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SCCM Member Volunteers to Care for NYC COVID-19 Patients

Visit sccm.org/disaster for more COVID-19 resources. 

Putting disaster preparation training to use, a Society of Critical Care Medicine (SCCM) member volunteers to aid in New York City's COVID-19 crisis.

While he received first responder training during his fellowship at Memorial Sloan-Kettering Cancer Center in hopes of being able to help after 9/11, Gregory Margolin, DO, FCCP, FCCM, was never called upon to use his disaster preparedness skills. When New York began experiencing a surge of COVID-19 cases in March, he knew he had something to offer. Dr. Margolin, an intensivist in Phoenix, will travel to New York City on April 16 with 10 colleagues, including nurses, respiratory therapists, and a hospitalist. His April 17 orientation will precede his first shift that evening at the Javits Center, the convention center in Manhattan repurposed for COVID-19 overflow. He will be assigned to various hospitals as needed. 

“While I feel well prepared to help in disaster situations, I have not had the opportunity to physically apply it,” said Dr. Margolin. “Helping NYC, a place I have loved since my training days, brings additional meaning and motivation as I lend my time.”

He will work five 13-and-a-half-hour shifts for five days, have one day off, and repeat that pattern for 30 days, flying back in time for his daughter Isabella’s 16th birthday, although he will be in quarantine and will have to celebrate virtually with his family, including his wife Alyssa and son Evan, 14. His family is fully behind his decision. His daughter wants to go into medicine, possibly critical care, and his wife, knowing he would be researching the potential, was the first to propose that he go to New York. 

Dr. Margolin has already treated COVID-19 patients in Scottsdale, working through various scenarios such as ethical simulations when resources are low. He's doubled down on his usual interest in researching prone positioning and ventilation. He followed the pandemic as it was accelerating in Italy and Spain, actively joining conference calls with think tanks and became a teleconference resource to European nurses in situations when local Intensivists were diverted or otherwise not present.

In those early months, he saw posts of Italian providers repurposing snorkel masks as PPEs and realized that -- while the concept was sound -- the actual setup could be improved. Dr. Margolin found a snorkel manufacturer in Australia (MozT2) and collaborated with him to retrofit the masks for PPE, using standard ventilator bacterial/viral filters superior to N95 masks. He claims the modifications provide total facial protection, keep his ears free for physical exam, completely separate inhaled air through the filter from humidified exhaled air of the user and can be used continuously with just a wipe down for up to 10 days before the filter should be changed. He already has used the mask to treat patients at home and he will take it with him to New York. Taking it as a sign of flattery, he has seen some of his colleagues adapt the mask into their practice as well.

He also relies on SCCM for resources, noting that SCCM “inspires me to do what I do better. I look forward to going to Congress and not only for the sessions. Often the greatest things are happening outside the classroom, sitting down and talking to colleagues. Some of the most amazing people attend and they open your eyes to new ways of seeing and doing. Nothing else in my career has been as informative. I am inspired all of the time. It’s exceedingly rewarding to be engaged and I tell all of my residents, ‘As soon as you complete your training, join your professional society and get involved.’”

While he feels well prepared to treat COVID-19 patients in New York, he knows there will be a need for innovative thinking on the fly. “Talking to others who are already there, it’s jazz-like, what’s going on, needing to improvise and knowing that someone else might be on a different beat,” he said. “I’m enthusiastic about doing what I can in the coming weeks and hope to be an effective relief for those who have already engaged in the heavy fight.”

Updates 

See Dr. Margolin on TODAY.

April 17, 2020



April 20, 2020


April 21, 2020


April 22, 2020


April 26, 2020


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Posted: 4/10/2020 | 1 comments

Comments
William
Please read web site sysmedco.com for an additional treatment for the ARDS. TNS is a Cytokine Blocker and also acts to block ACE2 sites. This TNS increases the serum albumin levels and limits third spacing. These are FDA approved products readily mixed in all hospital pharmacies.
This epidemic arrived before my studies were ready for publication but the initial draft and data is on the web site.
The use can Block or modify the development of ARDS and if worst case a bolus of 5% albumin has been administered. All other modalities and treatments can be continued without modification.
This is late action the ideal time should be early to block development and to avoid intubation. TNS was developed before Covid-19. (Not yet in my community). This can save lives and can legally be prescribed by treating physician for patient therapy. This is not research; it is patient management and does not require any special consent forms or institutional approval. This is a treating Doctor decision solely, Read the web site for further information call me for clarification. Why not try it before giving up?
William Norberg M D Critical Care Medicine
4/12/2020 4:28:39 PM


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