Thursday, May 21, 2020

The "SalScan" Procedural Research Project: Ultrasound Chest Monitoring of Covid+ Patient



PART 1:
In April, 2020, NYCRA's own "Cousin Sal" Banchitta (retired FF from the FDNY) recently tested positive for Coronavirus.  As a leading member of the community design team for the LUNGSCAN  program, Sal aimed to re-direct the GET CHECKED NOW! program for cancer prevention to provide alternative respiatory screening for Corona-related lung issues for emergency responders.

Sal volunteered himself to be the first test case and self-scanning trainee for LungScanning under the beta-tested REMOTE HOME-SCAN & TELE-RADIOLOGY program.  The developers hope to establish this protocol as a nationwide scanning alternative during Covid times, as it was first launched in European triage centers to identify covid-related respiratory disorders (see ITN feature). This program adapted key elements of lung ultrasound for a wider set of uses at the safety and comfort of the patient's home for regular ultrasound screening and continued monitoring.

................................................................................................................................................................

OBJECTIVES
A breakdown of goals for this procedural research program include:

* establishing a working blueprint (including scan diagrams on the torso, selected probes and frequency settings) that make up the entire LungScan process

* selecting ultrasound technology with easy-to-use controls for ANY patient

* an instructional lesson plan designed for fast & easy learning under remote patient training of probes and software

* additionally prove the strength of the firmware's user-friendly design

* confirming the effectiveness of a portable ultrasound as a self-diagnostic scanner in ANY field situation (from battlefields, the ER, an ocean liner, an ambulance or bedside/homes)

* promoting a safety-conscious program to test for contagious pathogens in the safely & comforts of one's own home without health risks from travel

* developing a solid 3-point communication system for a real-time remote diagnostic protocol; synergy between patient, trainer and radiologist

* opening many more potential patient types, disorders and scenarios for this level of remote scanning access and telemedicine

...................................................................................................................................................................

THE PLAN behind this remote scanning program is fairly straightforward in nature.

1. Bring the patient access to a reliable high-frequency PORTABLE ultrasound- the kind that can scan to the exact depths of LUNGS, HEART, LIVER and KIDNEYS.

2. Gather a test subject (Sal) to scan himself regularly within a given window of time.  In this case, Sal happens to be Covid + but has been recorded to NOT show symptoms.  Use of the ultrasound can either confirm that he is in fact asymptomatic, or may identify any hidden anomalies.

3. Have remote access to a professional ultrasound trainer (Mike Thury from Oklahoma) to operate the scanning software (using Teamviewer) and also instruct the test subject via video conferencing (Zoom) as far as how to properly use the hand held probes and the ultrasound device correctly.

4. After each scanning session, the patient and trainer shall save all daily scan images collected. Once a given number of days has been satisfied, the designated medical radiologist (Dr. Robert L. Bard, NYC) shall remote access into the device to collect/review all image files for a through analysis.

Through the use of TeleMedicine, remote access of the device and its saved files, the patient has unlimited personal use of a high frequency portable ultrasound while being remotely guided by a certified ultrasound instructor to scan specific organs of concern.  The remote LungScan project puts the patient in the drivers seat to safely monitor and receive diagnoses of their own condition.

...................................................................................................................................................................

BENEFITS FOR ALL PATIENT TYPES
Thanks to the modern upgrades in portable ultrasound technology, it is now possible for any patient undergoing treatment to track their own progress on a regular schedule.   In the case of covid-related infections & inflammation (that may appear in the Lungs, Heart, Kidneys or Liver) having personal access to a portable ultrasound and remote access to a designated clinical team is an easy and successful way to monitor one's health and condition daily.

During his training and scanning period, Sal's participation provided our program with important procedural data toward the foundation for this upcoming national screening initiative. Our program developers' goals aim to support the global use of ultrasound imaging devices for the many non-hospital applications where access to large-format devices are simply not available.  Use of the ultrasound can either confirm the patient is in fact asymptomatic, or may prove to be useful as an early detection device by identifying any hidden anomalies.













