:joker-troll: wot if i told you the pandemic is simultaneously stressing primary/preventative care while driving rural GPs to cities and causing a mass healthcare workforce exodus? wot if i did?
The big spooks for me are secondary and tertiary impacts. We only have decent meds to prevent clotting when it's clinically addressed for acute issues or stuff like aspirin for chronic risk. We can break them up certainly, but whenever I've pushed TPA it's within a strict four hour window with a full ER team and a helicopter on standby to get them to a neurosurgeon if needed. When we bust clots that can be a generalised drug which suddenly busts all clots, causing really serious issues that need a lot of resources. They're going into ORs with a massive backlog even for serious trauma patients. They're competing for ICU beds with COVID patients that are there longer than other patients needing more interventions from fewer nurses.
They can be lifesavers if you know the precise onset of the stroke but after that window the side effect risk outweighs the benefit since it's already done most of its damage. The brain drain in rural areas is a mix of longterm systemic cuts to budgets, better opportunities in urban hospitals and things to do in cities, and now their antivaxxer patients. There used to be a lot of romanticism to the idea of the country doctor, someone who truly had to do it all, but even before the pandemic I was reading stories about rural psychiatrists covering multiple counties and several hundred patients. That infrastructure was hollowed out years ago along with the prestige of the position.
:joker-troll: wot if i told you the pandemic is simultaneously stressing primary/preventative care while driving rural GPs to cities and causing a mass healthcare workforce exodus? wot if i did?
The big spooks for me are secondary and tertiary impacts. We only have decent meds to prevent clotting when it's clinically addressed for acute issues or stuff like aspirin for chronic risk. We can break them up certainly, but whenever I've pushed TPA it's within a strict four hour window with a full ER team and a helicopter on standby to get them to a neurosurgeon if needed. When we bust clots that can be a generalised drug which suddenly busts all clots, causing really serious issues that need a lot of resources. They're going into ORs with a massive backlog even for serious trauma patients. They're competing for ICU beds with COVID patients that are there longer than other patients needing more interventions from fewer nurses.
Thanks, this was really informative. Had no idea anti clotting interventions were that dangerous.
I haven't heard about this, is it GPs just giving up on their patients after they refuse treatment or something else?
They can be lifesavers if you know the precise onset of the stroke but after that window the side effect risk outweighs the benefit since it's already done most of its damage. The brain drain in rural areas is a mix of longterm systemic cuts to budgets, better opportunities in urban hospitals and things to do in cities, and now their antivaxxer patients. There used to be a lot of romanticism to the idea of the country doctor, someone who truly had to do it all, but even before the pandemic I was reading stories about rural psychiatrists covering multiple counties and several hundred patients. That infrastructure was hollowed out years ago along with the prestige of the position.