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erebos napísal:Greenie : len doplnenie k dochodcom...

Toto je uplne rovnaka situacia ako ked dochodcovi 70+ povies aby pocas 2 dni v roku ked je v BA poladovica sedel doma na riti. Just si musi ist kupit jogurt a zlame si hnatu... Doslovne musis pouzit nasilie U nas zabrala az vyhrazka, ze ked sa dolame tak ide do starobinca lebo s nim 3 tyzdne doma nebudem...
Rovnake je to tu. Vyuzivat E recept, ist im nakupit spolu s nasim rodinnym nakupom, zatrhnut opustanie bytu... doslovne obmedzit osobnu slobodu...

Interview with Christian Salaroli, anesthesia doctor in Bergamo from 'Corriere de la sera' from 9.3.2020, translated by Eva-Maria Michels

So you're really making a selection?

Of course I am. Only people who have respiratory insufficiency due to COVID19 will be included in this unit. The others: off home!

What happens then?

They get non-invasive ventilation. This is the first stage.

What are the following?

Early in the morning the anesthesia doctor comes along with the emergency room nurses. His opinion is crucial.

Why is his decision so important?

In addition to age and general condition, he evaluates the patient's ability to survive an invasive ventilation procedure.

What exactly does that mean?

The infection caused by coronavirus is an interstitial pneumonia. A very aggressive form that brutally hinders the supply of the blood with oxygen. The most attacked patients suffer from lack of oxygen: they no longer have enough oxygen in the organism.

When will the choice be made?

Immediately after visiting the anesthesia doctor. We need to make that choice. One or two days maximum after recording. Non-invasive ventilation is just an intermediate step. Unfortunately, there is a mismatch between hospital funds, the available beds in ICU and the number of sick people in critical condition. We can't intubate everyone, [d. h the ventilation hose is connected directly to this invasive ventilation after an incision into the trachea].

What is happening at this moment?

Those we have decided to continue care will be immediately intubated. We put them on the abdomen to facilitate the ventilation of the lower lungs.

Regarding the decision, is there a written rule?

Currently, unlike what I read, no. In reality, even if it sounds terrible to say so, we are very closely at the sick who also have severe cardio-respiratory diseases and those with severe heart wreath problems because they tolerate an acute lack of oxygen and have little chance of the critical phase to survive.

And then what?

If someone is between 80 and 95 years old and has major breathing problems, we usually do not continue the treatment. The same applies when a person infected with the virus has an insufficiency in three or more vital organs. Statistically, these people have no chance of surviving the critical stage of infection. These people are already considered dead.

So you're sending her away?

That too, that's a terrible sentence, but the answer is yes. We don't have the possibilities to try what is commonly called a miracle. This too is the sad reality.

Usually that's not the case?

No, no, no. In normal times, there is also an assessment to know if a person has a touch of a chance of survival during an intervention. But now we are dealing with a completely different number of cases.

And you as doctors, are you enduring this situation well?

Some of us are going to break this. Especially the youngest, the very boys who have just started their work and now suddenly don't have to decide anything about the question of someone's life and death.

What about you?

So far I still manage to sleep at night. Because I know that the selection is based on the hypothesis that some cases, almost always the younger ones, have better chance of survival than others. At least that comforts.

What do you think of the last decisions the government made?

Quarantine to limit the virus to certain zones is a good idea. But it's a measure that comes with two weeks delay. The most important thing is somewhere else anyway.

So that means?

Stay home, stay home stay home. I can't repeat it enough. I see too many people walking on the street like nothing.
You don't have the slightest idea of what's going on in the hospitals and you don't want to know. Stay at home.

Are you missing staff?

Yeah, yeah. We work almost 24 h and we are exhausted. Physically but also emotional. I've seen nurses crying 30 years of work experience, doctors suffer a nervous breakdown. No one can imagine what's happening in hospitals at the moment. This is why I accepted this interview.

Is there still a right to treatment?

At the moment, it is threatened by not being able to manage an ordinary situation and an exceptional situation at the same time. Standard treatments can be delayed and this can have bad consequences.

Can you set an example?

Usually a call is settled within minutes for a heart attack. Today you have to wait an hour and longer.

Do you have an explanation for all this?

I prefer not to look for it. I tell myself it's like war surgery. You only save those who have a chance. This is exactly what is happening at the moment.