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Thread: Message from Alaska's largest hospital. Triage.

  1. #1
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    Default Message from Alaska's largest hospital. Triage.

    Remember that discussion we had a while back about triage in hospitals? About the impact that COVID hospitalizations are having in some places, and the absolutely crushing ethical decisions which medical staff could potentially be forced to make?

    Also, remember our conversation yesterday about the apparent similar unwatchability of Tucker's or Rachel's respective shows?

    This excerpt of a press release from the Providence Alaska Medical Center was just linked in a tweet by Rachel Maddow's staff. Somebody tell me if Tucker mentions it on his show tonight, or if he says something else about vaccinations, ICU beds, etc. Somebody tell me how this is evidence of Maddow's "spin," rather than simply reporting what the Alaska hospital wrote.

    If I use the word "God," I sure don't mean an old man in the sky who just loves the occasional goat sacrifice. - Anne Lamott

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    Default Re: Message from Alaska's largest hospital. Triage.

    And those that present with Covid 19 and can't show proof of being vaccinated should be made to go to the back of the line.

    Why should someone who did everything right, got vaccinated, showed care and empathy for their fellow citizens by masking up, didn't smoke and maintained a healthy diet be forced out of emergency care due to an accident?

    Why should some nudnik with multiple comorbidity issues who took Ivermectin instead of a life saving vaccine and then shows up with 60% lung function, his body wracked with a deadly virus due to his failure to vaccinate get a room?

    Sorry, no room for you! No soup for you either! NEXT!
    "Unrepentant Reprobate"
    Lew Barrett



  3. #3
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    Default Re: Message from Alaska's largest hospital. Triage.

    Heard a report on NPR that down to the granular county level in every state, those that voted for Trump are anti vax and in the hospital or are dying at 1,500 per day.

    This virus is a political virus
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    Default Re: Message from Alaska's largest hospital. Triage.

    Back a couple of months ago CDC, Fauci, NIH, and other recognized experts were saying that this Delta Variant wave was going to be a pandemic largely for the unvaccinated where they would represent something like 98% of all Covid related hospitalizations and 99% of all the deaths this time around.

    Can't cure stoopid, best to give it a wide berth.
    "Unrepentant Reprobate"
    Lew Barrett



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    Default Re: Message from Alaska's largest hospital. Triage.

    Had my latest 'denialist' in today - 60's, works hard for a living - he grinds tree stumps out, does a lot of heavy lifting. Not vaxxed - and then proceeded to lecture me about how 'natural immunity' protects 27X greater than does the Vax!

    I had to admit - I did not know that.

    Moving right along....
    There's a lot of things they didn't tell me when I signed on with this outfit....

  6. #6
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    Default Re: Message from Alaska's largest hospital. Triage.

    Quote Originally Posted by Kevin T View Post
    And those that present with Covid 19 and can't show proof of being vaccinated should be made to go to the back of the line.

    Why should someone who did everything right, got vaccinated, showed care and empathy for their fellow citizens by masking up, didn't smoke and maintained a healthy diet be forced out of emergency care due to an accident?

    Why should some nudnik with multiple comorbidity issues who took Ivermectin instead of a life saving vaccine and then shows up with 60% lung function, his body wracked with a deadly virus due to his failure to vaccinate get a room?

    Sorry, no room for you! No soup for you either! NEXT!
    This doesn't pass the smell-test IMHO

    I'll agree that there's some validity to the ol' "god helps those who help themselves" vein of this position.

    on the other hand, it smells a lot like the thought that those who chant "defund the police" shouldn't call 911.

    Should those who haven't learned to swim be refused a seat on the lifeboat?
    What color are their hands now?

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    Default Re: Message from Alaska's largest hospital. Triage.

    I would support a directive that says the following.

    If a potential patient comes to the hospital and tests positive for COVID-19, AND
    Cannot prove a pre-infection COVID vaccination AND
    the hospital is more than 85% full THEN

    that patient is relegated to home care.

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    Default Re: Message from Alaska's largest hospital. Triage.

    Quote Originally Posted by Figment View Post
    This doesn't pass the smell-test IMHO

    I'll agree that there's some validity to the ol' "god helps those who help themselves" vein of this position.

    on the other hand, it smells a lot like the thought that those who chant "defund the police" shouldn't call 911.

    Should those who haven't learned to swim be refused a seat on the lifeboat?
    I'm not sure your examples are analogous.

    A lot of those chanting defund the police are not likely to call the police anyway for fear of becoming the victim of police violence, but that's besides the point.

