Dear List Members,
A few weeks ago we had an extended discusssion on nebulizing CS for SARS patients. I appreciated all the thoughts and POVs I received from you. Since then, I've had the opportunity to present CS to a group of physicians on Hong Kong. It was received with mixed feelings, but the dialogue between us remains alive today. Here is one of the comments I've received from the Hong Kong group. Please note the fourth item down on nebulizer treatments for SARS. Good day, Catherine, Here are a few things that you must know-- * The hypoxemia is severe and the CXR can deteriorate rapidly. Patients desaturate at the slightest provocation - talking, movement, coughing. * There is a preponderance of barotrauma, even in nonventilated patients - pneumothoraces, pneumomediastinum, and surgical emphysema. * Weaning from mechanical ventilation can be difficult and prolonged. While oxygenation eventually improves, many patients are easily fatigued. * We cannot use a nebulizer. This is probably the single most important factor in the spread of droplets on the medical ward at the Prince of Wales Hospital in early March. The patient who received the nebulizer has been identified as the index case for this hospital. Many patients, healthcare workers, and relatives who entered that ward contracted SARS. * Because of the vast improvement of patients when high dose steroids are introduced it has become apparent that the majority of damage being caused to the lungs is not from the pathogen but from an over-response by the immune system. I look forward to continued discussions. [Name deleted] Regards, Catherine -- The silver-list is a moderated forum for discussion of colloidal silver. Instructions for unsubscribing may be found at: http://silverlist.org To post, address your message to: silver-list@eskimo.com Silver-list archive: http://escribe.com/health/thesilverlist/index.html List maintainer: Mike Devour <mdev...@eskimo.com>
