Need Help With Ideas Hospital, E.R. & ICU Medical Staff

Bottles water and packets of Emergen-C Vit C AND Immune boosters - Electrolytes - Vit D3 - ALL types and flavors for use by staff !

WalMart and GNC and all drug stores carry this - could be asked for DONATIONS of the packets

Keeping them hydrated goes a long way to energy level just as in sports

Vitamin boost can’t hurt - just the placebo effect is WORTH IT

Has sugars but not like that junk Gatorade full of HFCS liver killer

I told him what I think and he said Im here to help, end of story

Emergen-C Is a good idea although it’s difficult to find. It will go on the list and there just might be a student that has a connection.
You never know until you try, right?

Peppermint tea, green tea, tea drops instant organic teas, good containers for hot beverages, mints, lotion, electric back and neck massager, nurse lapel pin watch, protein granola bars

KIND bars !

For the Gluten- FREE needs

Non-GMO and any gluten-sensitive individuals have to buy their own

CELIAC approved

You raised a hero. Keep positive thoughts.

I work in a physicians office.

When you are working without stopping you need food quick that you can pop in your mouth and keep running.

At my gym a girl makes these nutritionally rich bars. They can be eaten in three or four bites. They have dense nutrition like peanut butter and oatmeal and raisins and I think flax seed etc.

She sells them for a dollar a piece for people who work out.

This kind of quick convenient nutrition for energy is what medical staff needs to keep running.

Other than that.

I have thought about a back pack that has the mouth piece for water.

Hospital gowns are the ugliest I have ever seen.

And for those who sew. Baby gowns for premature babies who did not survive. Any major hospital has two or three infants in their morgue at any time. Those tiny gowns are much appreciated as the families are generally in shock and those bodies are stored in pathology and checked in and out for viewing.

Lots of needs related to this virus. And related to hospital life in general.

Teas are a good idea. Thank you!

Food delivered from restaurants struggling.

Find donated money from people.

One lady is doing this in Pennsylvania

A RN friend shared this with me of a colleague:

"I am an ER MD in New Orleans. Class of 98. Every one of my colleagues have now seen several hundred Covid 19 patients and this is what I think I know.

Clinical course is predictable.
2-11 days after exposure (day 5 on average) flu like symptoms start. Common are fever, headache, dry cough, myalgias(back pain), nausea without vomiting, abdominal discomfort with some diarrhea, loss of smell, anorexia, fatigue.

Day 5 of symptoms- increased SOB, and bilateral viral pneumonia from direct viral damage to lung parenchyma.

Day 10- Cytokine storm leading to acute ARDS and multiorgan failure. You can literally watch it happen in a matter of hours.

81% mild symptoms, 14% severe symptoms requiring hospitalization, 5% critical.

Patient presentation is varied. Patients are coming in hypoxic (even 75%) without dyspnea. I have seen Covid patients present with encephalopathy, renal failure from dehydration, DKA. I have seen the bilateral interstitial pneumonia on the xray of the asymptomatic shoulder dislocation or on the CT's of the (respiratory) asymptomatic polytrauma patient. Essentially if they are in my ER, they have it. Seen three positive flu swabs in 2 weeks and all three had Covid 19 as well. Somehow this ***** has told all other disease processes to get out of town.

China reported 15% cardiac involvement. I have seen covid 19 patients present with myocarditis, pericarditis, new onset CHF and new onset atrial fibrillation. I still order a troponin, but no cardiologist will treat no matter what the number in a suspected Covid 19 patient. Even our non covid 19 STEMIs at all of our facilities are getting TPA in the ED and rescue PCI at 60 minutes only if TPA fails.

Diagnostic
CXR- bilateral interstitial pneumonia (anecdotally starts most often in the RLL so bilateral on CXR is not required). The hypoxia does not correlate with the CXR findings. Their lungs do not sound bad. Keep your stethoscope in your pocket and evaluate with your eyes and pulse ox.

Labs- WBC low, Lymphocytes low, platelets lower then their normal, Procalcitonin normal in 95%
CRP and Ferritin elevated most often. CPK, D-Dimer, LDH, Alk Phos/AST/ALT commonly elevated.
Notice D-Dimer- I would be very careful about CT PE these patients for their hypoxia. The patients receiving IV contrast are going into renal failure and on the vent sooner.

Basically, if you have a bilateral pneumonia with normal to low WBC, lymphopenia, normal procalcitonin, elevated CRP and ferritin- you have covid-19 and do not need a nasal swab to tell you that.

A ratio of absolute neutrophil count to absolute lymphocyte count greater than 3.5 may be the highest predictor of poor outcome. the UK is automatically intubating these patients for expected outcomes regardless of their clinical presentation.

