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In the third wave, the most serious clinical pictures are, pneumonia develops very quickly and worsens very quickly. When a patient comes to us with late-stage pneumonia, they are approaching mechanical ventilation. We have younger people on respirators, who were healthy before the crown. All our capacities are full, we have about 300 patients and we are literally waiting for someone to be fired so that we can accept new people – says the anesthesiologist ass in an interview for Kurir. Dr. Marija Milenković, coordinator of the Kovid Bežanijska kosa Hospital, who works in the Emergency Center under normal circumstances.
What is the exact age structure of the patient on the ventilator?
– There is no elderly population, mostly patients between 45 and 65 years old. Of course, there are some very elderly patients, but most of them are those who came from the hospital, after an operation, where their crown was discovered. But there are many young people who neglected their symptoms with a high fever and then ended up on mechanical ventilation due to the worsening, with a high scan score. When they arrive in the late stage of pneumonia, there is not much help for them. They always require some type of mechanical, non-invasive or invasive ventilation. Currently, the youngest patient on our ventilator is in his 40s and the oldest is 86 years old.
And then there is progression to other organs?
– Absolutely. It is increasingly associated with heart problems, there are various forms of heart failure, to which, after so much experience, cardiologists are already used to. There are also problems related to the gastrointestinal tract, the nervous system … When you have diarrhea, vomiting, headaches, these are already symptoms of other organs and breathing is difficult from the lungs.
Does organ failure also start in the respirator?
– A respirator is a machine that helps, but you have to sedate there. And then slowly multi-organ dysfunction begins and other organs begin to fail. The kidneys fail, the patient ends up on dialysis and, in general, the whole body’s ability to fight and react is reduced.
Are there more deaths now than in the second wave?
– The clinical pictures are more difficult, but we have a lot of experience and we recognize the deterioration very fast and we coordinate everything in time. We know what to expect. We are literally one step ahead of the disease, at least that is the case with Bežanijska kosa. Except in cases where the patient is late and does not respond on time.
Are there constant thrombosis or clotting problems?
– They are immune thromboses, because they occur in the lungs, in the place where it becomes inflamed. But we cannot call them thrombosis in the classical sense. As we have a lot of experience, we give anticoagulant therapy as prevention. It meant all this what we went through with patients. And we don’t have a lot of deaths, at least as far as Bežanija’s hair is concerned, because it helps over time. Bežanijska kosa is a system of triage and frequent visits to patients, a system with semi-intensive and intensive care. When you recognize the patient and put him in semi-intensive care, avoid the appearance of complications.
Does remdesivir, which has recently been included in our treatment protocol, help patients?
– Remdesivir has worked very well. It is administered in the first days of the disease if there is respiratory deterioration, so it is very important that patients inform them in time. There’s also favipiravir, the precursor to remdesivir, which is given to all who call on time. Like remdesivir, it is an antiviral drug and we have a good experience with it. Both are used under the control of strict medical indications, and both are administered in the initial phase of the disease, up to the seventh day. And that is why I repeat that it is very important that people arrive on time. I think we are the hospital that gave the most remdesivir. More than 200 patients received favipiravir.
Do you have reinfected patients?
– No, it seems to me that only one of those patients lied. They are all new cases.
What did the crown show us?
– The Crown has shown us that neither fame, nor money, nor power mean anything! We are all the same. But also that as important as the role of the physician is, it is equally important that patients encourage themselves. In addition, the experience is not in doubt, but the close and humane attitude towards patients is also important. And I have to praise the Bežanijska kosa team of doctors, no matter who the specialty is, they all work together, but also the medical and non-medical staff. They all come on Saturdays and Sundays, and nothing is difficult for them. At Bežanijska kosa, everything works like clockwork and I, as someone from the side, am very well accepted. Here you can do everything in the hospital: diagnostic procedures, nothing is saved, cardiac ultrasound, gastroscopy, surgical procedures are performed … everything is placed under the red zone.
The most emotional moment The most difficult is when you treat close people
What moment is the most emotional for you?
– There were many of them, and the last one was when I treated the family of a colleague and friend, parents and brother. His father’s condition worsened and he ended up in the intensive care unit. He got off, went home, but it scared me, it was the first time that he treated someone close to me.
What do patients tell you?
– We are their only contact with the world and they ask about our families, they send messages. We had a father and son who quarreled, so the father asked us to tell our son that he was sorry and that he was wrong. In pulmonology, I told the man that he had to fight because his family and his wife were waiting for him, and he said, “My wife died yesterday of a crown.” That was very difficult. You have to choose the words, the most important thing is that psychological moment: how will you say some things to them, how will you approach them. It is important that you dedicate yourself to everyone, because at that time, the hardships and torments of all are the most difficult.
A soldier in the hospital
Milunka Savić at the time of the crown
Colleagues also call her Milunka Savić.
– My temperament is like that, maybe I’m a little sharp, I act a bit like a soldier and I don’t see how long I’ll be in the red zone. I don’t stay there for four or six hours, but longer if necessary. I may not be smart, but I do.
JS Spasić
delivery courier
Author: delivery courier
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