contain ozone, which is 03.

It's hard for people to accept (since we all know that oxygen is neccesary for life), but ozone is very, very toxic. Even though it is a form of oxygen, ozone is more toxic than chlorine gas, sulfer dioxide, carbon monoxide, and hydrogen sulfide. In terms of toxicity (as far as concentration in tbe air goes), it can be compared to hydrogen cyanide.* I seem to remember that--according to OSHA--eight hours is the maximum for safe exposure to ozone at concentrations of one part per ten million in the air.**

In my mind, the last thing anyone with a respiratory illness needs is to be inhaling any toxic gas in any concentration.

So . . . don't use welder's oxygen on any patient.

When caring for a pneumonia patient, it is best not to let them lie flat. Having them sit up at a 45° angle in the bed (use pillows, if you have to) is called the "semi-Fowler's" position, and this will help them breathe. A semi-Fowler's position can probably be approximated by using a reclining easy chair, but a bed is better.

If there are any medical people on this forum, please correct this info if you disagree with any of my points.

--------------------------
* Ozone may be just as toxic as hydrogen cyanide, but the mechanisms by which these two toxic gasses kill you are quite different, although they both cause different forms of suffocation.

** This is from memory, so I may be wrong about this specific ratio, but I am in the right ballpark.

 

[GaRp58]

Well, were doing something right, we get out with the dog several times a day, walk up and down a small hill of about 35 meter height and go around 2 miles per day.

 

[schpier]

Critical care physician here

Agree with most points. If one has diagnosed pneumonia then it’s time to be managed by a health care provider and follow their recommendations. It is highly likely that ( in this Covid-19 time),the patient will be isolated in a hospital environment and not allowed to walk around in the general public.


Sent from my iPhone using Tapatalk

 

[Brent S]

Agreed, there is a time to go into a hospital no matter how busy or overwhelmed they are. Yesterday I was using a mower to thin out the overgrowth in the blackberry patch. I stepped into a rabbit hole with my right foot. Nothing bad, and I kept working with no pain. This morning it’s really sore. Don’t see any swelling but hurts to put weight on it. I will limit use of it and rest today as I definitely don’t want it too get any worse. I have ace bandages and crutches here as well. Think I will break out the crutches just to give it a day or two to mend. Normally I would take aspirin and keep going but out of an abundance of caution I will give it some time. Be very aware of cuts and do you best to keep them clean and not getting infected too. Any unnecessary trips to a drs office of hospital should be avoided.

 

[DrHenley]

schpier, Welcome to the Board and Howdy from Georgia!

 

[Kevin L]

Critical care physician here

Agree with most points. If one has diagnosed pneumonia then it’s time to be managed by a health care provider and follow their recommendations. It is highly likely that ( in this Covid-19 time),the patient will be isolated in a hospital environment and not allowed to walk around in the general public.


Sent from my iPhone using Tapatalk

Agree 100%. I was only bringing these points up if one is in a situation where you absolutely can't get access to medical care, and I should have specified that in my post.

Something like pneumonia is definitely not a "fix it yourself" thing, unless there are no other options.

Thank you for bringing this up.

 

[Dani]

Agreed, there is a time to go into a hospital no matter how busy or overwhelmed they are. Yesterday I was using a mower to thin out the overgrowth in the blackberry patch. I stepped into a rabbit hole with my right foot. Nothing bad, and I kept working with no pain. This morning it’s really sore. Don’t see any swelling but hurts to put weight on it. I will limit use of it and rest today as I definitely don’t want it too get any worse. I have ace bandages and crutches here as well. Think I will break out the crutches just to give it a day or two to mend. Normally I would take aspirin and keep going but out of an abundance of caution I will give it some time. Be very aware of cuts and do you best to keep them clean and not getting infected too. Any unnecessary trips to a drs office of hospital should be avoided.

Few years back I did something similar going out to bottle feed calves right after a rain in the dark. Slipped on some mud and went straight down onto my ankle. Popped back up and continued looking for the two calves. It was sore and slower me down but those babies needed fed. . . When I got up the next day for work is when I could not put any pressure on it at all. Called into work and waited for my doctors office to open. They told me I had to go to the ER. I had fractured my ankle in three places. . . Let's hope your is nothing like that. Take it easy and see how it goes. Even years later my foot can still ache and give me problems.

 

[Brent S]

Few years back I did something similar going out to bottle feed calves right after a rain in the dark. Slipped on some mud and went straight down onto my ankle. Popped back up and continued looking for the two calves. It was sore and slower me down but those babies needed fed. . . When I got up the next day for work is when I could not put any pressure on it at all. Called into work and waited for my doctors office to open. They told me I had to go to the ER. I had fractured my ankle in three places. . . Let's hope your is nothing like that. Take it easy and see how it goes. Even years later my foot can still ache and give me problems.

You’re not making me feel better right now! Lol
I have ridden motorcycles just about my whole life, and with that have had a few broken bones. I completely understand the part about feeling them for the rest of your life. When you get an injury it can heal but is never as good as it was beforehand. Just take care of yourself, especially during this event.

 

[KateMTx]

You’re not making me feel better right now! Lol
I have ridden motorcycles just about my whole life, and with that have had a few broken bones. I completely understand the part about feeling them for the rest of your life. When you get an injury it can heal but is never as good as it was beforehand. Just take care of yourself, especially during this event.

Hopefully it's just a sprain and will heal on it's own with a little rest and support. I've sprained mine a few times and it's no fun but with gentle treatment it will get better. Sometimes it takes a few weeks or months though depending on the severity.

 

[Brent S]

Hopefully it's just a sprain and will heal on it's own with a little rest and support. I've sprained mine a few times and it's no fun but with gentle treatment it will get better. Sometimes it takes a few weeks or months though depending on the severity.

