Math is hard for at least three liberals

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Doctor CamNC4Me
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Re: Math is hard for at least three liberals

Post by Doctor CamNC4Me »

I mean just quickly googling there seems to be a consensus that CPAPs and BiPAPs can be used as ventilators for the less serious patients or the patients who don't require intubation or even a non-invasive 'ventilator'. I think where I can give you the win, for sure, is we don't have any numbers regarding the 1255 FDA-approved ResMed, Philips & Medtronic ventilators being delivered. From a Google search it appears the ResMed and Medtronic ventilators can be pretty small, but I have no idea if those were what were being procured. If I were, I dunno, a reporter for a national news media conglomerate I'd probably do more than run an article on one source, though. But, hey, that's just me.

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Doctor CamNC4Me
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Re: Math is hard for at least three liberals

Post by Doctor CamNC4Me »

ResMed’s CEO:

https://cleantechnica.com/2020/04/02/re ... ssion=true

“I think it’s great what Elon did. He went out and bought what I would call bi-level non-invasive ventilators from a platform of ours from five years ago from Asia and brought a thousand of them to New York.”

If you read the linked article there some interesting comments about cpaps being used to treat patients including doctors modding them to use as ‘ventilators’.

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Re: Math is hard for at least three liberals

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Icarus
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Re: Math is hard for at least three liberals

Post by Icarus »

This thread reminds of something I saw a few weeks about about an MIT student making an open source homemade ventilator. It was all the rage in the news for about a day until one doctor on one of the shows laughingly congratulated the student for being proactive, but emphasized the fact that this was not the kind of ventilator that is used for people with respiratory diseases. They're quite technical and computerized to make sure there is a right mixture of oxygen, etc.

http://news.mit.edu/2020/ventilator-cov ... -cost-0326

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Re: Math is hard for at least three liberals

Post by EAllusion »

[quote="Doctor CamNC4Me" post_id=1221893 time=1587096172 user_id=3779]
ResMed’s CEO:

https://cleantechnica.com/2020/04/02/re ... ssion=true

“I think it’s great what Elon did. He went out and bought what I would call bi-level non-invasive ventilators from a platform of ours from five years ago from Asia and brought a thousand of them to New York.”

If you read the linked article there some interesting comments about cpaps being used to treat patients including doctors modding them to use as ‘ventilators’.

- Doc
[/quote]According to this other electric car blog, the CEO of ResMed went on MadMoney with Jim Cramer to say it's great that Elon Musk went out and bought some cpaps and passed them off as vents because the CEO of ResMed thinks ResMed products are great and any philanthropy is appreciated.

Well then, that proves that the press are a bunch of hacks for reporting that Musk didn't purchase and donate 1000k mechanical ventilators because he actually bought and unloaded some cheaper Bipaps instead. Silly press, reporting things corroborated by your own defense of Musk.

The article notes that a Dr. (seemingly contacted through a Tesla fan Facebook group?) says cpaps can be used for mild cases of COVID. Then it mentions, without citation, the other issue that cpaps aerolize the virus and make patients more dangerous. That's not exactly a solid medical citation on either front. The benefit of cpaps in COVID treatment is - being generous - not established at this point, and that's not even particularly relevant, because the issue is that they aren't the vents that Musk supposedly was going to provide and you are taking issue with CNN for reporting that fact as fact. That people are trying to jerry-rig a Bipap into a crude mechanical ventilator doesn't mean a Bipap is a mechanical ventilator.

Musk, the dude who was blowing off public warnings about coronavirus as a dumb panic, got into a spat when a rando on twitter wherein he promised Tesla would make ventilators if there is a shortage. Then, he learned, there's a god damn shortage. Then, it seems, he learned that promising Tesla would make them was not as easy as it seemed. (Musk has a long history of this kind of thing.) So he then purchased 1000+ vents to donate to California hospitals and got a lot of positive press for this move. Then, it seemed to have turned out he didn't purchase vents, but instead donated a bunch of cpaps/bipaps. That sure as hell wasn't the "ventilator shortage" being talked about in his twitter spat. He got negative press for this.