    While the phrase "Defund the Police" has to be one of the most unfortunate, stupid and misleading calls for police reform ever made, it does garner a lot of attention. Most who understand nuance recognize that the call is really advocating for a redirection of police funding and a reorganizing of police response signal events and the methods of resolution.

    More funding for de-escalation techniques, health care responses, both mental and physical trauma responders as warranted by the event, and more community outreach versus the automatic militarized response that every single call seems to result in from simple traffic stops to domestic health crisis events.

    Swimming skills or none at all are not a requirement in emergency situations when being conveyed over water as a passenger. Life boats are installed to provide a seat for all aboard. If you are about to board a boat with 15 berths and find life raft accommodations for only 10 souls, perhaps rethink the need to take that ride. Just my .02 and no snark intended.
    "Unrepentant Reprobate"
    Lew Barrett



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    Default Re: Message from Alaska's largest hospital. Triage.

    Quote Originally Posted by George Jung View Post
    Had my latest 'denialist' in today - 60's, works hard for a living - he grinds tree stumps out, does a lot of heavy lifting. Not vaxxed - and then proceeded to lecture me about how 'natural immunity' protects 27X greater than does the Vax!

    I had to admit - I did not know that.

    Moving right along....
    "Natural Immunity" would, worked for the Black Death and in a small group Aids too.
    Darwin at work.

  10. #10
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    Default Re: Message from Alaska's largest hospital. Triage.

    Quote Originally Posted by Figment View Post
    This doesn't pass the smell-test IMHO

    I'll agree that there's some validity to the ol' "god helps those who help themselves" vein of this position.

    on the other hand, it smells a lot like the thought that those who chant "defund the police" shouldn't call 911.

    Should those who haven't learned to swim be refused a seat on the lifeboat?
    I think, as I wrote elsewhere, that we've strong precedent from the Substitute Decision Maker genre of legislation, that treatment decisions are already guided both by the kind of interventions available in a place, and also by the expressed wishes of the individual. That is, if a person has either written or told next of kin "don't give me that drug" or "don't bring me back if I go," those wishes must be considered.

    I think that when there's no limitation on beds or resources, and nobody's being bumped by such things, a medical team can offer every possible type of care their facility can provide ... despite what a patient may have said or written before.

    I also think, though, that when a facility reaches where this Alaska hospital now is, that triage should consider not merely the hospital's resources and the order in which a person arrived at the ER, but also whether the person has recently been actively and with full knowledge putting themselves at risk for exactly what they've contracted. That the people who have in contrast been working to safeguard their health and got whacked anyway should be a few steps higher on the waiting list. Because, honestly, both groups of people have very recently expressed their wishes, in full knowledge.

    It isn't intended to be punitive, but instead to have consequences occur in good-faith according to what a person's clearly said.
    If I use the word "God," I sure don't mean an old man in the sky who just loves the occasional goat sacrifice. - Anne Lamott

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    Default Re: Message from Alaska's largest hospital. Triage.

    Joe: I voted for Trump, yet I was in the vaccination clinic on the third day it was open to me. I don't think anyone can take NPR as correct on every item. I listen to NPR because the reporting is generally well done, interesting and well read, although slanted left. BTW, I am a registered Democrat, as well. When "all", "never", "always", and "none" are used, it makes it immediately not true.

    KG
    \"Of all the things I\'ve lost, I miss my mind the most.\"

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    Default Re: Message from Alaska's largest hospital. Triage.

    In Sydney a hospital for the mentally disturbed, a growing number amongst the young as a result of Covid, has been 'cleared', the patients sent home, to make room for Covid patients. That's a sort of triage I'd say.

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    Default Re: Message from Alaska's largest hospital. Triage.

    One of our local 'Old Rigs' boaters felt a bit unwell at a meet, so went home early. Had a stroke the next day. The hosptal would not admit him as he was not vaccinated and his wife had to look after him at home with some help.
    Not heard how he is doing. Know of several other 'antis', hope they don't fall ill.
    France has a great medial system, but you need to support it.... Quite a few are not.

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    Default Re: Message from Alaska's largest hospital. Triage.

    Quote Originally Posted by Kevin G View Post
    Joe: I voted for Trump, yet I was in the vaccination clinic on the third day it was open to me. I don't think anyone can take NPR as correct on every item. I listen to NPR because the reporting is generally well done, interesting and well read, although slanted left. BTW, I am a registered Democrat, as well. When "all", "never", "always", and "none" are used, it makes it immediately not true.

    KG
    Please look up the word ANTIDOTAL evidence

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    Default Re: Message from Alaska's largest hospital. Triage.

    Quote Originally Posted by joe (socal) View Post
    please look up the word antidotal evidence

    my damn predictive text does that to me!

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    Default Re: Message from Alaska's largest hospital. Triage.

