Barry Hunt Profile picture
Nov 5 โ€ข 30 tweets โ€ข 10 min read โ€ข Read on X
Well that's been a long day

4 am to 2 am

So far ๐Ÿ˜Š

But all good

After a 4h operation I was delivered to lucky PACU Bed #13

And the love of my life
โค๏ธโค๏ธโค๏ธ Image
I was supported with friendly, attentive, experienced staff

Tim Hortons

Cold compression therapy

Great ventilation

And more love โค๏ธ Image
Until it was finally time to say goodbye to my newfound friends

When a bed finally opened up a few hours later

Which initiated a major project for Suzi, transporting a lot of 'stuff' from PACU and from our truck in the parking garage up to our room Image
Image
Image
I say "our room" because Humber River Hospital was one of the first of a new generation of hospitals in Canada built to CSAZ8000:11 - single patient rooms, complete with 3-piece ensuite, & accommodations for family caregivers including a pull-out bed

๐Ÿ‘๐Ÿ‘๐Ÿ‘

.@CSAGroup
Cold compression therapy is NB to fast, effective wound healing

Sadly the compressor on my machine kept kicking out when compressing so I could only run it in ice water circulation mode

Luckily I had packed a soft cast that could be added to provide compression Image
Image
There are many things that can be done to improve the safety of a patient room

Some are very simple

And free

Like closing the door

Or adding a few signs to your door Image
Image
Some are new & novel & expensive

Like FarUV that safely & continuously disinfects air & surfaces

In the patient room

And in the bathroom

Where likely half of disease transmission originates

Sadly, FarUV is not yet commercially available in Canada

๐Ÿ˜ข๐Ÿ˜ข๐Ÿ˜ข Image
Image
Some are just different than what we've become accustomed to

Like going maskless in Hospitals

Handing out FREE .@CanadamasQ respirator masks was popular when I was here in 2023

Let's see how they're received in 2025

Earloop, easy-breathing, CSA-Certified, Made in ๐Ÿ‡จ๐Ÿ‡ฆ

๐Ÿ‘๐Ÿ‘๐Ÿ‘ Image
Image
We might have to take up a collection to help Humber buy new overbed tables

Arguably the most important surface in Hospitals

Shared by patients, visitors, staff

For food, personal devices, wound dressings, IV kits, etc

These are now 10 years old Image
Today you can get self-disinfecting Overbed Tables

Made with an aesthetically pleasing, easy-clean, solid-surface infused w Copper ions

.@EOSSurfaces



While I have an EOS copper overbed table at home, I didn't bring it in with meeoscu.com/the-product
So I packed a residual sanitizing surface treatment (Zoono) & an electrolyzed water disinfectant (aka hypochlorous acid) - safe, sporicidal, virucidal, more effective & faster acting than bleach, non-toxic, non-corrosive, & penetrates & disrupts dry surface biofilm.

๐Ÿ‘๐Ÿ‘๐Ÿ‘ Image
Image
I packed dark chocolate almonds & strawberries

(Made in Ontario)

Because why not?

Life is worth living

๐Ÿ˜Š๐Ÿ˜Š๐Ÿ˜Š

picardpeanuts.comImage
They are a marginally healthy-ish treat

Great to serve to guests

Like my daughter, Andrea

โค๏ธโค๏ธโค๏ธ Image
Optimizing a patient room for safety, convenience & joy

Can be tiring

And it was

For both Suzi & I Image
Image
Image
But well worth it

Cheers ๐Ÿฅ‚ Image
Image
23 hours later...

Fresh ice in machine

Hydromorphone top up

Time for sleep Image
Sigh ๐Ÿ˜”

Right after we correct this alarm Image
Image
OK, listening to this truck-backing-up-in-your-ear alarm gets annoying after 30 minutes at 3 am

When all you want to do is finally sleep

Sigh ๐Ÿ˜”
Only to be woken up 10 minutes after going to sleep to have vital signs taken

BP, temp, O2 sat

Sigh ๐Ÿซค
And then being refused IV hydromorphone because oral hydromorphone was already given

Even though that was the anesthesiologist's plan

Prescribed, documented in the pain management report, & followed by the highly skilled & experienced PACU staff
But not at 4 am

At pain level 8

Because "that was how I was taught"

Kudos to the nurse for following her teaching

Shame on the teacher / school for misinforming her
The only thing harder than learning something the first time

Is unlearning misinformation

And learning something new

In a mammoth top down industry like healthcare

Where critical thinking & empowerment of front line staff have been driven out of the system

๐Ÿ˜ข๐Ÿ˜ข๐Ÿ˜ข
I don't know how to fix the system

Yet

But fix it we must

This is just one small example

They add up

Eventually they can allow a global pandemic of misinformation & patient harm & disease transmission to run unchecked

๐Ÿ˜ข๐Ÿ˜ข๐Ÿ˜ข
4:40 am - a very pleasant RRT came in at my nurse's request to add an oxygen tee to my CPAP circuit

Despite being fatigued from only 10 minutes sleep in 24 hours, my leg hurts too much to sleep now anyway so the distraction was nice

And it was a learning experience
๐Ÿ˜Š
He taught me:

- SpO2 reading drops if hand is elevated above heart level

- I'm designated a category 1 - 94 to 96% on room air when resting / shallow breathing

- a category 2 is 88 to 92%

- Protocol for category 1 is to titrate to 96% O2 saturation when sleeping w CPAP
Sigh ๐Ÿ˜”

6 am

Still no sleep

At least now I qualify to get another hit of hydromorphone

Oh, Morpheus, take me away...

