How to Use a Mask and Maybe Save a Life and Can Pro-life, Science, or Medicine be Apolitical?
Well, I was at the grocery store the other day and saw people doing all sorts of things to contaminate the masks they were using. If the mask had virus on the outside -- which we assume to be case, they would be contaminating themselves, their cars, and their loved ones. The use of a mask in this way, even those bandana masks, or homemade masks, still requires some alertness to avoid contamination.
For some who would have no symptoms of infection or very few, it doesn't make a difference, but for those who are at high risk, it makes a big difference. If you're even concerned at all about reducing the risk of infection by wearing a mask, then doing it properly is necessary. Using a mask improperly defeats the whole purpose of wearing a mask.
With this pandemic, everyone is being put in the position to know how to do things that doctors and nurses do every day when they practice "clean technique" or even "sterile technique" in patient care.
The videos below show you how a nurse puts on and takes off a mask properly. This is how it should be done. If you imagine that the outside of your mask is covered in molasses or glue, for example, and you really don't want to get that on your hands or gloves, you will not touch the outside of the mask except by the straps, and then you will store it in a clean container or bag.
I see people (even nurses and doctors, who sometimes violate the standards) with masks tucked under their chin, or who don't wash their hands before putting on a mask and caring for a patient. or after caring for a patient and taking off a mask. This is a sure way to get infected.
Violating the standard of how to put on a mask and take it off is a way that assures you will contaminate yourself and breathe in whatever virus may be on the outside. That should never be done if we are to successfully reduce the risk of infection.
Here are some very short video clips showing how to put on a simple mask that many could use to avoid breathing in droplets that may contain virus.
In these videos, they are using hand sanitizer, but if you have access to a sink to wash your hands with soap and water, soap and water is much more effective and is always the preferred method to clean your hands before putting a mask on, and before and after taking off your mask!
This shows how to put on a mask with one elastic tie for the left and one for the right which each go over the ear:
https://www.youtube.com/watch?v=OABvzu9e-hw
Here's another one that's slightly different for a surgical mask which may be similar to those who have an upper set of ties and a lower set of ties:
https://www.youtube.com/watch?v=9VbojLOQe94
Here's one that shows how to put on a mask that you will be re-using again:
https://www.youtube.com/watch?v=JwPWdkbyizw
Please share these videos with those around you!
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Working in health care, we hold our patients lives in our hands in one way or another. Those who have held a newborn baby in their hands, let the baby sleep on their chest, and watched them breathe, hoping they keep breathing, and wondering at the miracle of this new life know what it means to hold a life in your hands.
Every health care worker of any kind should have that attitude for their patients, or they don't belong anywhere near a patient!
Everything that is done in healthcare settings, in science, engineering, or medical research has a very precise way that every thing must be done, otherwise the patients can be harmed, or the scientific research may be invalidated, or the engineering project may fail.
For that reason, there are protocols set up to guide those who are engaged in work in that field. In many cases, the protocols or standards offer exact guidance as to what to do, but in other cases, the guidelines offer little or nothing, because the situation has not been anticipated, not been encountered before, or because what would should be done simply was not written down or communicated.
For the past few decades, I've mostly cared for patients who serious disabilities and are living with assisted-breathing. They are on ventilators and have several medical problems -- multiple chronic conditions.
One patient several years ago was very "fragile" (just like those newborn babies you probably have encountered).
At the very beginning of my shift caring for the patient, he was in obvious respiratory distress though no other nurse had said anything about this for 2 days. The family caregiver told me the patient's condition was getting worse and worse.
He was using accessory muscles where you could see the shoulders raise a bit and he was trying hard to breathe, even on a ventilator. I and another caregiver checked his oxygen saturation which was below 90% and dropping.
In these cases, with a patient on a ventilator with a tracheostomy, we suction the patient to remove secretions that may block the airway. That's one of the first things to do if the ventilator is functioning correctly and oxygen is properly being provided.
As soon as I tried to introduce the suction catheter (in this case it was a thin rubber catheter "red robinson" type) I found that it didn't go in past a couple of inches. This almost never happens and was very unusual! There was no way to suction the patient, but he was in distress and the oxygen level kept dropping.
So, I tried turning the catheter round and round like you would turn a screw to try to slip past whatever was obstructing the catheter, and eventually got it down where I could suction some secretions out. Nevertheless, his oxygen levels still were dropping. We then called 911 to transport the patient to the Emergency Room.
It was clear there was something very wrong with the tube that goes into the opening in his neck, the tracheostomy, but it looked right from the outside. The protocol set by all the expert physicians and nurses who manage our healthcare system have told us that in this type of situation we were to remove the tracheostomy tube and then re-insert it.