    Anti dotard? nah...

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    Default Re: Message from Alaska's largest hospital. Triage.

    Joe: I don't understand the thrust of your comment. Testimony uncorroborated by solid evidence??

    kg
    \"Of all the things I\'ve lost, I miss my mind the most.\"

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    Default Re: Message from Alaska's largest hospital. Triage.

    Quote Originally Posted by Figment View Post
    This doesn't pass the smell-test IMHO

    I'll agree that there's some validity to the ol' "god helps those who help themselves" vein of this position.

    on the other hand, it smells a lot like the thought that those who chant "defund the police" shouldn't call 911.

    Should those who haven't learned to swim be refused a seat on the lifeboat?
    A humanitarian.

    Excellent!

    However, I would say that once the obstructionism and political lies have gotten to the point where their choice to decline the vax is causing people to die, they should be left to deal with the consequences of their decisions.

    Sorry.

    Comparing learning to swim with learning to be a responsible member of society is a bit of a stretch, to my way of thinking.

    Spit's gettin' real.

    They've had a year and a half to grasp the idea that there's a killer on the loose, and six months to get a free vaccine that denies the killer his in.

    Having such people taking ICU beds from every body else who needs them hardly seems like the moral choice, though I grant you it's not an easy choice.

    The fact is that these people have chosen to believe the lies that will kill them, and they are demanding that everybody else die, too.

    I refer you to Hunter S. Thompson . . .

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    Default Re: Message from Alaska's largest hospital. Triage.

    Quote Originally Posted by Joe (SoCal) View Post
    Please look up the word ANTIDOTAL evidence

    Let's try "anecdotal" evidence, shall we?

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    Default Re: Message from Alaska's largest hospital. Triage.

    Refusing service because someone's beliefs?
    Really!
    All I can say is I hope our politicians aren't as two face, Ok this country is just screwed!

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    Default Re: Message from Alaska's largest hospital. Triage.

    As a medical professional, you'll get my best whether you're wearing the latest MAGA-merch or an "I love AOC" button.

    But I get the frustration. We told you what to do to protect yourself and you wouldn't listen...'cause you know, what makes you the expert with only a few followers on your twitter account.
    Steve

    If you would have a good boat, be a good guy when you build her - honest, careful, patient, strong.
    H.A. Calahan

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    Default Re: Message from Alaska's largest hospital. Triage.

    Triage is a process usually used in a mass casualty incident. The 3 sorting criteria are those who will survive with immediate care, those who will survive with no immediate care, and those who will die regardless or with heroic care that can't be given without impacting the care that the 1st category needs. The second category and the third category are not immediately treated if at all.

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    Default Re: Message from Alaska's largest hospital. Triage.

    Quote Originally Posted by Kevin G View Post
    Joe: I voted for Trump, yet I was in the vaccination clinic on the third day it was open to me. I don't think anyone can take NPR as correct on every item. I listen to NPR because the reporting is generally well done, interesting and well read, although slanted left. BTW, I am a registered Democrat, as well. When "all", "never", "always", and "none" are used, it makes it immediately not true.

    KG
    Curious whether you voted for Trump once or twice?
    Speak softly and carry a mouthful of marbles.

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    Default Re: Message from Alaska's largest hospital. Triage.

    Quote Originally Posted by cbcc View Post
    Let's try "anecdotal" evidence, shall we?
    Sorry predictive texting
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    Default Re: Message from Alaska's largest hospital. Triage.

    Quote Originally Posted by Andrew2 View Post
    One of our local 'Old Rigs' boaters felt a bit unwell at a meet, so went home early. Had a stroke the next day. The hosptal would not admit him as he was not vaccinated and his wife had to look after him at home with some help.
    Not heard how he is doing. Know of several other 'antis', hope they don't fall ill.
    France has a great medial system, but you need to support it.... Quite a few are not.
    France? Someone unvaccinated who does not have the virus is more dangerous than someone actively infected? That doesn’t sound right. Or it sounds unscientifically punitive. Do they exclude fat people and smokers as well?

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    Default Re: Message from Alaska's largest hospital. Triage.

    Anti-vaxxers are no doubt the kind of people that bleat endlessly on about personal responsibility and the like. They swallowed whole Reagan's BS about how the government is the problem.

    Well, screw them. Not vaxxed and ill? Go straight to the hell you so eagerly believe in. Pray to your deity for help. Meanwhile, the ER and ICU people have serious work to do. Taking horse paste? Go talk to a veterinarian.
    Gerard>
    Langley, WA

    Don't believe Republican lies.