Special thanks to Terason Ultrasound and Michael Thury (scan instructor) for helping to make this project a reality.

Covid Pandemic and the "Wild West" PPE Industry

Written by: Cheri Ambrose
Edited by: NYCRA NEWS publishing team

Months into the Coronavirus Pandemic, health responders everywhere continue to struggle to protect themselves from contamination as cases continue to pile up in hospitals across the country. Understanding viral self-protection is job #1 for companies like American Health Supply Company- a 20+ year old supplier of Personal Protective Equipment (PPE) to healthcare practices and medical centers. To help identify how PPE's work, and various options available to the healthcare worker, we interviewed chief distributor and CEO, Jayson Dauphinee.  "From masks, face shields, gowns, nitro gloves and hazmat suits, we use all our existing contacts and constantly seek out new manufacturers who carry FDA certificates. The "name of the game" is getting only certified products for our people- because anything less would be adding risk to injury for all users."

The supply chain industry, especially those coming out of China, Hong Kong, Taiwan, Korea is a mixed bag when it comes to quality.  A big part of a distributor's job is sifting through bootlegs and counterfeit items. Where human lives that are at risk, discerning who's who is in and of itself a lifesaving job.  New and seasoned manufacturers showcase in international trade shows mixing reputable with questionable ones as far as their quality and follow-through.  Dauphinee claims honorable producers usually introduce themselves by sending sample products for integrity testing and copies of their certifications.   

N95 vs KN95- WHAT'S THE DIFFERENCE?
Mayors, Governors and health officials nationwide are now suggesting anyone in public to have protective face coverings of any kind (scarves, bandanas and surgical paper masks) as a bare-bones safety solution to the contagion. This call is a desperate responses to the limited supply of FILTRATION GRADE PPE MASKS.

The most widely publicized face mask in the service field is the N-95.  Due to the high demand, healthcare people are suffering a shortage of this mask, forced to surrender to alternative (and lesser quality) products.  According to Mr. Dauphinee, the KN95 is the same product -as identified by the EPA when it comes to the 95% effectiveness of its triple micron filtration.  "N" means manufactured in the U.S.  The USP code that K and 95 is China code. Then there's an AF94 from Korea. and the FFP2 is the Euro code. They all have the same 94.6% rating with that .3 micron filtration.


















These filter masks are typically made of spun bound non-woven polyethylene built up one cylinder layer on top of another. Above that is a melt blown layer of polyethylene filtration, then on top of that is going to be another one of the spun bound polyethylene. Next is a P E wire, which is a metal free, and that kind of holds everything together. Then on top, you're going to have a cotton layer of filtration- the piece that goes across the face at the anti microbial hypoallergenic piece of cotton. This gives you a decent feel to the face- abd  the finishing piece on the mask.

FROM THE CDC/NIOSH

Counterfeit Respirators / Misrepresentation of NIOSH-Approval
Updated May 18, 2020 (complete link)
Counterfeit respirators are products that are falsely marketed and sold as being NIOSH-approved and may not be capable of providing appropriate respiratory protection to workers. When NIOSH becomes aware of counterfeit respirators or those misrepresenting NIOSH approval on the market, we will post them here to alert users, purchasers, and manufacturers.

How to identify a NIOSH-approved respirator:
NIOSH-approved respirators have an approval label on or within the packaging of the respirator (i.e. on the box itself and/or within the users’ instructions). Additionally, an abbreviated approval is on the FFR itself. You can verify the approval number on the NIOSH Certified Equipment List (CEL) or the NIOSH Trusted-Source page to determine if the respirator has been approved by NIOSH. NIOSH-approved FFRs will always have one the following designations: N95, N99, N100, R95, R99, R100, P95, P99, P100. (go to complete article | Original source: https://www.cdc.gov/NIOSH)


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The Humbling of 3M: New Industry Boom by the Pandemic
The recent explosion of today's PPE market is greatly influenced by the Coronavirus pandemic- for better and for the worse.   On one hand, the major demand has sparked a global wave of new manufacturers of all sizes. Meanwhile, there is a rampant loss of $$ from private buyers and distributors' due to delayed or lost orders as shipments from foreign countries are often seized or even destroyed.  This is either due to the major wave of bootlegging or political issues at the border.  In addition, new tarriffs, price wars, gouging and travel bans have all added to the import restrictions and challenged access to these PPE's.  This opened up a floodgate of other countries now getting involved in product sourcing.  Countries like Germany have Bosch (the spark plug manufacturer) who is now manufacturing great masks.

