Thread by @AnnaBoniface

#COVID reflections from ICU (THREAD) my experience & own views
💙 I have been blown away by the incredible human beings I’m working alongside - their compassion, ability to stay upbeat & calm doing tasks outside their comfort zone

⚙️MDT teamwork - everyone is an important cog working together. This is crucial & it’s been exceptional
🚩 Obesity, HTN & T2DM seems to be the a common trend of co-morbidities (I’m calling it the triple threat)
🌬Patients have ⬆️FiO2 requirements which fluctuate regularly

🎈Derecruitment often with repositioning = big ⬇️ SpO2 - preoxygenate & have dr nearby for vent recruitment is helpful. Once repositioned often need time to settle again (can be a 15 min nervous wait!)

🛌 Proning really works! but it’s an art. Lots of careful prep & communication is 🔑- nail the Cornish Pasty technique 🥟 with the sheets
🦠 Sputum - not a lot in the early stages but > later with traches

🚶🏼Early mobilisation is essential & needs to happen ASAP
👩🏻‍🦽ITUAW requires a long rehab journey - specialised services for BOTH #covid & non covid ICU pt’s needs to be established & appropriate follow up long are they are discharged from the acute setting

😷 Many issues will include breathlessness, exercise ⬇️ sats, BPD, atrophy, fatigue, loss of ROM, anxiety, PTSD, cognitive impairments, shoulder subluxation, ⬇️ ex tol, anxiety etc,etc,etc! These are complex issues & can result in long term disability & ⬇️ QoL

👍🏼 it’s exciting to see lots of ideas/discussion on looking after this cohort of pt’s, but I hope ALL critical care patients will be considered in this

🌈 patients are rehabbing, weaning off vents & being discharged with their #rehablegend badges 💙 there is lots of positivity!

👌🏼 Staff are being well looked after - peer support, wellbeing locations, generous donations & psychological help is all available (Thank You!)

*appropriate follow up long term after they are discharged from the acute setting #whycantyouedittweets