Bitter experience helps French ICU peak the latest virus waves


Rouen, France (AP) — Slowly choking in the French intensive care ward, Patrick Alisik said, “Completely burned from the inside, like a cathedral in Paris,” as tired doctors and nurses worked all day. I was afraid that I might die from a lung disease that I felt “burned.” And at night, he keeps alive with a seriously ill COVID-19 patient like him.

The couple in the same ICU died within hours, just like Aliseek, feeling as fragile as “soap bubbles are ready to pop.” “I saw an archangel, I saw a little cherub. It was like communicating with the posthumous world,” he said.

There was a French medical expert on his side, Previous bitter experience of infectious wavesIf possible, fight relentlessly to awaken the patient and avoid using a ventilator. They treated Aricique with a nasal tube and a mask that immerses his raised lungs in a constant stream of oxygen. It escaped the discomfort of the thick ventilation tube deep in his throat and the intense sedation (sometimes of course) that the patient often feared not waking up.

Mechanical ventilation is unavoidable for some patients, but it is a less systematic step than at the beginning of the pandemic. “We know that every tube we insert can result in complications, extended stays, and in some cases morbidity,” said Dr. Philippe Gouin, who leads the ICU ward where Aricique was treated for severe COVID-19. Stated.

He said that about 15% to 20% of his intubated patients could not survive.

“This is a survival-focused milestone. We know that we will lose a certain number of patients who cannot help negotiate this corner.”

The transition to minimally invasive respiratory treatment has also helped the French ICU stop the collapse under the new. Crushing coronavirus cases. A wave of third infections in France, supercharged by a more contagious viral variant that first destroyed neighboring Britain, has pushed the country’s COVID-19-related deaths in the past. Just 100,000 people.. Hospitals across the country are reworking on the eerie math of creating space for thousands of critically ill patients.

“We have a continuous flow of cases,” said Dr. Philippe Montlaver, ICU Chief of the Bisha Hospital in Paris. “Each of these cases is absolutely terrible for the family, for the patient himself, and of course for the doctor and the nurse.”

Sedated patients who are alive using mechanical ventilation often occupy the ICU bed for weeks or even months, even before the physical and psychological trauma of the trial is healed. It may take several months. However, 13 days after being admitted to the ICU treatment room in Normandy’s cathedral city of Rouen, Aliseek recovered well and another critically ill patient replaced him.

A non-invasive nasal ventilation system that distributes thousands of liters (hundreds of gallons) of life-sustaining oxygen per hour survived the worst of his infections until the flow became trickle and sufficient to stand upright. , His New Testament on his side. Dressed in a small lunch of omelets and red cabbage, he said he felt a resurrection as he began to rebuild his strength. The nurse freed him from the drips that had been plugged into his arm and put the tube in a bottle like an internal organ.

Dr. Dorothy Carpentier towed junior doctors and nurses touring and, as he passed Alisik’s room, declared himself worthy of being discharged and allowed himself a small celebration. She decided that the patient in the next room could also leave. She describes the imminent departure as a “small victory” for a complete 20-bed ward, formerly a surgical unit but a temporary setup that is now fully converted to C0VID-19 care. did.

“I think they will be filled again by the morning,” Carpentier said of the two vacant beds. “The difficulty with this third wave is that it doesn’t have a stop button. I don’t know when it will be late.”

Further down the corridor, a 69-year-old woman was laid face down on her stomach, struggling to breathe with an oxygenated mask, and dangerously approaching the point where the doctor decided to anesthetize and intubate. I did. Nurse Gregory Bomberd impressed her with the importance of recruiting a woman-visiting daughter-in-law and sticking to the mask to stop the next step.

“Morale is so important that she has to turn this corner. We do what we can. They also have to work hard to win. Otherwise they lose.”

“Do what you can,” the nurse told her daughter-in-law.

Relatives later came out of the hospital room, clouding their eyes and trembling.

“It’s really hard to see her like this,” she said. “She is letting go of herself.”

In another room, Guin gently pleaded with a 55-year-old stall operator, complaining that his oxygenated mask made him feel claustrophobic.

“You have to play games,” the doctor insisted. “My goal is not to reach the point where you have to sleep.”

The patient agreed. “I don’t want to be intubated, I’m in a coma and I don’t know when I’ll wake up,” he said.

Intubation can be traumatic for everyone involved. Patients who sobbed when they fell asleep remained sedated in the ICU almost two weeks later.

“You’ll see him scared,” Bomberd recalled. “It was terrible.”

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