COVID-19 - random thoughts

[karen2205]

Cutting to help people who're limiting what they're reading about this



Wondering whether the sequence of handwashing is important or whether it's enough that you've washed all of your hands and the sequence shown in NHS posters/videos is random. I've now basically got the technique without having to think too much about it, but it's not automatic, so I'm swapping the steps around most times I'm washing my hands.

Some of the resources I've seen (maybe from the WHO?) talks about washing your wrists as you wash your hands. Others don't. Wondering if we should all be giving up on wearing wrist watches to make sure we wash our hands (and wrists) properly and if wearing old fashioned nurses watches [of the sort you pin to your top] will catch on. Also wondering whether anybody's making any devices to hold smart watches to a piece of clothing rather than a wrist - this would seem to me to be an untapped gap in the market for people who like their smart watches.

Also wondering why in ITUs they initially sedate and intubate people, rather than giving them tracheostomies where they could have less sedation. [google might help me with this, haven't been wondering intently enough to go looking yet].

Comments

[cosmolinguist]

I don't think it matters what order the handwashing steps happen in, just that they all get done.

[barakta]

I agree, the posters at my hospital on Monday were saying all the steps are needed to be thorough and most right handers clean their left hand better than their right and the opposite for left handers. It's about making sure you've soaped and scrubbed all the area of the hand.

for this virus specifically it's cos it has an out lipd (fatty) layer which terminates it. Kim was saying that the reason alcohol is not preferred is that if you dehydrate the virus it might reanimate upon contact with water unless the alcohol is above 60% and below too dehydraty % so presumably over 90%. So pure alcohol if used needs diluting a wee bit.

Re intubating v tracheostomy it can cause infection risk and permanent damage to the trachea and larynx including permanent damage to the voice and speech. Also if you're ill enough to need ventilation being sedated probably makes you easier to manage than if you're 'will but with it and have a hole in your neck' cos wriggling and distress or confusion from things like high temperatures.

[karen2205]

I have A*A* in GCSE double science and though I've read the stuff about corona meaning it's a virus with a lipid layer, I don't really understand how any of the science works. Would like there to be some better science education in general.

What has me thinking about tracheostomies is that it's usual to transfer people who've been ventilated long term to a tracheostomy anyway. I can't tell how long people are being really unwell with this coronavirus - but wondering if it's long enough that most people would need to be transferred over anyway.

And I've been reading bits of medical twitter where they're talking about turning ventilated patients onto their stomachs as part of their treatment for large chunks of the day and this being a risky procedure (?aerosol generating) for the staff and needing a lot of staff. So wondering whether people who are less sedated in ways where they'd be able to cooperate with staff and reposition themselves would be useful.

But *nods* yes re risk to trachea and larynx and sedation being beneficial for people who are very confused/distressed.

[karen2205]

*nods* - I'll stop trying to memorise the sequence and just keep going with all the extra handwashing.

[hilarita]

Cutting holes in people is an additional vector for infection, so is not really desirable. There's clearly a cost-benefit thing for infection vs sedation (as well as probably other factors I don't know about).

[karen2205]

*nods* - I know most people who need long term ventilation get moved to tracheostomies, but wonder how long that usually is from when they were first ventilated.