The patient's oxygen levels continued to drop and they were down below 60%! And then it went below 50% and we were terrified. It was clear the patient would die if we couldn't resolve the problem right away in minutes or seconds.
We had oxygen going to the tube with air from the ventilator and then we started providing oxygen also through the nose with a "nasal cannula" at the same time. That is usually never ever done, but it helped a little.
Somehow, I didn't follow the protocol to remove the tube. It didn't feel right. The Emergency Medical Technicians arrived after about 10 minutes and when I offered to let them suction him or take care of the patient, they refused and told me to suction the patient if need be. They figured we knew the patient better in any case.
Then they loaded the patient into the ambulance and after another 10 minutes arrived at the hospital emergency room.
We explained the situation to the emergency room physicians who then "followed the protocol" to remove the tracheostomy tube and re-insert it. It didn't go in! They managed to provide air by ventilator while they tried to get a tube in through the tracheostomy.
The physicians were stunned. The ER doctor found another ER doctor to come in and try, and he couldn't get a tracheostomy tube in either. They then had 4 different doctors coming in trying with different type tracheostomy tubes but none of them could get the tube in. Hours went by as different doctors tried to get a tube in.
All of this took time. I had arrived at the patient's home at 7 pm and it was now near midnight and they were trying all sorts of tubes, 14 different types pulled out of a cabinet nearby were tried and then thrown on a table nearby because they didn't work!
They called a pulmonologist finally and after waiting an hour for him to arrive, he determined there was a growth of tissue in the throat blocking the tube from being placed. They call it granulation tissue.
See:
Tracheal granulation as a cause of unrecognized airway narrowing
Gaurav Bhatia, et al J Anaesthesiol Clin Pharmacol. 2012 Apr-Jun; 28(2): 235–238.
doi: 10.4103/0970-9185.94907 PMCID: PMC3339733 PMID: 22557751
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3339733/
Anyway, the pulmonologist solved the problem and the patient was able to go home a few hours later.
However, if I had followed the protocol set by the healthcare system (set by all those expert doctors and nurses who know what we nurses in the field should do), I would have removed the tube and not been able to put it back and the patient would have died in the home. We didn't have any different tracheostomy tubes and certainly couldn't deal with the granulation tissue!
That patient is still alive today.
I only have a few stories like that, but the brave ICU. surgery, and emergency room nurses, physicians, respiratory therapists, and others see such cases every day. When you think of those health care professionals, you can know they are dealing with life and death situations. It's not easy for them.
Whenever we who care for patients step into the field of care, a patient may suddenly have some emergency or condition that could be life-threatening, even if all the previous time they were very stable and had no abnormal problems at all. It happens!
Sometimes, nurses have to use their "nursing judgment" or the doctors have to use their "physicians' judgment." It's not always based upon "pure science," but sometimes upon what our experience tells us, perhaps intuition tells us, or God's guidance that in those challenging times gives us the insight or information we need.
Ignaaz Semmelweis was a physician who lived in the 1800s in what was called the Austrian Empire (in the area now called Hungary). He became involved in obstetrics caring for women who were giving birth and was alarmed that so many women who gave birth at the hospital were dying.
He noted that those women who were cared for in one side of the hospital died much more frequently than the other side, and then noted that those women whose doctors had visited the morgue before coming up to care for their patients -- died much more than those whose doctors had not. The malady was called puerperal fever.
Dr Semmelweis then implemented a procedure and had all physicians wash their hands with "chlorinated lime" solution. The death rate fell from 18.27 percent to 1.27 percent!
He had an insight, tried his theory that something was being carried to the patients to cause their death, and decided to try hand hygiene, and it worked!
There was no committee to tell him to do this. No long term studies. In fact, all the more experienced doctors ridiculed him at the time.
Eventually, his insights and suggestions for patient care were adopted throughout the world, but in the meantime, he was not accepted by many and suffered much because of this rejection.
As a great physician in a time of urgency when the patients he was treating were dying right in front of him, he did what worked and provided important case history evidence which is considered "anecdotal" but formed the basis for modern hygienic practices in health care!
See:
Ignaz Semmelweis GERMAN-HUNGARIAN PHYSICIAN
by Imre Zoltán Last updated: Mar 26, 2020 Encyclopedia Britannica
https://www.britannica.com/biography/Ignaz-Semmelweis
When we are ailing, we put our lives in the hands of physicians and when they help us, the debt of gratitude we owe them cannot be measured. Without health or healing, much in life becomes very difficult and suffering increases.
