COVID-19 Trends of The Day

The Toughest Triage — Allocating Ventilators in a Pandemic The Covid-19 pandemic has led to severe shortages of many essential goods and services, from hand sanitizers and N-95 masks to ICU beds and ventilators. Although rationing is not unprecedented, never before has the American public been faced with the prospect of having to ration medical goods and services on this scale. Of all the medical care that will have to be rationed, the most problematic will be mechanical ventilation. Several countries, but not the United States, have already experienced a shortage of ventilators. Although shortages of other goods and services may lead to deaths, in most cases it will be the combined effects of a variety of shortages that will result in worse outcomes. Mechanical ventilation is different. When patients’ breathing deteriorates to the point that they need a ventilator, there is typically only a limited window during which they can be saved. And when the machine is withdrawn from patients who are fully ventilator-dependent, they will usually die within minutes. Anticipating the need to allocate ventilators to the patients who are most likely to benefit, clinicians should proactively engage in discussions with patients and families regarding do-not-intubate orders for high-risk subgroups of patients before their health deteriorates. Once patients have already been placed on mechanical ventilation, decisions to withdraw it are especially fraught. In the weeks ahead, physicians in the United States may be asked to make decisions that they have never before had to face, and for which many of them will not be prepared. Though some people may denounce triage committees as “death panels,” in fact they would be just the opposite — their goal would be to save the most lives possible in a time of unprecedented crisis. To read more- https://www.nejm.org/doi/full/10.1056/NEJMp2005689?query=featured_home Source-The New England Journal Of Medicine Authors- Robert D. Truog, M.D., Christine Mitchell, R.N., and George Q. Daley, M.D., Ph.D. Do Such situation may arise in India in the Near Future? Share your views Doctors.

Patient came with c/o left eye pain Civid positive 15day back *Chief Complaints* L.E.pain *History* Covid positive 15day back Treated under intensive care(steroids) Hypertensive under rx Non diabetic *Vitals* Shortness of breath Rest WNL *Physical Examination* Wheel chair assisted Left eye - Periorbital swelling Black brown discoloration of periorbital skin Mild proptosis Restricted ocular movement. Ant.seg- Chemosis Cornea-clear Iris/pupil-n/RRTL A.C.-quite Post.seg- Retina ON CDR-0.3 Vitreous-n *Investigations* BP-140/100 BSL(R)-170mg/dl. MRI(BRAIN AND ORBIT) SHOWS:- -B/L Ethmoide,frontal and maxillary sinusitis - no hemorrhage. -left preseptal orbital swelling. -suggestive of agressive fungal sinusitis with left intraorbital extension. *Diagnosis* Mucormycosis...??? *Management* Pls suggest further prognosis and manegement.

"COVID - 19" ------------------ C➡️COUGH O➡️ORAL DISCOMFORTNESS V➡️VULNERABLE I ➡️ILLNESS SERIOUSLY D➡️DIFFICULTIES IN BREATHING Don't spread misguided news about "Corona virus" PROPHYLACTIC TREATMENT -------------------------------------------- Antitussive Antiallergic Antipyretic Praziquantel Antibiotics....prophylaxis Ribavirin Other manage accordingly..... Medical person should not be lily- livered. Should be strong....and fight against COVID-19 Lastly more important....awareness..... Corona virus comes from animals, Veterinary doctors can also play important role...... I just try post......

A 30 yrs old, Female patient with postive h/o of Covid-19 virus, gradual developed redness & itching than Blackening of both eyes. Right side mild Blackening and left side heavy Blackening occurs. After 28 days, when the covid-19 treatment is over patient suffers from this disease. May be like Mucormycosis ? Kindly suggest investigation with management for this patient. Shifted to AIIMS.

It makes no sense for us to panic over the corona Virus.