Thanks, I’m not sure if weeks or months helps me feel any better but I’ve had enough injuries to feel it’s just a sprain. I had it elevated all day and wrapped it. I am able to walk very gently with no pain at least. I tried to walk the stairs normally and that was a bad move. I have to step up one step at a time with both feet. I was hoping for two days with this but it may not be that simple. Tilling the garden was my main task for the day and it was everything I could do to not go out and try it. They say patience is a virtue, but I say it’s frustrating as hell! I know going slow is smart on an injury like this but I need to get that garden planted too....

 

[KateMTx]

Thanks, I’m not sure if weeks or months helps me feel any better but I’ve had enough injuries to feel it’s just a sprain. I had it elevated all day and wrapped it. I am able to walk very gently with no pain at least. I tried to walk the stairs normally and that was a bad move. I have to step up one step at a time with both feet. I was hoping for two days with this but it may not be that simple. Tilling the garden was my main task for the day and it was everything I could do to not go out and try it. They say patience is a virtue, but I say it’s frustrating as hell! I know going slow is smart on an injury like this but I need to get that garden planted too....

This is probably bad advice so don't listen. With a sprain it's the movement of the ankle that causes most pain and further injury because the injury is to the ligaments and muscles that keep it stable. So if you can immobilize it you can generally do most things other than running. A walking boot accomplishes this purpose and lets you still be able to walk, so you can still get all your chores done (I might still be a little wary of tilling the garden, try some less intense tasks first). But I would give it a few days before trying this to let the swelling go down.

 

[Brent S]

This is probably bad advice so don't listen. With a sprain it's the movement of the ankle that causes most pain and further injury because the injury is to the ligaments and muscles that keep it stable. So if you can immobilize it you can generally do most things other than running. A walking boot accomplishes this purpose and lets you still be able to walk, so you can still get all your chores done (I might still be a little wary of tilling the garden, try some less intense tasks first). But I would give it a few days before trying this to let the swelling go down.

Luckily it’s raining today so I am forced to take it pretty easy for the day at least. I know that pushing it faster than needed isn’t wise right now. We should all do everything we can to avoid having to need any more advanced medical attention right now.

 

[DrHenley]

"Walking off" a sprain keeps the blood flowing instead of pooling and keeps it from getting as stiff.
This only works for minor sprains, not when there is major damage to the tendon, ligaments and joints. They will tell you if they are too badly injured, so listen to them. LOL.

Chinese don't believe in using ice on sprains. (my wife is Chinese) They believe it makes it worse in the long run. They only use heat. In fact they think cold anything is bad for you (iced drinks, etc.) They also believe bananas are bad for a sprain and make it worse.

I think alternating heat and cold are probably best on a sprain though.

 

[Brent S]

"Walking off" a sprain keeps the blood flowing instead of pooling and keeps it from getting as stiff.
This only works for minor sprains, not when there is major damage to the tendon, ligaments and joints. They will tell you if they are too badly injured, so listen to them. LOL.

Chinese don't believe in using ice on sprains. (my wife is Chinese) They believe it makes it worse in the long run. They only use heat. In fact they think cold anything is bad for you (iced drinks, etc.) They also believe bananas are bad for a sprain and make it worse.

I think alternating heat and cold are probably best on a sprain though.

When I was in the medical field, when the dinosaurs roamed, they recommended lying still to recover. Now so much research shows that moving speeds recovery in most cases. I am moving on it, but am listening to my body and will progress as I can. Luckily it isn’t a terrible sprain but is bad enough I’m really glad I didn’t get it on a hike out in the woods. I should be fine in a week or less I believe. My sister was messing with me about not being able to outrun the zombies now.....

 

[GaRp58]

If you sprained an ankle, it might be that the ligaments and tendons are no longer in the right place. Warm, not hot, water and baby oil. Massage the ankle in a spiral form from inside your leg and high to outside low around the ankle and towards the sole on the side away from your arch. Then massage the backside of your leg and ankle from a middle point towards an outter point always in a downward motion. Gentle enough not to hurt, but strong enough that the ligaments will be gently moved back into the right places...

 

[KateMTx]

"Walking off" a sprain keeps the blood flowing instead of pooling and keeps it from getting as stiff.
This only works for minor sprains, not when there is major damage to the tendon, ligaments and joints. They will tell you if they are too badly injured, so listen to them. LOL.

Chinese don't believe in using ice on sprains. (my wife is Chinese) They believe it makes it worse in the long run. They only use heat. In fact they think cold anything is bad for you (iced drinks, etc.) They also believe bananas are bad for a sprain and make it worse.

I think alternating heat and cold are probably best on a sprain though.

I would definitely agree with alternating ice and heat for the first few days when it's swollen.

 

[Brent S]

I always learned to use ice at first when swollen and then go to heat for soreness after. Every few years these recommendations change as we learn more. Mostly I’m just glad this wasn’t worse than it is. With two days of being wrapped and rested it’s allready less sore, so it wasn’t badly injured. It will be a couple weeks before I could outrun any zombies though... I can’t stress enough for everyone to be extra careful about injuries though. And to be really good about cleaning scrapes and such to prevent them from getting worse. Normally I would have the hot tub to help with something like this. The heater in it shorted out and was DOA. So I went on line and ordered a new heater. It came in about 5 days by fed ex and was damaged in shipping. So I ordered another one and should have it by the end of the week now. It seems like bad things can snowball into more bad things sometimes! By the time I get the tub working again I won’t need it for the ankle anymore.....

 

[Kevin L]

I should be fine in a week or less I believe. My sister was messing with me about not being able to outrun the zombies now.....

You don't have to outrun the zombies. You just have to outrun her.

 

[Brent S]

You don't have to outrun the zombies. You just have to outrun her.

That’s great, and really bad....!