Then it appears he's gone on a scorched earth offensive against the press for this, because Musk is an awful person, and his extremely online fans are out in full force joining in. If he actually sent 1000+ actual vents, this could be cleared up, but it's not looking too good for the theory that he did that. The initial stories seem to be well sourced and topical, so I don't see the problem. This is a heck of a bad example to go after when discussing CNN's flaws. You shot at the broad side of a barn and missed.

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Re: Math is hard for at least three liberals

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One positive about Bi-Paps is the absence of ventilator-induced lung injury.

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Re: Math is hard for at least three liberals

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[quote=moksha post_id=1221917 time=1587107182 user_id=49]One positive about Bi-Paps is the absence of ventilator-induced lung injury.[/quote]

Speaking of which:

https://www.forbes.com/sites/billrobers ... e68971a531

“ The President of Mount Sinai says a team at the New York hospital has designed a conversion kit that makes breathing assistance machines donated by Tesla CEO Elon Musk into desperately needed ventilators that can used on critical care patients suffering from COVID-19. The conversion kit instructions have been made public as well.”

The linked article has some neat pictures, information, and links that discuss the issue further.

edit:

“David L. Reich, MD
@DrDavidReich
· Apr 2, 2020
Very grateful to Tesla for providing Resmed ventilators that our team was able to convert to critical care-capable. Innovation by The Mount Sinai Hospital's team in a crisis!”

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Re: Math is hard for at least three liberals

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EAllusion wrote:
Thu Apr 16, 2020 6:48 pm
I've never heard anyone refer to a CPAP/BiPAP as a ventilator and I wrote a system-wide protocol to help people use them that required me to learn at least a little about them. I'm perfectly happy to accept that they can be called a ventilator in the right context, but they sure as hell are not vents in the sense that hospitals are in desperate need of vents for critical COVID-19 care. CPAP's and BiPAP's aren't machines to take over your breathing. There's a reason vents cost a fortune and sleep apnea machines do not. Mechanical ventilators are a significantly more complex machine that is more difficult to produce and acquire.

The picture you posted of Musk's delivery was a BiPaP. If the evidence of Musk's shipments is that, then it's perfectly appropriate for the Governor of California to say the vents didn't arrive because that isn't a vent in any meaningful sense given the context. And, of course, it's appropriate for CNN to report that.
I've used a CPAP for 15 or 20 years, and I've never heard it referred to as a ventilator, until Musk did it. Neither a CPAP nor a BIPAP take over the job of breathing. Ventilating a patient requires sticking a tube down the patient's windpipe and a trained technician to monitor the breathing and settings. I put my CPAP mask on every night by myself and fall asleep.

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Re: Math is hard for at least three liberals

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More than that, there wouldn't be the talked about national vent shortage if CPAP's counted. Musk's whole twitter spat that started this was about a shortage of mechanical ventilators of the type that CPAPS are not. The entire argument is based on an equivocation even if you decide to call a CPAP a ventilator. It's like if there were a critical national shortage of parachutes, and after I downplayed it for a while I was was all like, "Pfft. I'll get you your parachutes."

Then, I announced I got the parachutes and received a ton of praise for my charity. Then journalists report that I actually bought some cheap bed sheets from a Wal*Mart warehouse and sent them over. I go on the attack against the lamestream media and offer proof I sent over tons of sheets, or bedchutes as I call them. DocCam gets angry and is all like, "You can make crude parachutes from these materials, brah. Not everyone is jumping out of planes. EAllusion's cousin said on a fishing blog that what EAllusion did was great and that guy has his pilot's license. You're a bunch of lying liars."

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Doctor CamNC4Me
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Re: Math is hard for at least three liberals

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Vintage, EAllusion. I love how he creates this fantasy world argument, then goes about knocking it over.