New standards in protective gear for EMS professionals
in all New York fire departments (Elizabeth Banchitta)
Where 3M once 'ruled the game', the War Powers Resolution Act pushed every major company to get involved in producing ventilators and PPE's.  This brought out the Ford's and the GM's who once paid 3M millions of dollars for masks and  are now learning to make them in house for public distribution as well as for their own protective uses. Now, if they know how to make them in house, 3M just lost that client making it hard for 3M to recover from that loss.   Due to this massive new demand escalating new price points, so many small manufacturers can finally afford to pay an American employee and earn a reason to get up and running.  Many small mom and pops throughout the country are going to get a little bit of booming. And the 3D printing industry right now has also become a huge factor because people at home can make PPE for relatives or loved ones or anything because you can put it in the program.



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COMMUNITY FOOD DRIVES:
CARING BOOTS ON THE GROUND
The definition of a "First Responder" is one who takes on the task of coming to the aid of any emergency or crisis in the community. In our current pandemic, firehouses are 'stepping up to the plate' by collecting food and staple supplies for the many lives affected by the Coronavirus issue. 

April, 2020- The King's Park Volunteer Firehouse collected over 4500 pounds of food on a one-day drive to replenish the various empty Food Pantries in their immediate area- including ones in King's Park, Bayshore and St. Joseph's church. This is just one of their many charitable initiatives on their calendar where the firehouse is poised as the central drop-off and distribution area.

"We swore an oath to take care of the people and patients in our community to support the safety and the well-being of all our neighbors. That's always instilled in you from the beginning. But the real thanks go to all the food donors in our area!" says EMT Elizabeth Banchitta (second generation first responder and daughter of Ret. FDNY FF. Sal Banchitta - see CousinSal.org).  "There are many types of FIRES to put out, and many ways to HELP... working with the fire dept. puts us at the front lines of these 'fires' to address them accordingly. This pandemic really puts our whole country upside down economically-- and getting food to those who need is one of our major challenges..."  



Wednesday, May 13, 2020

Covid-19 Effects on the Lungs + Chest Ultrasound (v)

Written and presented by: Dr. Stephen Chagares
Edited by: Dr. Robert L. Bard & Lennard Gettz (of NYCRA HealthScan News)
The Coronavirus has been shown to be very lethal to a subset of patients. What happens is that the virus is ingested into the mouth or nose, going down into the back of the throat (called the hypopharynx and the larynx) and then is breathed into the lungs themselves. The lungs are made of millions of little air SACS called alveoli, and the virus gets into these little layer sacks and adheres to the inner lining. That lining is what allows the interface between the blood and the air and the CO2 from the blood is given out. The oxygen from the air is given into the blood. That's how we breathe in oxygen and blow out CO2.

When the virus gets in there and coats that surface, everyone creates some kind of reaction. One is an antibiotic body reaction- which is an immune response. The other thing that happens is a physical inflammatory response where the immune system automatically goes into defense mode and wants to go in and kill the virus. It senses it's there and sends in "defender" cells, and to most people, it can send the proper amount of little soldiers to do the job. But in a small percentage of patients, the body's internal reaction causes too much inflammation causing a large body of fluid to fill up in the alveoli (air sacs) in the lungs. This stops the ability for oxygen to fuse through those air sacks to get oxygen into the entire body, include vital organs like the heart, the brain, the liver etc.  Without oxygen, this could result serious problems like heart and liver failure (and other such symptoms).