An elevated Interleukin-6 (IL6) is an indicator of their cytokine storm. If this is elevated watch these patients closely with both eyes.

Other factors that appear to be predictive of poor outcomes are thrombocytopenia and LFTs 5x upper limit of normal.

Disposition
I had never discharged multifocal pneumonia before. Now I personally do it 12-15 times a shift. 2 weeks ago we were admitting anyone who needed supplemental oxygen. Now we are discharging with oxygen if the patient is comfortable and oxygenating above 92% on nasal cannula. We have contracted with a company that sends a paramedic to their home twice daily to check on them and record a pulse ox. We know many of these patients will bounce back but if it saves a bed for a day we have accomplished something. Obviously we are fearful some won't make it back.

We are a small community hospital. Our 22 bed ICU and now a 4 bed Endoscopy suite are all Covid 19. All of these patients are intubated except one. 75% of our floor beds have been cohorted into covid 19 wards and are full. We are averaging 4 rescue intubations a day on the floor. We now have 9 vented patients in our ER transferred down from the floor after intubation.

Luckily we are part of a larger hospital group. Our main teaching hospital repurposed space to open 50 new Covid 19 ICU beds this past Sunday so these numbers are with significant decompression. Today those 50 beds are full. They are opening 30 more by Friday. But even with the "lockdown", our AI models are expecting a 200-400% increase in covid 19 patients by 4/4/2020.

Treatment
Supportive

worldwide 86% of covid 19 patients that go on a vent die. Seattle reporting 70%. Our hospital has had 5 deaths and one patient who was extubated. Extubation happens on day 10 per the Chinese and day 11 per Seattle.

Plaquenil which has weak ACE2 blockade doesn't appear to be a savior of any kind in our patient population. Theoretically, it may have some prophylactic properties but so far it is difficult to see the benefit to our hospitalized patients, but we are using it and the studies will tell. With Plaquenil's potential QT prolongation and liver toxic effects (both particularly problematic in covid 19 patients), I am not longer selectively prescribing this medication as I stated on a previous post.

We are also using Azithromycin, but are intermittently running out of IV.

Do not give these patient's standard sepsis fluid resuscitation. Be very judicious with the fluids as it hastens their respiratory decompensation. Outside the DKA and renal failure dehydration, leave them dry.

Proning vented patients significantly helps oxygenation. Even self proning the ones on nasal cannula helps.

Vent settings- Usual ARDS stuff, low volume, permissive hypercapnia, etc. Except for Peep of 5 will not do. Start at 14 and you may go up to 25 if needed.

Do not use Bipap- it does not work well and is a significant exposure risk with high levels of aerosolized virus to you and your staff. Even after a cough or sneeze this virus can aerosolize up to 3 hours.

The same goes for nebulizer treatments. Use MDI. you can give 8-10 puffs at one time of an albuterol MDI. Use only if wheezing which isn't often with covid 19. If you have to give a nebulizer must be in a negative pressure room; and if you can, instruct the patient on how to start it after you leave the room.

Do not use steroids, it makes this worse. Push out to your urgent cares to stop their usual practice of steroid shots for their URI/bronchitis.

We are currently out of Versed, Fentanyl, and intermittently Propofol. Get the dosing of Precedex and Nimbex back in your heads.

One of my colleagues who is a 31 yo old female who graduated residency last may with no health problems and normal BMI is out with the symptoms and an SaO2 of 92%. She will be the first of many.

I PPE best I have. I do wear a MaxAir PAPR the entire shift. I do not take it off to eat or drink during the shift. I undress in the garage and go straight to the shower. My wife and kids fled to her parents outside Hattiesburg. The stress and exposure at work coupled with the isolation at home is trying. But everyone is going through something right now. Everyone is scared; patients and employees. But we are the leaders of that emergency room. Be nice to your nurses and staff. Show by example how to tackle this crisis head on. Good luck to us all."

Good quality (not runny) hand cream/lotion. Skin gets very chapped from so much hand washing.

It’s 5 am here, I’m going to get some sleep and I’ll check back in a few hours.

Thank you for your suggestions. If you know anyone working in a hospital maybe you can send them off with an item or two from this thread.

Finally. Someone understands what medical staff goes through

The worst part is providing top level healthcare to illegals and yet having thousands of dollars of their own familys’s medical bills

They take care of the “useless peasants” in the ER all day but can’t afford to go to the ER themselves

And likewise, Americans can’t afford ambulance or airvac that the illegals get for free and use every time they have a tummy ache

No doubt they’d much rather have a few of their bills paid than donated tea and energy bars

They can get food from the cafeteria or bring from home anyways

Give them true piece of mind and pay a utility bill... electric, Internet, phone... that they can’t enjoy right now anyways

Contact utility companies and ask for reduced fees or a month free service for medical staff during this time

Considering the insane amounts of money doctors, nurses, and other medical personnel make, I can't imagine why anyone would donate anything to them.