Meanwhile, back on planet Earth CNN updated their coverage with a fairly investigated and vetted article here:

https://www.cnn.com/2020/04/17/tech/elo ... index.html

I’d like to think had they done that initially, their reputation might’ve not taken a hit. As far as RI’s point, I’ve made my points, so I don’t feel the need to re-hash them, but I’m willing to concede that intubation ventilators, 1,0000 of them, were not bought and distributed.

That said, Wiki:

https://pbs.twimg.com/media/EVvnYaBXgAI ... ame=medium

Perhaps a Musk operative updated the wiki entry to make EAllusion look bad...

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Re: Math is hard for at least three liberals

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The CNN article you linked, in defense of yourself, is stating what I just got done telling you. Almost point by point.

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Re: Math is hard for at least three liberals

Post by Doctor CamNC4Me »

I posted the CNN article as a matter of integrity, not to bolster my point, which should’ve been obvious by my commentary. What you conveniently forget to mention is, I dunno, Musk’s response that he provided what ICUs requested, and now that CPAPs can, in fact, be referred to as ventilators, used as non-intubation ventilators, and some modded to be used as intubation ventilators in a desperate situation, which, if you bothered to do some cursory searches on Google and Twitter, you would’ve discovered and graciously conceded.

But, hey, I get it. That’s not how you roll. You feel a soul crushing existential crisis if you’re not the best Googler on the forum. I know, man. It hurts to not always be the rightest on every issue. We all have our cross to bear, and yours is heavy, indeed.

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Re: Math is hard for at least three liberals

Post by Jersey Girl »

Oh for god sakes everywhere I look on this board lately there's a pissing contest of some kind.

YES, the PAPS are a type of ventilator. God, you people, I swear. :rolleyes:

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Re: Math is hard for at least three liberals

Post by Doctor CamNC4Me »

[quote="Jersey Girl" post_id=1222014 time=1587177064 user_id=16]
Oh for god sakes everywhere I look on this board lately there's a pissing contest of some kind.

[size=150]YES[/size], the PAPS are a type of ventilator. God, you people, I swear. :rolleyes:
[/quote]

We’re just having discussions on a discussion board, Jersey Girl. Chillax.

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Re: Math is hard for at least three liberals

Post by Jersey Girl »

The ICU ventilators, the PAPS, are types of positive pressure mechanical ventilators. The PAPS are non-invasive ventilators. They're ALL types of ventilators.

You're welcome.

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Re: Math is hard for at least three liberals

Post by Jersey Girl »

Res Ipsa wrote:
Fri Apr 17, 2020 5:39 pm


I've used a CPAP for 15 or 20 years, and I've never heard it referred to as a ventilator, until Musk did it. Neither a CPAP nor a BIPAP take over the job of breathing. Ventilating a patient requires sticking a tube down the patient's windpipe and a trained technician to monitor the breathing and settings. I put my CPAP mask on every night by myself and fall asleep.
Yes, your CPAP is a type of positive pressure mechanical ventilator that is non-invasive. The ICU vents are invasive positive pressure mechanical ventilators. When the EMT"s bag you, they're using a manual ventilator. Not that I've been bagged lately. :wink:

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Re: Math is hard for at least three liberals

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When we are specifically talking about the national shortage of ventilators during a pandemic that strains the needed supply of them, we are talking about ventilators in the sense this wiki article is primarily about:

https://en.wikipedia.org/wiki/Ventilator

If you want to call CPAPs and BiPAPS ventilators, it's not jargon I'm used to, but feel free as it doesn't really matter. I don't care whether or not some people call it a vent in a certain context. What matters is that CPAPs and BiPAPs aren't ventilators of the type there is a critical national shortage of. A dot that isn't connecting here is that if CPAPS and BiPAPS were interchangeable with the vent shortage, then there would be no vent shortage. There isn't a critical shortage of sleep apnea machines.

The entire argument here is resting on an equivocation.

Something else I did professionally that strikes me is relevant is I worked with a pair of nurses on developing strategies to talk with intellectually disabled people about advanced directives so they could make choices regarding their medical care. I then went to their houses in meetings with a nurse (and other people) and helped them make informed advanced directive choices.