To visually identify this problem, existing technologies have to be tuned to track and monitor cardio-pulmonary performance. Chest x-rays or CT/catscans are available and are widely used now- but carry a number of key issues when it comes to regular chest monitoring. Often normal chest X rays are going to miss this because radiation itself will go through the lung tissue and the fluid and it may not show anything too specific. And then a cat scan may show something totally different where you can see how both lungs are all inflamed and have fluid in them.

The newest thought is the "LUNGSCAN" paradigm through the  use of ultrasound technology- as published by Dr. Robert Bard and a number of European experts in this field. The system of checking the lungs for covid-related issues is applied in tandem with (and not instead of) replacing other radiologic testing.  The concept of INTEGRATIVE solutions is about making as many solutions available to the public as you can to support patient treatment. So although chest X rays and cat scans are often used, there's a lot of radiation to them- and that's a major discrepancy to regular testing.

THE COMPLEX PROCESS OF CT IMAGING
If you're in the ICU, taking a "field trip" down to a radiology center is no fun at all.  It's probably the most dangerous part of a patient's day. Just getting switched from everything on the wall to everything portable and then getting them down and transferring them first from their bed to the stretcher, and then another stretcher into the cat scan table- can be quite harrowing. And then everyone has to get out and leave the patient there. And all the tubes still have to work. And as they come through to make sure nothing pops off and then they have to get transferred back onto the stretcher, up into the elevator, back into the ICU, back into their bed, and then hook everything back up again. So yes, cat scans work great, but there's a lot to it.

PORTABLE IS "IN"
Though we still have the high-powered center units the size of a washing machine, today's ultrasound technology design has been streamlined to offer PORTABLE versions to respond to its many field applications and demands. An "all-in-one" touch screen with detachable probes can be used at the bedside or in any kind of radiologic facility. It is also used in triage units, battlefields, ocean liners, helivacs/ambulances and even the space station.

You can expect to see "LUNGSCAN STATIONS" open up everywhere for outpatients to get quick lung scans (about a 5-minute experience) in urgent care centers per se.  The accuracy, speed and low prep combination of ultrasound alongside our new TeleMedicine trend makes for a SAFER alternative to imaging.



Ultrasound for Critical Care and Regular Covid Monitoring of Respiratory Pathogens

Adding to the arsenal of diagnostic solutions for the Covid-19 respiratory pathogen, the LUNG (or CHEST) ULTRASOUND is making great strides in triage facilities and bedside monitoring.  A growing community of European health specialists are joining a procedural movement to "replace" the dependency on stethoscopes with portable ultrasound use to check a patient's immediate cardiopulmonary condition. For Covid-positive patients, today's ultrasound excels in getting immediate answers safely without radiation - allowing for screening and repeated monitoring. Such is the case in this test sample.

According to radiologist Dr. Robert Bard, indication of the presence of Covid-19 will show in the form of B-LINES (or the 2 vertical rays). "B-Lines specifically mean that the lung tissue adjacent to the coating of the lung is abnormal- and that's what generates these lines. Normal lung tissue should never have B-lines. If you don't have B-Lines, you don't have Covid in the lungs..."

ULTRASOUND ACCESS TO THE "NEW WORLD" OF MEDICINE
The evolution of the portable ultrasound is now being viewed by many as a diagnostic game-changer for patient care in the field. From an interview with professional technical instructor Michael Thury of Terason Ultrasound, he states "the industry just exploded from 30 years ago with the ability and the confidence that ultrasound can give you. The technology enables the physician to really do a much better job diagnosing the patient. As a clinical trainer with clients worldwide, the boom of telemedicine adds to the success of teaching clinicians how to get the most out of remote ultrasound, but also to have fast and easy access to the physician to read and diagnose the patient from any location!"

...............................................................................................................................................................

Seeing your doctor (during the coronavirus pandemic) can be more systematic these days. Just come right to an exam room, get the ultrasound examination, go home, and then review those results with your physician via Video chat.  This third imaging option helps augment radiologic testing for Coronavirus effects in the chest area.

