viral filters / disconnect / gauze

[anes121508]

how are you determining if you are using the right one?


FILTERS:
hypothetical
99.99% effective.

10,000 particles ---> filter --> 1 particle

particles used 100 microns in size

electrostatic

Wouldn't work right?

read some stuff that this thing is small more like .6 - 1.5 microns

can't find the specs on our HME filters so we have other filters coming that cover this size.

am I nuts?

are there filters that people think might be effective, but truly aren't?

anyone using filters in series? too much resistance?

DISCONNECTION
are you guys clamping even though you have filters on?


WET GAUZE
Chinese stuff says they did this. Whats the basic science? Moisture on the gauze grabs the aerosolized particles?

this is probably insane and stupid to type before thinking, but what happens if you stick wet gauze up your nose under PAPR?

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[PlayToWin]

I am placing a filter over ETT and filter over expiratory limb. I’m hoping between filters and N95 it is sufficient.

Don’t know much about the wet gauze technique , can you discuss?

I am not clamping as I’ve read not to do that. It increases pressure and extubation will lead to increased aerosolized viral particles.


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[Mikkel]

WET GAUZE
Chinese stuff says they did this. Whats the basic science? Moisture on the gauze grabs the aerosolized particles?

this is probably insane and stupid to type before thinking, but what happens if you stick wet gauze up your nose under PAPR?

I've lived and worked in the medical systems in China for a brief time.

I wouldn't trust anything that Chinese physicians do differently since a lot of their "unusual" practices are based on... let's say gracefully... "non-scientific" thought processes.

 

[anes121508]

I am placing a filter over ETT and filter over expiratory limb. I’m hoping between filters and N95 it is sufficient.

Don’t know much about the wet gauze technique , can you discuss?

I am not clamping as I’ve read not to do that. It increases pressure and extubation will lead to increased aerosolized viral particles.


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gauze - check out the anesthesiology papers that got published ahead of print and see what the folks in China were doing. several of them mention it. I think the australian one does as well.

i'm not sure I understand what you mean about clamping your ett.

 

[abolt18]

I am placing a filter over ETT and filter over expiratory limb. I’m hoping between filters and N95 it is sufficient.

Don’t know much about the wet gauze technique , can you discuss?

I am not clamping as I’ve read not to do that. It increases pressure and extubation will lead to increased aerosolized viral particles.


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I think the appropriate time for clamping the tube is ONLY in a paralyzed, mechanically ventilated patient. Otherwise they're at risk of creating negative pressure pulmonary edema.

 

[PlayToWin]

I think the appropriate time for clamping the tube is ONLY in a paralyzed, mechanically ventilated patient. Otherwise they're at risk of creating negative pressure pulmonary edema.

makes a ton of sense, but if patient is not breathing why do you need to clamp if there is theoretically no air exchange taking place ?


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[abolt18]

makes a ton of sense, but if patient is not breathing why do you need to clamp if there is theoretically no air exchange taking place ?


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If your patient has high PEEP requirements, you clamp at the end of inhalation to avoid losing all those valuable, hard earned, well recruited alveoli. When you have ARDS and your PaO2 is in the 50s on FiO2 100%, you do NOT have wiggle room and cannot afford to develop or increase atelectasis.

 

[PlayToWin]

Thanks !


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[deleted171991]

Don't clamp the tube, unless you can't lose PEEP in that patient. It's not made to be clamped regularly. Next thing you know, they call you for tube exchange.

Get used to the idea that you're cannon fodder. For the president, for the politicians, for the bean counters. Protect yourself, but don't go crazy (in every sense of the expression). Short of wearing a China-level PPE all day long (which hospitals don't let you do), you will become infected, more likely than not, sooner or later. Most N95s people put on leak around the masks. One has a more than 1% chance of becoming infected at EVERY encounter with Covid, even with N95.