Sometimes life may not be tenable at all. Sometimes, physicians do what works, what their experience enables them to perceive as a solution, even if nobody has done it before.
When there is a new virus, for example, that is in its own class of virus (a "clade"), that nobody has immunity to, physicians are like firefighters running to the rescue of people trapped in a building. Or they are like lifeguards going out to rescue a drowning swimmer in the ocean.
Physicians do what they can to rescue their patients in the moment and later, learn from the experience, adding to the body of human knowledge that others can benefit from. Studies can later be done and should be done to confirm that the methods used are valid and work for others who try them.
I am grateful for the dedication of physicians with the experience and insight to find new treatments that may be helpful or cures for this new COVID 19 disease. The scientific studies have not all been done yet, but in the meantime, they are treating patients with what works.
Some have used Intravenous Vitamin C, some have used Remdesivir an experimental antiviral, and some are using the combination of hydroxychloroquine with azithromycin along with (in many cases) zinc, vitamin D and/or C. There are dozens of remedies being tested to see if they cure COVID 19 right now.
But, many of us are tired of all the sniping and squabbling and politics that surround the government's handling of this global pandemic, and the unnecessary controversy introduced by those who have an agenda.
But let me ask you,
"Can there be governmental policy without politics?" Obviously not. There are always those who disagree about just about everything. It's part of human nature.
"Can there even be exploration without politics?"
When Christopher Columbus wished to sail West to find what he imagined was a Western route to India, could he explore without politics being involved? He had to get funding for his trip, so politics was involved!
"What about science? Can there be scientific research without politics?" "Pure science?"
Well, to do science there are some things you can do on your own if you have the equipment and facilities and have the financial well-being to do that in your own home.
But in this day and age, like Christopher Columbus, you can't do scientific research unless you get a government grant, work in a government laboratory, or get private funding to do it.
What if the type of research you wish to do is not "politically acceptable" at the time, or would expose the harms done by medical vaccine manufacturers for decades?
What if your research would cause pharmaceutical corporations to lose billions because you found a cheaper remedy for a condition? Would you likely be able to get funding for your research? Would those in power look kindly at your research proposals?
Sometimes, research proposals that would validate remedies that are very inexpensive are rejected by those who fund scientific research, because it not only would not bring profit, but also would cause serious financial loss to the corporation or financial interest that could provide funding.
Sometimes, the corporations are more concerned with making that profit than finding a cure for the people. That is immoral, but it's the reality!
Can scientists avoid politics if their discovery or insights are not accepted by those who establish the laws in a nation?
When scientists, ethicists, philosophers, and other experts testify to government bodies like Congress, State legislatures, or courts like the Supreme Court, are they practicing in their field -- science, ethics, philosophy or other fields -- when they try to influence decisions made on policy?
No, they're not doing science at that time; they're being political and that's not wrong. It's part of how they contribute to the public well-being.
Can pro-lifers avoid politics if they try to influence the policies regarding how patients or people in general are treated? If pro-lifers try to protect any from being killed, are they being political when they try to influence policy? Of course!
Politics involves the way the group, city, state, or nation is governed and how the people interact to influence all of this. It's part of human life.
We cannot separate politics from advocacy for the protection of others, because the force of law, the force of the State, is directed at us and affects all of us including those we seek to protect. The moment someone encourages others to sign a petition, call their Congressional representative or the President, Governor, or mayor, they are engaging in political activity.
That doesn't mean one is supporting one political party or another, but it means doing one's best to save others and protect them, and that is admirable!
As the dear Lord said,
... You must not stand aside
when your neighbor's blood is being shed;
I am the Lord. - Leviticus 19:16
This is our duty.
Man's Duty to Man
by Ron Panzer August 27, 2016
https://www.hospicepatients.org/radical-radical-1-duty-of-man.html
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Have you heard about telehealth in hospice? It's happening! What can go wrong with telehealth in hospice??
Is it possible that patients would receive fewer physical visits, less actual help with patient care, more neglect, more fraud since they bill for complete services but provide less?
Of course, they promise to provide full service and bill for full service. Will they get it? The hospice industry is eagerly jumping on the bandwagon and embracing it.
Hospices Tackle Telehealth Challenges During COVID-19
By Holly Vossel April 20, 2020
https://hospicenews.com/2020/04/20/hospices-tackle-telehealth-challenges-during-covid-19/
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Stand Up for Your Rights, says Bio-Statistician Knut M. Wittkowski, PhD, ScD
Edward Peter Stringham April 6, 2020 American Institute for Economic Research
https://www.aier.org/article/stand-up-for-your-rights-says-bio-statistican-knut-m-wittkowski/
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