I also see the "bedside ultrasound" in the ICU carry huge benefits use. Being able to bring in a portable unit to a patient's room has a major safety element. Ultrasound can see fluid levels and in densities very nicely and with a small amount of training, you are able to use ultrasound to distinguish the density of the fluid in the areas where there is most fluid. This kind of imaging innovation really helped to support the understanding of A.R.D.S. (Acute Respiratory Distress Syndrome) in association with SIRS (Systemic Inflammatory Response Syndrome) where the lungs are majorly affected by these types of illnesses, filling them with fluid.

For regular monitoring of the lungs, ultrasound is a safe (non radiation) bet.  To identify symptoms in the lungs where the fluid can fill up is priceless data as part of early detection. Failure to breathe happens next, where ventilators come in to increase the oxygen level and be able to push through that fluid all caused by this simple little virus that just goes in and wreaks havoc on a small number of patients.

Percentage wise (not small total number), over 60,000 patients had that high reaction and it loops right back to "how do we keep an eye on that"?  Let's say you had grown a virus and then you're discharged. The lung reaction afterwards can be weeks or months until all the inflammation has gone. Some people less, some people more. And if chest X rays don't really see that type of level of fluid and and infiltration of the lungs with water and if cat scans or a lot of radiation, then these outpatient ultrasound sites could provide a literal progression from the discharge date all the way out until it looks like a normal lung again.

To me, that's a sensible protocol for early detection.


..............................................................................................................................................................

ABOUT THE AUTHOR


STEPHEN CHAGARES, MD, FACS - CANCER SURGEON
Dr. Chagares is a board certified general, laparoscopic, robotic and breast surgeon in Monmouth County, NJ.  He obtained specialty training in breast surgery at Memorial Sloan Kettering Cancer Center. In addition to breast surgery, Dr. Chagares regularly performs hernia repairs of all types, including open, laparoscopic and robotic repairs. He was the first surgeon in his region to perform a robotic hernia repair and remains on the cutting edge of all advanced surgical techniques.  He routinely performs multiple other abdominal procedures, including laparoscopic gallbladder removal.  Dr. Chagares has received numerous awards for excellence and academic teaching, Top Doctors Awards and Patients’ Choice Awards. His philosophy is to provide quality care with a personal touch. He respects the art of surgery and feels honored to treat patients every day. visit his website- drchagares.com


EDITOR / CO-PUBLISHER


ROBERT L. BARD, MD, PC, DABR, FASLMS  - RADIOLOGIST
Dr. Bard is recognized for his specialized work in advanced cancer diagnostic imaging. He co-founded the 9/11 CancerScan program to bring additional diagnostic support to all first responders from Ground Zero. His main practice in midtown, NYC (Bard Diagnostic Imaging- www.CancerScan.com) uses the latest in digital imaging technology and has been also used to help guide biopsies and in many cases, even replicate much of the same reports of a clinical invasive biopsy. Imaging solutions such as high-powered sonograms, Power Doppler Histogram, sonofluoroscopy, 3D/4D image reconstruction and the Power Doppler Histogram  are safe, noninvasive, and do not use ionizing radiation. It is used as a complement to find anomalies and help diagnose the causes of pain, swelling and infection in the body’s internal organs while allowing the diagnostician the ability to zoom and ‘travel’ deep into the body for maximum exploration.


Special thanks to: Alice Chiang and Michael Thury of Terason Ultrasound (https://www.terason.com/) and LonShine Technologies Inc.

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Thursday, May 7, 2020

Covid-19 Effects on the Lungs + Chest Ultrasound

Written and presented by: Dr. Stephen Chagares
Edited by: Dr. Robert L. Bard & Lennard Gettz (of NYCRA HealthScan News)

 The Coronavirus has been shown to be very lethal to a subset of patients. What happens is that the virus is ingested into the mouth or nose, going down into the back of the throat (called the hypopharynx and the larynx) and then is breathed into the lungs themselves. The lungs are made of millions of little air SACS called alveoli, and the virus gets into these little layer sacks and adheres to the inner lining. That lining is what allows the interface between the blood and the air and the CO2 from the blood is given out. The oxygen from the air is given into the blood. That's how we breathe in oxygen and blow out CO2.

