Not sure what you mean by over-eager. Patients are only intubated and placed on mechanical ventilation when they will die otherwise. There is a step wise increase in ventilatory support in these cases, starting at a nasal cannula, then increasing to face mask, then a positive pressure (CPAP) mask, and then if they are still hypoxic or hypercarbic - intubation is the next step.
In the early days of Covid, hospitals were seeing pulse ox levels so urgently low (70s and lower) that they put many patients on vents much sooner than they normally would. The protocols were quickly changed once we realized vents harmed Covid patients more than they helped… but not before thousands died on them.
VAP (ventilator associated pneumonia) is a known morbidity of mechanical ventilation. ICU protocols are much improved these days to combat it (oral hygiene, suctioning, early extubation protocols etc).
No, but a GP can also not do those things and on top of that I've met some pretty terrible GP's :p
So maybe some classes of doctors are done...
Another thing to keep in mind: tons of people don't have access to any type of doctor at all (too expensive, too far away, queue too long, etc). Is current state of AI better or worse than no doctor at all? I don't know, but the answer is not obvious to me.
In those cases AI isn't competing with GP's, it's competing with internet searches.
A GP does a lot of hands-on work that is currently out of reach of a robot. And in addition, the interaction between the theoretical and practical parts of the job is quite complex.
No, but most doctors do at least some procedures, often a lot more of them than you might initially think. I'm an anesthesiologist; I have to think, of course, but a lot of my job is doing (just like a surgeon's). Cardiologists do cardiac catheterizations, GI doctors do endoscopy, pulmonologists do ICU procedures, radiologists do interventions, OB/GYNs do surgery and deliver babies. Even pediatricians fix simple problems like nursemaid's elbow. About the only ones who never, ever have to touch patients are pathologists, psychiatrists, nephrologists, and endocrinologists. You could make a career in neurology, outpatient general medicine, heme-onc, pure diagnostic radiology, and a few other fields with minimal physical interventions if you wanted to, but most doctors do at least some.
I am a vascular surgeon, and have many patients in the ICU constantaly. #6 confuses me - the original operating surgeon should be a constant through the patient’s stay. And while the ICU doctor might be the captain while the patient is in the ICU, the original surgeon is the general. He has complete control and should dominate the patient’s care. While the surgeon can not be bedside 24/7, they or someone from their team should “round” at least once daily on these ICU patients, talking to family, checking catheters and tubes, reviewing medicines, checking wounds.
I recently had emergency surgery for an obstructed small intestine and the surgeon was pretty much in charge of my care. I can't tell you how many times I heard "we have to talk to the surgeon before we do xxx" Members of his team saw me every morning and he came around every afternoon. This was at the West Palm Beach Medical Center in SE Florida.
Not getting the attention it deserves. CT scans with IV contrast are critical for trauma, cancer staging, emergency general surgery, orthopedics - everything. Having to ration it at all is a big deal. And IV contrast is used for more than just CT scans.
I am a vascular surgery trainee. Myself and others rely every day on IV contrast to do our jobs. We were told today the hospital has a two week supply left - and the production side could take 6 weeks to catch up. Scary stuff.
The problem the paper is addressing is fibrin micro clots, which occurs in long Covid. This also occurs in acute Covid. The treatment is similar - anti coagulation. We (doctors) knew this from the beginning (1). Chill out bubba.
I find this to be such a bizarre statement. “What causes long COVID?” has been a common question for a year and a half now. Someone publishes results indicating it might be X and treatable with Y and we get a couple of people chiming in with “yeah, we knew that already”.
You knew the solution to long COVID and just kept it quiet? The NIH was publishing guidance to give anticoagulants to hospitalized acute COVID patients but just neglected to tell people the cure to long COVID?
I’ve got no dispute that you knew to give hospitalized patients anticoagulants early on. My statement is that this is a different thing than knowing to treat long COVID with a related protocol. This study hasn’t even been published yet, has it? This is a preprint we’re discussing. Have there been a bunch of other studies showing this is a viable treatment I’m unaware of (this is certainly possible)? Or is this new data?
I am an expert in the field of clotting mechanics (US NIH funded research / vascular surgery fellow). Not sure why they chose TEG to monitor coagulation status - it does not reflect well changes from any of the drugs used in the study.
It would be interesting to see the results broken down by gender - females respond much differently to aspirin and have less of a survival benefit than males (don’t get me started, many of the initial trials in the 60’s with aspirin were done with mostly males).
Also, in my own research - we have found that aspirin “softens” clots which allows platelets to squeeze pathological clots to smaller sizes, which allows more recannalization of thrombosed vessels and thus less ischemia - would be interesting to see if that same MOA happens here.
I always take aspirin before flights to avoid DVT due to chronic venous insufficiency and ankle swelling.
Do you recommend aspirin to thin blood for flights where I am sitting with legs bent and pressure from the seat underneath the leg pressing into the skin contributing to clotting?
As an engineer the PCL seemed like foreign territory as it was in the other side of campus. Thus it was a nice place to go and think, especially in the map room, it was a magic place.
They mention in the paper that the Dark Ages power spectrum would require a 100,000 dipole antenna array, seems like we are far from that.
Full disclosure brain fart - dark side of the moon still gets sun light (duh, right?), this basic fact had me scratching my head with regards to power source for an embarrassing amount of time.
One of two components of phase 1 implementation of the SKA[1], the SKA1-LOW in Australia, will host around 130,000 dipole antennas[2] when finished with construction starting soon.