Listerine. Kills 99% of germs and would feel nice to rinse a mouth after hours of wearing a mask. Also toothbrushes and toothpaste. I would think any personal hygiene items might be good because some of these folks are not going home.


Microwave popcorn. Pretzels. Nuts are great protein. Dried fruit, trail mix, pudding or jello cups.


I wondered about essential oils and a diffuser for a break room to help relieve stress but wasn't sure if that would be a good thing for patients to breathe.

Really nice idea and I commend you for that but before you go through all that effort, you need to make sure that the hospital management will really allow the employees to wear the protective gear that you round up. Think I’m kidding? Read this article. Totally describes my hospital.

[link to medium.com (secure)]

I posted this as a separate thread.

Ask people to send the items by USPS
Minimal human contact and reaching more ppl

Why not just ASK the hospital folks? Duh.....

Go Fund me too

You ever work a 15 hour shift at a hospital before?

How many times have nurses ate their food from home and still 8 hours left on shift.

Have you ever worked a hospital 4-5 nights each week and eating hospital food.

Do you own a restaurant business that is losing customers and profit.

Not wise to shoot down other people ideas, especially if you have little experience.

Go to any nighttime shift or day time shift floor and ask any nurses or doctors if they would appreciate food delivered from a decent restaurant.

Not to mention how expensive it is to eat from a vending machine. My daughter is in healthcare, among other family members and I know what they go through. I send things to my daughter's work all of the time. They are so grateful to have some homemade food.

.22 Long Round ammo
Nylon stockings
Whisky
Tobacco products
Condoms
Chocolate
Gold

$5 Starbucks giftcards.
Hard candy: Lifesavers, Jolly Ranchers, etc.
Travel toiletries

toilet paper
rubber bands
paper clips

I can donate some bellows that can be used as a sort of manual respirator.

OK, I also have some handkerchiefs, a bandana, vodka and a carton of smokes. I've been unemployed for seven years but I am always happy to help the medical community.

First and foremost, every effort needs to be made so they don't end up infected or spreading this.
No exceptions or excuses and no half measures.

Think along these lines...any daily chore you could do for doctors & nurses so they could focus 100% on their medical duties.

Grocery shopping, cooking, laundry, per care, caring for their elderly parents, oil change, haircut, give them a wake-up call...ANY DUTY OR CHORE!

Of course doing it all would be impossible...but even to take over SOME daily chores would help them...and help them to help us!

- Mental Case

You could put this link on your site. It's for free shoes, Crocs. I understand from this site that it's what a lot of medical personnel wear and for this coronavirus, they are giving them away free to medical staff. [link to www.crocs.com (secure)]

Get you some free crocs if you are one of the medical staff caring for people with this virus.

And Krispy Kreme is giving nurses and hospitals free donuts. So ask around to the restaurants and see if they can donate some free meals to put in the fridge at the hospital so the nurses and doctors and others don't have to pay for their food while they are working.

Some camping supplies might be real nice. Some air mattresses to rest on or sleep if they are not allowed to go home. Maybe a few sleeping bags or sheets for the air mattresses. Buy only the plastic ones that can be easily cleaned and they are cheaper than the others too.

Some stuff for the kids to do while in the hospital because they are allowed no visitors. Games, books, cards, coloring books/crayons/markers, maybe some craft stuff or legos. Stuff that can be easily cleaned or given to them to take home when they leave, like coloring books/boods that are hard to clean. You could always give them pages of the coloring books with a small box of crayons to take home. Or remove the crayon paper and rinse the crayons in a bleach bucket. And some adults might like to color stuff too. Rinse some pencils. LOL

Buckets to carry these craft, coloring, books around so they so they can grab and go with it. Don't put it on the floor except where it belongs in the nursing station and it will be easier to give stuff out to the kids. Kids still get sick and need to stay in hospitals. They don't seem to care if hospitals are full of the flu. LOL And they are playing outside again. Oh no!!! Broken bones incoming. LOL I am so hoping that the kids discover the outside world again and learn how much fun it is to ride a bike, explore the woods and nature, get off the spider's web they are stuck to most of the time. Get a tan. LOL

Some white sheets for the dead to use as shrouds.

An instant photo camera so they can take pictures of dead if they are not letting the families see them. Or maybe set up a simple website to have virtual funerals at the funeral homes. I would want to see my family member and I understand they are not allowing that. I guess you could use your phone and post it somewhere....

Ashtrays. People smoke and as most hospitals are no smoking zones.... I would place some ashtrays outside the cafe or doors so they can slip down and have a smoke when they need it. Stress will make you smoke. LOL