When the virus gets in there and coats that surface, everyone creates some kind of reaction. One is an antibiotic body reaction- which is an immune response. The other thing that happens is a physical inflammatory response where the immune system automatically goes into defense mode and wants to go in and kill the virus. It senses it's there and sends in "defender" cells, and to most people, it can send the proper amount of little soldiers to do the job. But in a small percentage of patients, the body's internal reaction causes too much inflammation causing a large body of fluid to fill up in the alveoli (air sacs) in the lungs. This stops the ability for oxygen to fuse through those air sacks to get oxygen into the entire body, include vital organs like the heart, the brain, the liver etc.  Without oxygen, this could result serious problems like heart and liver failure (and other such symptoms).

To visually identify this problem, existing technologies have to be tuned to track and monitor cardio-pulmonary performance. Chest x-rays or CT/catscans are available and are widely used now- but carry a number of key issues when it comes to regular chest monitoring. Often normal chest X rays are going to miss this because radiation itself will go through the lung tissue and the fluid and it may not show anything too specific. And then a cat scan may show something totally different where you can see how both lungs are all inflamed and have fluid in them.

The newest thought is the "LUNGSCAN" paradigm through the  use of ultrasound technology- as published by Dr. Robert Bard and a number of European experts in this field. The system of checking the lungs for covid-related issues is applied in tandem with (and not instead of) replacing other radiologic testing.  The concept of INTEGRATIVE solutions is about making as many solutions available to the public as you can to support patient treatment. So although chest X rays and cat scans are often used, there's a lot of radiation to them- and that's a major discrepancy to regular testing.

THE COMPLEX PROCESS OF CT IMAGING
If you're in the ICU, taking a "field trip" down to a radiology center is no fun at all.  It's probably the most dangerous part of a patient's day. Just getting switched from everything on the wall to everything portable and then getting them down and transferring them first from their bed to the stretcher, and then another stretcher into the cat scan table- can be quite harrowing. And then everyone has to get out and leave the patient there. And all the tubes still have to work. And as they come through to make sure nothing pops off and then they have to get transferred back onto the stretcher, up into the elevator, back into the ICU, back into their bed, and then hook everything back up again. So yes, cat scans work great, but there's a lot to it.

PORTABLE IS "IN"
Though we still have the high-powered center units the size of a washing machine, today's ultrasound technology design has been streamlined to offer PORTABLE versions to respond to its many field applications and demands. An "all-in-one" touch screen with detachable probes can be used at the bedside or in any kind of radiologic facility. It is also used in triage units, battlefields, ocean liners, helivacs/ambulances and even the space station.

You can expect to see "LUNGSCAN STATIONS" open up everywhere for outpatients to get quick lung scans (about a 5-minute experience) in urgent care centers per se.  The accuracy, speed and low prep combination of ultrasound alongside our new TeleMedicine trend makes for a SAFER alternative to imaging.



Ultrasound for Critical Care and Regular Covid Monitoring of Respiratory Pathogens

Adding to the arsenal of diagnostic solutions for the Covid-19 respiratory pathogen, the LUNG (or CHEST) ULTRASOUND is making great strides in triage facilities and bedside monitoring.  A growing community of European health specialists are joining a procedural movement to "replace" the dependency on stethoscopes with portable ultrasound use to check a patient's immediate cardiopulmonary condition. For Covid-positive patients, today's ultrasound excels in getting immediate answers safely without radiation - allowing for screening and repeated monitoring. Such is the case in this test sample.

According to radiologist Dr. Robert Bard, indication of the presence of Covid-19 will show in the form of B-LINES (or the 2 vertical rays). "B-Lines specifically mean that the lung tissue adjacent to the coating of the lung is abnormal- and that's what generates these lines. Normal lung tissue should never have B-lines. If you don't have B-Lines, you don't have Covid in the lungs..."

