Yikes - Printable Version
+- The CardBoard (https://thecardboard.org/board)
+-- Forum: Emergency (https://thecardboard.org/board/forum-11.html)
+--- Forum: Covid-19 (https://thecardboard.org/board/forum-12.html)
+--- Thread: Yikes (/thread-19253.html)
+- The CardBoard (https://thecardboard.org/board)
+-- Forum: Emergency (https://thecardboard.org/board/forum-11.html)
+--- Forum: Covid-19 (https://thecardboard.org/board/forum-12.html)
+--- Thread: Yikes (/thread-19253.html)
Yikes - BostonCard - 03-27-2020
https://app.figure1.com/images/5e7e72d4367ca61003392ffa
Holy mother of god, this chest X-ray.
Quote:Initial ED CXR of a 32 yo female with hx of HTN otherwise healthy who presented after 7 day hx of uri symptoms with c/o sob and cough. Walked to triage with initial O2 sat of 48% RN thought equipment was not working. 48% O2 on RA confirmed in room improved to 81% with 15L via non rebreather. Intubated and admitted to the ICU for suspected COVID.
32 year old coronavirus patient. Looks like she is getting hydroxychloroquine/azithromycin.
BC
Yikes part 2::
https://app.figure1.com/images/5e71be566aa8714a04de3386
Right image is what the chest X-ray is supposed to look like. The left image is the current (awful) chest X-ray.
44 y/o M with diabetes.
BC
Yikes part 3, a CT scan from a 28 year old.
https://app.figure1.com/images/5e74b6eb0e81d08e00a7ef14
BC
RE: Yikes - thatboy - 03-27-2020
Requires an account (log-in) to view.
RE: Yikes - BostonCard - 03-27-2020
(03-27-2020, 05:18 PM)thatboy Wrote: Requires an account (log-in) to view.
Sorry, I thought they opened up their coronavirus cases. I'll see if I can copy the images.
BC
Can you see this?
![[Image: display?urlToken=5e7e72d2d162605401051b84&imageSize=9]](https://app.figure1.com/image/display?urlToken=5e7e72d2d162605401051b84&imageSize=9)
BC
RE: Yikes - thatboy - 03-27-2020
(03-27-2020, 05:20 PM)BostonCard Wrote: Can you see this?
BC
Nope. But I am curious! Can you post on imgur.com or something and link?
RE: Yikes - 82lsju - 03-27-2020
(03-27-2020, 05:20 PM)BostonCard Wrote:(03-27-2020, 05:18 PM)thatboy Wrote: Requires an account (log-in) to view.
Sorry, I thought they opened up their coronavirus cases. I'll see if I can copy the images.
BC
Can you see this?
BC
no
RE: Yikes - BostonCard - 03-27-2020
Sorry. Ironically, when you guys quote I can see the image (I guess my computer remembers).
How's this:
![[Image: display.jpg]](https://i.ibb.co/fFSLbTW/display.jpg)
BC
RE: Yikes - thatboy - 03-27-2020
(03-27-2020, 05:42 PM)BostonCard Wrote: Sorry. Ironically, when you guys quote I can see the image (I guess my computer remembers).
How's this:
BC
I can see that one. Thanks. I can't read xrays, but it looks cloudy. I assume that's not good.
RE: Yikes - BostonCard - 03-27-2020
Yeah, here is a normal chest X-ray for comparison.
![[Image: normal_pa.jpg]](https://www.med-ed.virginia.edu/courses/rad/cxr/web%20images/normal_pa.jpg)
The lungs are supposed to be filled with air, which doesn't absorb X-rays and shows up as black. When the lungs are white, it means they are filled with fluid or pus or cells.
BC
RE: Yikes - thatboy - 03-27-2020
Thanks. Do you ever see that with other diseases, illnesses, etc.? Can a bad case on pneumonia get like that or is this worse than you've seen generally speaking?
By the way, kind of off topic, but can someone like this be put on a heart / lung machine (or just a lung machine, if there is such a thing)? And really off-topic -- are there any developments in artificial or re-grown lungs?
RE: Yikes - stupac2 - 03-27-2020
Secret video of BC taking a picture of his computer screen:
![[Image: giphy.gif]](https://media.giphy.com/media/l41lUdr4N79775yuc/giphy.gif)
RE: Yikes - BostonCard - 03-27-2020
(03-27-2020, 08:18 PM)thatboy Wrote: Thanks. Do you ever see that with other diseases, illnesses, etc.? Can a bad case on pneumonia get like that or is this worse than you've seen generally speaking?
By the way, kind of off topic, but can someone like this be put on a heart / lung machine (or just a lung machine, if there is such a thing)? And really off-topic -- are there any developments in artificial or re-grown lungs?
Yes, you can see it with other diseases, most notably ARDS (acute respiratory distress syndrome), which can be triggered by a lot of things, including coronavirus (but also a lot of other things, including severe trauma, severe infections [even outside the lungs] that lead to sepsis, pancreatitis, etc.). Severe viral pneumonias (like coronavirus but also influenza) will cause bilateral pneumonias. Traditionally, bacterial pneumonias like those caused by pneumococcus, will cause one lobe of one of the lungs to be almost completely filled with pus, but the other lobes and the other lung are usually ok. That being said, Staph pneumonias can affect both lungs, though it looks patchier. Pulmonary disease aside, heart failure can look a lot like this.
The answer to your second question is yes. A few articles have made reference to ECMO machines (extracorporal membrane oxygenation), which are essentially heart lung machines, which can keep oxygen flowing if the lungs are so trashed that it is impossible to get any oxygen to the blood that way. The problem is that they are rare. There are fewer than 1000 hospitals nationwide capable of providing the service, and they probably can only run a handful of machines at most each. They are also very resource intensive (you need a perfusionist 24/7 at the machine to make sure it is constantly working), it is a high risk intervention (it can lead to blood clots and strokes and kidney failure and a whole host of other things), and it generally can only be done successfully in young, otherwise healthy individuals whose only problem is their lungs (or heart and lungs).
Here's an article about its potential use in Covid-19:
https://jamanetwork.com/journals/jama/fullarticle/2761778
BC
RE: Yikes - thatboy - 03-27-2020
Thank you.
RE: Yikes - BostonCard - 03-27-2020
(03-27-2020, 08:25 PM)stupac2 Wrote: Secret video of BC taking a picture of his computer screen:
Not me. I might be old (according to my son), but I know how to screen capture. That was the original poster onto Figure 1 (the website).
BC
RE: Yikes - akiddoc - 03-28-2020
Ugh. Looks like a newborn X-ray from the 1980's with RDS.
RE: Yikes - stupac2 - 03-28-2020
(03-27-2020, 09:15 PM)BostonCard Wrote:(03-27-2020, 08:25 PM)stupac2 Wrote: Secret video of BC taking a picture of his computer screen:
Not me. I might be old (according to my son), but I know how to screen capture. That was the original poster onto Figure 1 (the website).
BC
Ah, I was definitely surprised to see a screenshot. Really I just love that gif.