Please ๐Ÿ˜Š Image
6:15 to 6:35 am - disturbance to add IV antibiotic drip & to open compression cast to view leg
6:40 to 6:45 am - disturbance to have bloodwork taken

Phlebotomist wore an N95!

๐Ÿ‘๐Ÿ‘๐Ÿ‘

(My nurse wears a chin strap ๐Ÿ˜ข)
Shift change is underway

The daily morning flurry of hospital activity has begun anew

That 10 minutes of sleep I enjoyed last nite around the 23h mark will be it for awhile
New learning: it helps me relate to the bizarre system of forced sleep deprivation known as medical on call

And all that entails

Hmm ๐Ÿค”

โ€ข โ€ข โ€ข

Missing some Tweet in this thread? You can try to force a refresh
ใ€€

Keep Current with Barry Hunt

Barry Hunt Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!

PDF

Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @BarryHunt008

Oct 14
Another junk RCT came out

This time claiming "air purifiers don't reduce exposure to viruses in classrooms"

BOLLOCKS Image
1st clue this was going to be a junk study: they did an RCT

Wrong tool

There is no equipoise, no unknown or barely discernible benefit to weigh against likely harm
2nd - Many studies already show cause & effect & mathematically quantify the relationship between exposure levels / reduction levels of pathogens in air and infections

An RCT is two steps backwards at this point

And could be considered unethical
Read 15 tweets
Oct 5
I learned something new this morning

Inhaled fine particles can cross the alveolar capillary junction into the bloodstream

Where red blood cells can pick up, carry and deposit the particles into organs and tissue cells throughout the body

๐Ÿ˜ณ
Sadly, fine particles can be quite toxic

Laden with chemicals and heavy metals

Like particles from vehicle exhaust for example

Including diesel exhaust with toxic particles <1 ยตm in diameter

link.springer.com/article/10.100โ€ฆ
The fact these particles can directly enter the bloodstream and wreak havoc throughout the body adds a whole new dimension to the issue of air pollution
Read 4 tweets
Sep 13
I broke a front tooth recently

And needed an extraction and implant

A 2 hour procedure

So off to the oral surgeon I went yesterday Image
Staff were masked

HEPA Air filter was on

I wore my [breathe]2

As usual
For the procedure I donned a filtered nasal CPAP Image
Read 9 tweets
Sep 11
Important Study from Canada ๐Ÿ‡จ๐Ÿ‡ฆ
๐Ÿ‘๐Ÿ‘๐Ÿ‘

Risk mitigation of shared room ventilation and filtration on SARS-CoV-2 transmission: a multicenter test-negative study | Infection Control &amp; Hospital Epidemiology | Cambridge Core - bit.ly/3Vf0RyX
โฌ†๏ธ ventilation = โฌ‡๏ธ Covid HAIs

Increasing from 1 to 6 ACH = 50% reduction
(~40% to 20% attack rate)

Increasing from 6 to 10 ACH = more reduction
(~20% to 10% attack rate) Image
"For each additional ACH, we measured an estimated 12% lower odds of infection, while presence of any RMV carried approximately 50% lower odds."
Read 9 tweets
Jul 25
Good News!

Canadian Standards Association (CSA) has called for universal respirator use in healthcare settings & when performing patient care outside of healthcare settings (eg โ€“ in the home) in the latest edition of CSA Z94.4, Selection, use and care of filtering respirators.
How you can help:

The draft CSA Z94.4 Standard is now out for Public Review until August 19, 2025.

Please weigh in with your positive, constructive comments at .

Public Review comments are open to everyone who registers.publicreview.csa.ca/Home/View/2256โ€ฆ
The draft Standard embodies the Precautionary Principle.

In the absence of risk analysis, N95s are required because healthcare spaces & activities involve daily HCW exposure to Risk Group 2 (RG 2) pathogens like Influenza and RG3 pathogens like SARS-CoV-2, often unknown.
Read 14 tweets
Jun 8
@alijzimmerman @naner81 @GhostOfSocrates @N0nyM00se @doctor_zeest Thx Alison,

hopefully we can all take the temperature down a few notches, after all, we're all trying to make the system better. ๐Ÿ˜Š

Let's start with 20 ACH Laminar Air Flow (LAF) in ORs. Good idea from the 1960s & generally an improvement over lower airflows.
@alijzimmerman @naner81 @GhostOfSocrates @N0nyM00se @doctor_zeest Does it stop all airborne transmission?

Sadly, no.

Is it the best approach to stopping airborne transmission?

Sadly, no.

Does the medical community think it's the best approach to stop airborne transmission?

Sadly, yes. ๐Ÿ˜ข
@alijzimmerman @naner81 @GhostOfSocrates @N0nyM00se @doctor_zeest First, several systematic reviews and comparative studies have shown that LAF is no more effective than Mixed Ventilation (MV).

Some comparative studies have shown MV to be superior
Read 15 tweets

Did Thread Reader help you today?

Support us! We are indie developers!


This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Don't want to be a Premium member but still want to support us?

Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal

Or Donate anonymously using crypto!

Ethereum

0xfe58350B80634f60Fa6Dc149a72b4DFbc17D341E copy

Bitcoin

3ATGMxNzCUFzxpMCHL5sWSt4DVtS8UqXpi copy

Thank you for your support!

Follow Us!

:(