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Talking With UMC Doctors On The Front Line Of COVID-19

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UNLV School of Medicine

Dr. Angelica Honsberg (center) and her ICU team.

As of May 17, Nevada had just shy of 7,000 cases of coronavirus that led to 350 deaths. Clark County specifically had nearly 5,400 cases with 300 deaths.

But what’s the deeper story behind those numbers? With the COVID-19 pandemic in its third month, doctors in hotspots around the world are studying trends and rethinking how they treat certain symptoms.

University Medical Center is a part of a nationwide effort to track information about COVID-19 patients. 

Dr. Angie Honsberg is a UNLV School of Medicine professor and UMC ICU pulmonologist. She has been working on the front lines of the pandemic in Southern Nevada for weeks. She explained to KNPR's State of Nevada the importance of the data that is being gathered.

"Those patients have a variety of different data points collected that are put into a central registry," she said, "Then the different institutions will be able to review that data, and hopefully, understand more about effective treatment, about patients that are at higher risk, things that we maybe should be doing differently, things that don't work or treatments that do work." 

One treatment that Dr. Honsberg, and others treating COVID-19 patients, have found does work is moving patients onto their stomachs. The medical term is proning. It is a technique that has been used for decades on patients on ventilators but it is now being used on patients that are awake. 

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"The theory behind that is that with laying on your stomach you're taking the extra weight off the back of the lungs, and allowing the blood flow and the oxygen in the lungs to redistribute itself more effectively or more efficiently than laying on your back with potentially the weight of the lungs and the heart compressing the back of the lungs so that they can't participate in oxygen exchange as well," she said.

Honsberg said medicines that have not seemed to help much in her ICU include hydroxychloroquine, an anti-malaria drug touted as a "game-changer" by President Donald Trump, and the anti-viral drug remdesivir, which has shown promise in early studies elsewhere.  

Honsberg is hopeful that when researchers can secure more remdesivir they can use it on more patients to see if it does actually help.

While the search for treatments and vaccines goes on, doctors, nurses and other hospital staff are working every day to deal with patients. 

Dr. Deborah Kuhls is a professor at UNLV School of Medicine and the medical director for the UMC Trauma ICU. She said doctors and nurses are trained to work with patients with severe injuries and illnesses but this has been different.

"Seeing a new disease and many patients having extreme illness, it has taken a toll on all health care workers, no matter how experienced we are in whatever else we do, and it might include working in intensive care units," she said.

She said hospitals are offering employee programs for workers who need help, and the Clark County Medical Society, of which she is incoming president, is offering a new warmline for those who just need to talk.

"It's volunteer psychiatrists, who are not getting paid," she said, "Any first responder — and that could be a paramedic, it could be a nurse, it could be physician, anyone who takes care of patients — can call in free of charge, confidentially and talk to a professional about what they're experiencing." 

Kuhls said many doctors and nurses in Southern Nevada learned during the aftermath of the October 1, 2017, mass shooting to reach out for help if they need it. 

Despite the toll on front-line workers' mental health, Kuhls said, the virus has not taken a large toll on the their physical health. She said very few nurses and doctors have tested positive for the coronavirus. 

Kuhls said she and other doctors are working with Honsberg and her team to review and create the best guidelines for medications and treatments for COVID-19 patients.

"Dr. Honsberg and her group have really taken care of dozens and hundreds of COVID positive patients to date," she said, "We review these guidelines to be sure we're giving our patients the benefit of every piece of science that exists."

Guests

Dr. Deborah Kuhls, UNLV School of Medicine professor, UMC Trauma ICU medical director, and incoming president of the Clark County Medical Society; Dr. Angelica Honsberg, UNLV School of Medicine professor and UMC ICU pulmonologist

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