ULTRASOUND ACCESS TO THE "NEW WORLD" OF MEDICINE
The evolution of the portable ultrasound is now being viewed by many as a diagnostic game-changer for patient care in the field. From an interview with professional technical instructor Michael Thury of Terason Ultrasound, he states "the industry just exploded from 30 years ago with the ability and the confidence that ultrasound can give you. The technology enables the physician to really do a much better job diagnosing the patient. As a clinical trainer with clients worldwide, the boom of telemedicine adds to the success of teaching clinicians how to get the most out of remote ultrasound, but also to have fast and easy access to the physician to read and diagnose the patient from any location!"

...............................................................................................................................................................

Seeing your doctor (during the coronavirus pandemic) can be more systematic these days. Just come right to an exam room, get the ultrasound examination, go home, and then review those results with your physician via Video chat.  This third imaging option helps augment radiologic testing for Coronavirus effects in the chest area.

I also see the "bedside ultrasound" in the ICU carry huge benefits use. Being able to bring in a portable unit to a patient's room has a major safety element. Ultrasound can see fluid levels and in densities very nicely and with a small amount of training, you are able to use ultrasound to distinguish the density of the fluid in the areas where there is most fluid. This kind of imaging innovation really helped to support the understanding of A.R.D.S. (Acute Respiratory Distress Syndrome) in association with SIRS (Systemic Inflammatory Response Syndrome) where the lungs are majorly affected by these types of illnesses, filling them with fluid.

For regular monitoring of the lungs, ultrasound is a safe (non radiation) bet.  To identify symptoms in the lungs where the fluid can fill up is priceless data as part of early detection. Failure to breathe happens next, where ventilators come in to increase the oxygen level and be able to push through that fluid all caused by this simple little virus that just goes in and wreaks havoc on a small number of patients.

Percentage wise (not small total number), over 60,000 patients had that high reaction and it loops right back to "how do we keep an eye on that"?  Let's say you had grown a virus and then you're discharged. The lung reaction afterwards can be weeks or months until all the inflammation has gone. Some people less, some people more. And if chest X rays don't really see that type of level of fluid and and infiltration of the lungs with water and if cat scans or a lot of radiation, then these outpatient ultrasound sites could provide a literal progression from the discharge date all the way out until it looks like a normal lung again.

To me, that's a sensible protocol for early detection.


..............................................................................................................................................................

ABOUT THE AUTHOR


STEPHEN CHAGARES, MD, FACS - CANCER SURGEON
Dr. Chagares is a board certified general, laparoscopic, robotic and breast surgeon in Monmouth County, NJ.  He obtained specialty training in breast surgery at Memorial Sloan Kettering Cancer Center. In addition to breast surgery, Dr. Chagares regularly performs hernia repairs of all types, including open, laparoscopic and robotic repairs. He was the first surgeon in his region to perform a robotic hernia repair and remains on the cutting edge of all advanced surgical techniques.  He routinely performs multiple other abdominal procedures, including laparoscopic gallbladder removal.  Dr. Chagares has received numerous awards for excellence and academic teaching, Top Doctors Awards and Patients’ Choice Awards. His philosophy is to provide quality care with a personal touch. He respects the art of surgery and feels honored to treat patients every day. visit his website- drchagares.com


EDITOR / CO-PUBLISHER


ROBERT L. BARD, MD, PC, DABR, FASLMS  - RADIOLOGIST
Dr. Bard is recognized for his specialized work in advanced cancer diagnostic imaging. He co-founded the 9/11 CancerScan program to bring additional diagnostic support to all first responders from Ground Zero. His main practice in midtown, NYC (Bard Diagnostic Imaging- www.CancerScan.com) uses the latest in digital imaging technology and has been also used to help guide biopsies and in many cases, even replicate much of the same reports of a clinical invasive biopsy. Imaging solutions such as high-powered sonograms, Power Doppler Histogram, sonofluoroscopy, 3D/4D image reconstruction and the Power Doppler Histogram  are safe, noninvasive, and do not use ionizing radiation. It is used as a complement to find anomalies and help diagnose the causes of pain, swelling and infection in the body’s internal organs while allowing the diagnostician the ability to zoom and ‘travel’ deep into the body for maximum exploration.


Special thanks to: Alice Chiang and Michael Thury of Terason Ultrasound (https://www.terason.com/) and LonShine Technologies Inc.

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