NHS Hot topics....docx - NHS Hot topics Coronavirus Causes...

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NHS Hot topics Coronavirus Causes localised inflammation causing damage to alveoli and pulmonary oedema swelling triggering ARDS as it leads to fluid and swelling of lungs leading to cytokine storm Leads prothrombotic state with lots of clots form Steroids to dampen immune system, vaccines and support by providing oxygen and increase percentage of oxygen through different masks and techniques if not enough then put them on CPAP - continuous positive airway pressure which is a mask giving background pressure into lungs constantly keeping alveoli open helps with gas exchange helps with recovery If not then eventually intubate them - monitor gases and pressures and tailor breathing for patients and sedate them and put them on mechanical ventilator and allows a machine to breathe for person and allow for lungs to recover and machine does breathing for person and controlled in ICU High likely of blood clots in kidney and brain give blood thinner Increase fluid in lungs - ARDS so patient short of breath cannot get adequate oxygen into lungs in blood lead to death and can present with additional pneumonia and additional bacterial infections. Inflammation and fluid overload Protect immunosuppressed people, herd immunity, protects vulnerable people Efficacy - 90% - take years this has been quick, not enough people tested in clinical trials, population may be skewed or selected so not all backgrounds tested in short space, some bias to make profits and short time so don’t know long term side effects, cost to roll out is a lot and some people unwilling to have vaccines , compliance to vaccine by younger, rate of supply of vaccines and transport and mutation of strains and how often vaccinated R value how many people person can spread it to If R is 1 but number of new cases aren’t increasing and are same as people get better or pass away if more than 1 rate of cases increases If R is less than 1 then disease is dying out difficult job by government Prod they did lockdown and are doing regional lockdowns depends on number of cases and they developed furlough scheme to keep economy stable so good financial support to population Took 2 weeks to act on country for lockdown where cases are so significant Prepared with nightingale hospital to prepare for this tent like hospitals in Manchester, Birmingham and London if too many hospitals with cases and people that don’t require hospital level care go there had to use them a lot in second wave not much in first - gov prepared for that
lack of PPE face mask 50% effect, FFP3 type of mask used for specialist areas in AGP aerosol generating procedure like CPAP or ICU full PPE FFP3, gown etc lots of confusion about guidance and risk of getting COVID is 1% with FFP3 and is very expensive Vulnerable people been shielding so working from home so burden NHS with elderly doctors work experience consultant didn’t do many ward rounds Movement of all care to just emergency care cancelling elective procedures

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