absolutely this thread

I don’t think we were hit as hard first go round but here are my additions: https://twitter.com/ercowboy/status/1279193569975250945

figure out your level of comfort for keeping your family uninfected

MrsAware’s sis lives nearby so they lived in their basement through the worst of it

I still had (and still do) a rigorous post shift routine

being extra scrubs to change into before leaving

carry as little on me as I need

wipe everything down

shift bag in shed outside

shower immed on coming home

some relatively minor airway tips we got from others & implemented:

HAVL default, keeps you a bit further away

3 sets of gloves, immed after tube placement, drop disposable blade + outer gloves in lab bag -> garbage

no apneic ox / NC during laryngoscopy

seeing peritube hypoxia like we haven’t since I was an intern

all the PPE for ETI, we did towels around our necks

HEPA filter immed on tube and never comes off, clamp tube for any disconnection

little white board in intubation room and another outside to communicate with the teams in & out of the rooms.

speakerphone sucks in general and behind an N95+surg mask it’s nothing

work out guidelines for intubation vs HFNC/proninf etc with ICU folk

incredibly frustrating to litigate it every time

call proning “tummy time.”

yes it's a little silly but it also demystifies it a lot. a top hospital/ICU shared their protocol (thank you) and it was 2 pages of detail

it boils down to

patient awake? ask them to turn over

(intubated proning is very different)

self-care is impt. esp with FamilyAware out of the house, it got lonely

I reached out to a lot of colleagues from residency etc, some calls & zooms

bunch of twitter zooms

breaking plates with people going through similar is v helpful

also give yourself permission to turn off your brain at home

the only TV I could watch was Office/30 Rock/Tiger King

played a lot of mindless xbox

only movie I watched was The Other Guys ()

I appreciated the privilege we had to be able to help in these historic times, to maintain my salary when the economy is toast, to see people at work going through the same when others are isolated

and it helps that our work is directly related to the big existential threat. it's not like we work at a shoe factory and there's a looming pandemic, we deal with the big thing in our work

as usual, it's important to be nice to everyone. we're all under pressure, we're all dealing with the same constantly changing situation & response

I basically started every shift by apologizing to the charge RN that I would keep asking stupid questions all day

also if it's not obvious just stop doing anything unnecessary

I had a few projects get delayed and it's fine, now's not the time

order from restaurants.

"support local business" + less labor at home + yummy food.

in The Time Before I did a combo of bus + Lyft to/from work

our hospital got us cheap parking and I drove instead. don't want to get others' sick

also it sucks it sucks it sucks but remember that at work we're all near a bunch of other people who are both near a lot of COVID patients but also just other people in general:

wear a mask at work all the time.

also remember how scared and lonely patients are

as much as we don’t know, they likely know less, and we unfortunately can’t let them have visitors :/

also I don’t mean this as a humblebrag but I helped lead our ED’s airway planning/protocols/supply org etc for COVID and would be happy to share or discuss with anyone who would like

I certainly don’t pretend to think that what we did is The Way but it seemed to make sense and we learned a lot along the way (largely building off standing on the shoulders of others etc)