One of those choices is whether you consent to being put on a mechanical ventilator should the need arise. That's the language. "Mechanical ventilator." No one, absolutely no one, thinks this is referring to consent to go on a CPAP or BiPAP. The very idea is funny. Even if you call those devices vents, that's clearly not what is meant by use of the term. The vents being talked about are the kind that show up in advanced directives and refer to taking over a person's breathing using relatively sophisticated technology to maintain it. That's what was referred to on Musk's twitter; that's what the government of California means; that's what journalism referring to vents not being sent means.

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Re: Math is hard for at least three liberals

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It occurs to me that I have advanced directives and I'm a "no" on mechanical ventilation. (Like a lot of critical life-sustaining care, it's awful, guys.) However, with COVID, the odds of you going under and actually being brought back with not-too-bad harm relatively quickly aren't terrible. I just don't want to be in a medical coma on a ventilator for a longer stretch of time or as a critical treatment to keep me alive despite prior oxygen loss. That's bad news. I probably should look into what I'm doing here as a just in case.

That all said, because we need vents to save people's lives, that might be obscuring that a lot of people whose lives are being saved with vents are probably gonna have a hell of a time in recovery with enduring psychological damage. I'm sure someone's written about it, but I haven't seen that talked about in this context yet.

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Re: Math is hard for at least three liberals

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EAllusion wrote:
Fri Apr 17, 2020 9:15 pm
It occurs to me that I have advanced directives and I'm a "no" on mechanical ventilation. (Like a lot of critical life-sustaining care, it's awful, guys.) However, with COVID, the odds of you going under and actually being brought back with not-too-bad harm relatively quickly aren't terrible. I just don't want to be in a medical coma on a ventilator for a longer stretch of time or as a critical treatment to keep me alive despite prior oxygen loss. That's bad news. I probably should look into what I'm doing here as a just in case.

That all said, because we need vents to save people's lives, that might be obscuring that a lot of people whose lives are being saved with vents are probably gonna have a hell of a time in recovery with enduring psychological damage. I'm sure someone's written about it, but I haven't seen that talked about in this context yet.
Last week Andrew Cuomo said in New York, getting on a ventilator meant you had an 80% chance of dying as only 20% who went on it actually got off it.

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Re: Math is hard for at least three liberals

Post by EAllusion »

Going on a ventilator can be a harrowing experience. When you live, you might come to with functional cognitive or motor deficits, delirium, PTSD, permanently damaged organs...

Some people who go on vents don't fully go under and retain some truly horrifying semi-conscious experiences. For some, this can last a long time as people can be kept stable on vents for a long time.

It's a big deal to go on a ventilator with a lot of potential for harm. For the normal reasons people end up on them, my decision is to refuse that critical care. People with medical experience, which I suppose includes me, are much more likely that average members of the public to refuse end-stage critical care because there's greater understanding of the down-side. I definitely don't want to be kept around with an anoxic brain injury.

With COVID, however, you are getting a nontrivial number of situations where people go under and make it back out relatively quickly seemingly not significantly worse for wear. It's not the dying I'm concerned about. It's the living with a bad vent experience. Maybe I should change my decision given present circumstances? *shrug*

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Re: Math is hard for at least three liberals

Post by EAllusion »

So I attended a team meeting for an older developmentally disabled women who was making her advanced directive decisions. It was me, a nurse who specializes in ID/DD, a case manager, guardian, and caretakers. My job was to help people help explain to her the cares/treatments. For this particular person, she could understand and relate to examples of cares she'd seen in people she knew. And every single thing we had to talk about - which is a bit of a list - she had direct experience with someone who had that done. This made the job easy, but also, think about that.

With every item, there was a "Remember so and so..." followed by an "Oh yeah..." with a pretty well-informed description of what that looked like and meant. Only, because she was so blunt about it, it was also a list of horror stories told matter-of-factly. It was a challenge not to bias her decisions by reacting to them.

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