the Tracheotomy tube cannula, high-flow oxygen therapy, anticoagulants… “front Line” is being held in COVID-hospitals. Doctors go to work – how to battle. Hold the Fort, ill, knocked out of action. Their ranks is a non-core professionals.
to Retrain for a pandemic and decided to take Orlickie. In “life before the war” Nikita Karlicky doctor of football club “the locomotive” Ilya Karlicky – chief doctor of the national team of Russia in beach volleyball. Now both work in one of Moscow hospitals, reallocated to combat coronavirus.
what is duty, what is really behind the bursts of “imminent”, why the high temperature is not an indication for hospitalization, as well as how to operate the applied treatment algorithms, Nikita Karlicky told “MK”.
Ilya and Nikita Orlickie — doctors in the third generation.
– we Grandmother of infectious diseases, worked all his life in the infectious diseases hospital №2 at mount Falcon. Father – doctor – neurologist – says Nikita. And my mother – an engineer-mathematician. Nobody forced us to go to medical school, we are, consciously chose this path.
That during an epidemic, when their team was in isolation, the life in the clubs came to a standstill, the brothers decided not to sit at home on quarantine.
– the Load on doctors is enormous now. Doctors first take the brunt. Because the other can’t. Their nature is to save. Caught, knocked out of action. In this viral war to stay on the sidelines? Brother called and said that not enough doctors. Those that remained, took the triple burden, working sometimes up to three nights. Elijah said, “Go?”. I said, “come here!”
the Brothers Orlickie was already savvy. Following the situation, studied books, watched the speeches of my colleagues, including foreign.
– it is important to retrain was not necessary. One of my diplomas therapeutic. I have over six years working in a hospital as a neurosurgeon. I have not had a problem for patients, says Nikita. – Especially since there are always doctors who are constantly working. Great helping us and head of the Department, on any subject it is possible to consult, it is 24 hours on the phone.
the Most difficult, as for most doctors to work in the protective suit that Nikita Karlicky calls “protective gear”.
– to be fully clothed in protective gear, it takes about 15 minutes. First put on scrubs, on top of it – overalls feet – high boot covers to tightly closed legs. Protected face. Put on respirator with valve, on top of it is a surgical Maswell, eyes shielded tight points.
How long is a shift?
– all hospitals – in different ways, we have 6 hours. We just have increased the number of shifts, but reduced the duration of the change. We work six hours, then 24 hours rest. And so on according to schedule. Seven days a week. A few hours before changing my brother stop drinking. 9 hours with no problems without water.
– what is your duty in the “red” zone?
I work in a hospital bed ward. Depending on the load branch, each of us is 5-8 patients. If the doctor is not a lot of patients, they can secure one who enters the office in his duty. As the only hospital on the basis of our hospital was opened, all 150 beds was completed in 2 days. The townsfolk were shocked by the turn of the ambulance that stood at the entrance to the hospital. Actually it just loaded the hospital. Now the hospital is taking patients on a vacant bed. The ambulance takes the outfit and brings the patient to us.
sorting the patients in military field surgery. Now we often hear that the person a week keeps the temperature of 39, and not taking him to the hospital. I want to say that high temperature is not an indicator for hospitalization, and not an indicator of the severity of the patient. In hospital get people who have the background of the coronavirus were complications developed viral pneumonia, there is intoxication. Their body can no longer cope with the disease.
And these patients are on oxygen, is not the temperature. And those who recently arrived with a temperature of 39, quietly keep the saturation (the oxygen saturation in the blood), and pneumonia, they are less pronounced.
– What percentage of patients in the ICU is oxygen?
– If the patient has shortness of breath and saturation 93-94%, we give it oxygen to breathe. Whom the oxygen mask, some two cannulas, which are fed to the nose. I try not to abuse if the patient to cope, he showed more or less normal, it is preferable that he was breathing on his own. For example, the last shift we oxygen was only three out of 38.
– Recommendations for effective treatment from a position of evidence-based medicine after all, no?
Evidence– based medicine suggests the evidence. Need a large sample, comparison, it takes years. At the same time, I watch people come to us with a temperature of 39, he CT-3, the involvement of pulmonary parenchyma 50-75%. And 3-4 days after the treatment it starts to decrease the temperature in 10 days – an improvement on CT, after 14 days it is issued. So, those algorithms that we have used working, dayut good results. The person had complications, and we coped with it.
of Course, there is an important and immunity and comorbidities. Therefore, all such different disease. There is an old adage that medicine is the second precision science after philosophy. Initially it is impossible to say what will happen.
– it Is believed that patients with strong immune systems, are more likely to develop severe forms of the disease.
– There are people with reactive immunity, their body reacts very violently to get any type of infection. Against this background, they have a fever occurs chills, headache. But they have often not developed any serious complications. On the one hand.
on the other hand, what you perceive as a strong immune system can be allergic reaction in contact with alien DNA. And leaking all this will be very rapidly.
We, for example, brother we believe we have a very strong immune system. I’m sick with the flu 12 hours. I have once temperature rises to 38, and the next day – I’m healthy.
Why among patients hospitalized with viral pneumonia, more men than women?
In my opinion, they look after their health. Women used to take care of yourself to take care of their loved ones.
– Helps what around you is the brother?
– of Course, we are each other moral support. With Ilya we work in different departments. Sometimes overlap. I today, for example, from 13.00 on duty, and he with 12. The medical community is now sharing its experience. We have our own chats. And head of the Department constantly sends us new information. We discuss how individual patient and common tasks.
– are You based out?
– we had a choice to live at home or in the hotel. We decided to stay on while working in the hotel to protect and reduce the risk of infecting loved ones. It is more like a hostel, located close to the hospital, 50 meters. No need to waste time on the road. It is still possible to test for anosmia – loss of smell, to see if they still smell Apple blossoms?
How many intend to work in the hospital?
– We decided to work out exactly a month. 21 may I have the last watch. Each week we pass the tests and blood on the coronavirus. If smears continue to be negative, then perhaps quarantined after work we’ll be only a week. In this case it is necessary in the last day, and then twice more to obtain negative test results.
I Think that the experience of working with patients infected with the coronavirus, both of us with his brother will be useful. I do believe that there is no useless information. The most inconvenienced by the unknown. And when you understand, tyou already calm. We realized that all of this can be treated if God forbid, something happens with loved ones. To some extent it is also self-assertion. What a difficult time not left behind.
How your team? Continue to communicate with players remotely?
With all the players I was in touch, monitor their status, see what problems they have. However, now for the time of enforced quarantine all healed. The problem is all different now, as if not to lose shape.
But the guys are working, they did well. Some of the guys went to his small home, where not as pronounced quarantine, and have the opportunity to run through the woods. Someone has their home sites.
Worse, of course, those who remained in a Moscow apartment. But even there, the athletes equipped have mini-gyms, bought exercise equipment, someone took them out of the club. Train.
we Have a fitness coach who is very seriously to this matter came from the first day. Each player has its own individual program. They have heart rate monitors, watches, the readings from which are recorded. Athletes can remotely control. Even if you want to earn some, they will not succeed. Everything is tracked, you guys report, programs in the course are adjusted. The work continues.
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