BLEP!
The increasingly familiar indication of a new announcement coming over the PA system. We all pause to hear where the next Code Blue is located. I'm starting to dread that BLEP! On the rare occasion it's not a Code Blue is momentary reason for rejoicing! Last night at one point there were three bleps in a 30 minute span, and we went from one straight to the next.
I paused to ask our medicine resident colleagues the other day how they are holding up. Codes have become their new normal, but 3 in 30 minutes is more than usual for us. My junior on call with me last night has a friend at Montefiore, designated COVID hospital in the city, and reports on his shift he averages a code every 15-30 minutes.... for 12 hours straight.
We admitted a kidney transplant patient the other night on call whose presentation looked like COVID, smelled like COVID, and sure enough, it was COVID. On interview in the ED, he had this look on his face like he knew something he wasn't telling us. Like he was trying to cover something up, dead set on being as brave as possible, despite being terrified. In my gut I knew this wasn't going to end well, and any other time I would have admitted him to an ICU... but this isn't any other time, and in the ED he was maintaining his saturation with minimal supplemental oxygen via nasal cannula. So he was admitted to the COVID floor. By morning, despite best wishes, he was one of those Bleps.
I keep checking stats hoping the rise in cases will slow, but it doesn't and the black bar of deaths at the top just keeps getting thicker and thicker.
Last night on call, I had set my goggles down at some point and forgotten them, only realizing when I was set to go see a new patient rule/out COVID, and they weren't sittting on top of my head for me to pull down. I felt as naked as one does when they forget to wear their watch to which they are accustomed, and paced back and forth outside the door as my junior went in without me, with his goggles and splash guard in place. I grabbed my backup goggles, and then later found my usual goggles again so walked around with two goggles on top of my head. A much better feeling than not having any, and no one said anything. It made me wonder though... is this going to stay the new normal? Even after COVID is controlled, even after we are all vaccinated?
Proning teams have also become a new normal at the hospital. You see them walking down the hallway in a group, going from ICU to ICU clad in bunny suits, turning patients one by one. Physiologically, a patient in acute respiratory distress syndrome (ARDS) like that caused by COVID is aided by being placed in prone positioning. There are rotorest beds available that will rotate a patient itself, however they are special order beds, expense and few in number. It's not possible to put all of our patients on such beds, so they are manually flipped twice a day. By the time the proning team finishes with morning rounds, it's about time to start the afternoon round of turns.
Much Love and Prayers.
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