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    Default

    My neighbor is an emergency room nurse at the University of Washington hospital. He says that the hospital are swamped with COVID-19 patients right now. All but 2 are unvaccinated. And the 2 vaccinated patients are cancer patients with compromised immune systems.

    As far as I'm concerned, if you are in the USA, a COVID-19 patient, eligible for the vaccine and yet unvaccinated, you should go to the bottom of the triage list. God helps those who help themselves.
    You would not enjoy Nietzsche, sir. He is fundamentally unsound. — P.G. Wodehouse (Carry On, Jeeves)

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    Default Re: Message from Alaska's largest hospital. Triage.

    I don’t think it would be ethical to provide different levels of care for vaccinated or non-vaccinated COVID patients who present for care.

    Waiting for the Federally-required employer vaccine mandates to land.

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    Default Re: Message from Alaska's largest hospital. Triage.

    Quote Originally Posted by C. Ross View Post
    I don’t think it would be ethical to provide different levels of care for vaccinated or non-vaccinated COVID patients who present for care.

    Waiting for the Federally-required employer vaccine mandates to land.
    Do you think it would be ethical to treat drunk drivers the same as sober drivers?

  30. #30
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    Default Re: Message from Alaska's largest hospital. Triage.

    Quote Originally Posted by The Ranger View Post
    Triage is a process usually used in a mass casualty incident. The 3 sorting criteria are those who will survive with immediate care, those who will survive with no immediate care, and those who will die regardless or with heroic care that can't be given without impacting the care that the 1st category needs. The second category and the third category are not immediately treated if at all.
    So you don't think that 667,000 odd deaths from Covid are a mass casualty incident?

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    Default Re: Message from Alaska's largest hospital. Triage.

    Quote Originally Posted by Jim Mahan View Post
    Curious whether you voted for Trump once or twice?
    Quote Originally Posted by oznabrag View Post
    Do you think it would be ethical to treat drunk drivers the same as sober drivers?
    If they are in the hospital, then yes.

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    Default Re: Message from Alaska's largest hospital. Triage.

    Quote Originally Posted by C. Ross View Post
    I don’t think it would be ethical to provide different levels of care for vaccinated or non-vaccinated COVID patients who present for care.
    However, in the land of the free, do those with a massive heath care insurance package get the same level of care as those with no insurance or funds at all?

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    Default Re: Message from Alaska's largest hospital. Triage.

    Quote Originally Posted by Andrew2 View Post
    One of our local 'Old Rigs' boaters felt a bit unwell at a meet, so went home early. Had a stroke the next day. The hosptal would not admit him as he was not vaccinated and his wife had to look after him at home with some help.
    Not heard how he is doing. Know of several other 'antis', hope they don't fall ill.
    France has a great medial system, but you need to support it.... Quite a few are not.
    Quote Originally Posted by ShorelineJohn View Post
    Refusing service because someone's beliefs?
    Really!
    All I can say is I hope our politicians aren't as two face, Ok this country is just screwed!
    If the second post is a comment on the first then the refusal is not because of belief but for lack of action.
    I'd much rather lay in my bunk all freakin day lookin at Youtube videos .

  34. #34
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    Default Re: Message from Alaska's largest hospital. Triage.

    Maybe the next pandemic won’t be as mild, but we’re getting ready for it!

    https://khn.org/news/article/over-ha...s-in-pandemic/

    A KHN review of hundreds of pieces of legislation found that, in all 50 states, legislators have proposed bills to curb such public health powers since the covid-19 pandemic began. While some governors vetoed bills that passed, at least 26 states pushed through laws that permanently weaken government authority to protect public health. In three additional states, an executive order, ballot initiative or state Supreme Court ruling limited long-held public health powers. More bills are pending in a handful of states whose legislatures are still in session.

  35. #35
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    Default Re: Message from Alaska's largest hospital. Triage.

    an “excess” death

    https://www.cbsnews.com/news/covid-u...table-illness/

    When U.S. Army veteran Daniel Wilkinson started feeling sick last week, he went to the hospital in Bellville, Texas, outside Houston. His health problem wasn't related to COVID-19, but Wilkinson needed advanced care, and with the coronavirus filling up intensive care beds, he couldn't get it in time to save his life.
    .
    Last Saturday, Wilkinson's mother rushed him to Bellville Medical Center, just three doors down from their home.
    .
    Belville emergency room physician Dr. Hasan Kakli treated Wilkinson, and discovered that he had gallstone pancreatitis, something the Belville hospital wasn't equipped to treat.
    .
    Kakli told Begnaud that his patient was dying right in front of him. Wilkinson needed a higher level of care, but with hospitals across Texas and much of the South overwhelmed with COVID patients, there was no place for him.

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