Reflections from #COVID19 nights
- SARS-CoV2 continues to confound, humble + amaze
- Seeing lots of arterial clots - ischemic limbs, strokes, MI w/o CAD
- Re-emergence of non-COVID pts w/ surge waning - lots of DKA, decompensated heart fx, HHS

Reflections #COVID19 nights
- Still seeing comfortable hypoxia + still w/o HFNC or BPAP
- Critical to learn how to create your own CPAP to avoid intubations
- Best solution: make kit w/ BVM, CPAP mask, Viral Filter, PEEP Valve, NC + tegaderm

Reflections from #COVID19 nights: awake proning is powerful
- O2 Sat 60’s on RA
- O2 Sat 80’s on NRB
- O2 Sat 95 on NRB while proned

1/2 dozen similar cases
Check out http://www.prone2help.org  via @airwaycam

Reflections #COVID19 nights: as surge wanes + more non-COVID pts, lung US more valuable
- COPD/CHF/asthma/PE w/ similar presentations
- Subpleural consolidations, thickened/irreg pleural line, focal/multifocal b-lines
Chat w/ @UltrasoundMD @bedsidesono http://bit.ly/3bnMPlE 

Reflections from #COVID19 nights
- Patient w/ classic COVID w/ leg swelling
- US w/ RV dilation + "D sign"
- Minimal response to pressors, inhaled nitro
- HD response to lytics

Role for US in selected patients

Reflections #COVID19 nights: admission not the end
- Boarding pts longer
- Inpt teams overwhelmed
- Round frequently looking for O2/HD decompensation
- Evaluate pts for AC
-dimer < 1500 = prophylactic
-dimer > 1500 consider therapeutic
-Balance w/ bleeding risk

Reflections #COVID19 nights:

The surge will pass
New challenges will present themselves
Be vigilant w/ #PPE
Support eachother