Jim Wright

speaker

217 appearances 1 recordings 1 series first heard Apr 2020 last heard Apr 2020

Jim Wright’s voice in public audio — every appearance, attributed to the second.

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GeriPal - A Geriatrics and Palliative Medicine Podcast · COVID in Long Term Care: Podcast with Jim Wright and David Grabowski · 6 Apr 2020 podcast

experience and so you can talk very specifically about futility of care and and that has helped some families that we you know we've been talking to them about code status on their 80 year old relative for years now it is it has really helped

to have that specific information and bring it to the families and allow them to make an informed decision.

So we've been surprised at how families seem to be primed.

I mean, everyone's heard about the lethality of the virus, so they're primed for the discussion.

It doesn't take long to give them the specifics and then come to a decision about maybe a time-limited DNR, do not hospitalize.

So we've been...

But like I said, we scrambled at the beginning.

So that first week,

We were simply not prepared for the, in some patients, the sudden decline.

You, of course, don't have time for ACP discussions when you're trying to triage patients.

So our recommendations to the community is if you haven't started COVID-specific ACP discussions with your families, you're behind the ball and you need to get going.

So we've seen about three different typical courses.

I guess the most common has been what we call... So there's an indolent, convalescent presentation where you will...

develop symptoms of generally a fever of 101 to 102 and mild to moderate respiratory symptoms that last about 48 hours.

And that can be, bronchospasm is fairly common.

Those symptoms do seem to respond to inhaled bronchodilators.

And then there'll be a stabilization for four to five days.

And then there'll be recovery.

Now, after that four to five days, we also have seen an increase in the risk of secondary pneumonia.

And so you still in those indolent convalescent folks, you still have to be very vigilant.

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