Medicius

Intro

Pandemology

Truths

Pandemic Hygiene

Resources

For Clinicians 

There are thousands of COVID-19 pages already. Why another one? In a nutshell because this is an all hands on deck task, and we feel we have something worthwhile to say to our patients and our colleagues.

This site recognizes the primacy of local public health authorities, clinicians and leaders. Also the expertise reflected in the links on the patient site and the clinician resources linked to at the bottom of this page.

Our goals:

* Provide lucid, panic free education for patients in English & français.
* Promote strategic actions by patients, clinicians, and health systems.
* Champion tactical policies that enhance knowledge and care.
* Summarize the KEY articles that we feel drive practice.
* Provide educational tools & roadmaps for repurposed clinicians.
* Promote pragmatic and efficient working tools.
* Collect and share clinical pearls.

Medicius

Lexicon

Literature

Pandemology

Ventilation

EOL … en route

Covid Academy

Home

If you are new to this site,

  1. Read the comments on the public page (opening  and reading all the tabs in the language of your choice)
  2. Read this page, then
  3. Go to COVID Academy and follow the instructions
  4. Therafter browse the link in the top right menu of this page as are added or as they become active
If you find something horribly upsetting of just wrong on this or any other part of the site, reach out to me through the contact page of www.Saineville.com

 

Pandemologist Manifesto

The only emergency is the protocol!

#1

Prevention trumps Treatment!

#2

The goal of the moment is to save and comfort the patient ...

#3

... the goal of a career is to save and comfort a generation!

#4

One of these goals is more important - multitask strategically!

#5

Unproven heroic treatment diverts resources and costs lives.

#6

Strategies and tactics change rapidly - Practice Adaptability!

#7

Good communication is critical but difficult. Seek to improve yours constantly.

#8

Make acknowledgement and thankfulness your habit.

#9

TRUTHS

  • COVID-19 is a bad thing.
  • COVID-19 or something worse was inevitable.
    In theory we could have prevented or delayed this event, but not easily, and it’s water over the dam.
  • COVID-19 or something worse will happen again!
    We need to learn as much as we can about this disease, about preparedness, about managing health care systems, about collaboration, and about humanity.
  • There is a silver lining of COVID-19 (there is always is a silver lining).
    We will sacrifice a lot for this virus. And learn a lot …… if we pay attention.
  • There is no cure or known effective medicines for the treatment of COVID-19 (as of April 1, 2020).
    The only effective prevention is education and promotion of what I call “Pandemic Hygiene” (see below).
  • Wherever possible, patients and health care workers should be treated within randomized control trials (RCTs).
    This is the fastest way to discover what works and what doesn’t. We dont have the time or the resources for undisciplined clinical choice. Don’t mistake random care for randomized care.
  • There is a place for compassionate non-evidence based care.
    It will be difficult to resist throwing heroic and unproven treatments at young previously healthy patients who are crashing.We do this all the time in critical care medicine, often invoking noble motives “We shall leave no stone unturned in the care of the patient”, or justifications, “We have nothing to loose, the patient will otherwise die”. In the context of a pandemic those arguments carry less weight. You have a lot to lose! Namely resources like ventilators, medications, PPE, and human resources which are very limited, and which are put at risk by the act of providing care. Heroic resources applied to an unsaveable patient cannot be taken back, and in resource challenged settings, will reduce the quality of care and the outcomes of all patients.This is the ugly and unpalatable truth of disaster medicine. One of the first things clinicians need to learn is to recognize a sick and potentially unstable patient. One of the first things you need to learn in disaster medicine is to recognize an unsaveable patient.The reality of resource limits hits hard and fast, and it becomes rapidly clear that rigour and evidence based practice is the most compassionate care. This is where physicians learn to make very hard choices, and at that point compassion, which is heart driven not evidence driven, is about the only tool you have. In the end this is what will get us through the long days to come and the longer nights to follow.

Pandemic Hygeine – 10 Rules

Wash your hands regularly with soap and water or an alcohol based sanitizer.

#1

Try to capture your cough or sneeze by wearing a mask, or with your hands or tissue.

#2

Wash again after coughing, sneezing, touching your nose, mouth or eyes, or after contact with a person or COVID-19 infected surface.

#3

Practice not touching your face.

#4

Limit high contact social gestures such as handshaking, high fives, fist bumps, hugs and kisses.

#5

Avoid groups and keep a distance of 2 meters from non household contacts or wear protective equipment (a mask, eyewear, etc.)

#6

Limit your contact with the public if you have been in contact with COVID-19 patients, or if you have travelled to high risk areas

#7

Call your local health services if you have fever or new respiratory symptoms to see if you can or should be tested for COVID-19. Enquire whether you should isolate yourself at home, or be evaluated by a clinician.

#8

If you are not at high risk (young, non smoker, no medical problems), volunteer to help with essential chores for high risk people in your community.

#9

Stay in tune with the directions of local public health leaders. They can provide more specific actions as things evolve in your area.

#10

All linked content on this site is open access. Many thanks to the researchers, clinicians and publishers for putting patients first.

Classics

BLOGS etc.

Twitter

@cuttingEDjgh
JGH Twitter feed

Talks, Workshops, Posts, etc.

JGH COVID-19 ER Workshop

A protocol for “self proning” FYI

EBM:OH-Chlor

EBM:Ig tests & False +s

McGill: ICU Journey

All linked content on this site is open access. Many thanks to the researchers, clinicians and publishers for putting patients first.