Deltex Medical Share Discussion Threads

[chrisdgb] 21/4/2020 09:57

Looking good for the sector.............Will be interesting to see the detail we get with the results.....

[mrc2u] 21/4/2020 09:46

NobbyI promise I won't forget but welcome the remindersThe turkey has tried to run the latest nonsense before and been shown to be both a buffoon and a snide, devious petty liarI had forgotten thatMrC

[buywell3] 21/4/2020 04:32

Three adverse events in the USA with date 2018

MAUDE - Manufacturer and User Facility Device Experience

FDA Medical Devices Databases



Manufacturer ------------- Brand Name --------- Date Report Received
DELTEX MEDICAL LTD --------- DP6 ----------- 10/06/2018
DELTEX MEDICAL LTD --------- DP240 --------- 10/06/2018
DELTEX MEDICAL LTD - DOPPLER PROBE 240 HOUR -10/01/2018

[buywell3] 20/4/2020 01:13

02/04/2020

BRITISH SOCIETY OF ECHOCARDIOGRAPHY

Clinical guidance regarding provision of echocardiography during the COVID-19 pandemic


" Approach to the provision of echocardiography scanning

It is essential to minimise exposure of healthcare professionals to aerosolized particulate matter from COVID-19 infected cases.

Accordingly, transthoracic echocardiography offers a safer approach than trans-oesophageal echocardiography (TOE) both in the unventilated and invasively ventilated patient where disturbance of the airway protective cuff of the endotracheal tube may occur during intubation with the oesophageal probe."

Now buywell stands to be corrected but does that not mean that the BRITISH SOCIETY OF ECHOCARDIOGRAPHY don't recommend that a 'specialized probe containing an ultrasound transducer at its tip is passed into the patient's esophagus ' ?

Transesophageal Echocardiogram

A transesophageal echocardiogram, or TEE (TOE0 in the United Kingdom and other countries such as Australia, reflecting the spelling transoesophageal), is an alternative way to perform an echocardiogram. A specialized probe containing an ultrasound transducer at its tip is passed into the patient's esophagus.

buywell thinks that others might follow the lead of the BRITISH SOCIETY OF ECHOCARDIOGRAPHY , since the safety of the dwindling number a highly trained and valued ( by buywell and by Boris) ICU front line staff is now paramount in winning the battle against the highly contagious Covid-19 killer coronavirus.

Perhaps someone can suggest another group of ICU based professionals that might look at this move ?



IMO dyor it pays

[schloo] 19/4/2020 23:45

Myosite

1. University College London Hospital for one: it was just filmed in use on CoVid patients in the ICU!!!

2. Seriously? Don't ventilated patients gets tubes down the throat? And you are happy (point 5) to use invasive (aka real bleeding) indicator dilution instead?

3. GMC guidance on doctors use of social media is very clear:

"Anonymity
17
If you identify yourself as a doctor in publicly accessible social media, you should also identify yourself by name. Any material written by authors who represent themselves as doctors is likely to be taken on trust and may reasonably be taken to represent the views of the profession more widely.

18
You should also be aware that content uploaded anonymously can, in many cases, be traced back to its point of origin.

Conflicts of interest
19
When you post material online, you should be open about any conflict of interest and declare any financial or commercial interests in healthcare organisations or pharmaceutical and biomedical companies."

4. I don't believe anything he says but Myosite post 307 "in the aorta where ODM measures central blood flow": I took this to mean ODM measures central blood flow, but feel free to put us right before you are struck off

5. Indicator dilution measures dilution of an indicator and derives central blood flow. That is not the same as measuring central blood flow. Anyway, LID is now all about the Lidcorapid with emphasis on the rapid bit as it entirely removed the Lidco bit (aka LIthium Dilution Cardiac Output)

Feels like rock solid ground all round to me even if 4 is corroborated by a distinctly flaky source!!!

[nobbygnome] 19/4/2020 20:56

And dear oh dear buywell is so slow at understanding how the Deltex monitor can function. In fact you might come to the conclusion that he is deliberately trying to mislead everybody as usual. The reality is that you can do multiple different measurements on the Deltex monitor including the same measurement as the LID monitor does (see link below) so it just doesn't matter if ODM is possible or not. The DEMG monitor is flexible whereas the LID monitor is not. That is the reality that buywell doesn't want you to know.....

[buywell3] 19/4/2020 20:17

Regarding Covid-19 and health risks to NHS ICU staff It would seem others share buywells concern re an oesophageal probe being inserted where a sedated patient was on mechanical ventilation where the balloon cuff around the ventilator airway tube sealed the patients esophagus .

02/04/2020

BRITISH SOCIETY OF ECHOCARDIOGRAPHY

Clinical guidance regarding provision of echocardiography during the COVID-19 pandemic


" Approach to the provision of echocardiography scanning

It is essential to minimise exposure of healthcare professionals to aerosolized particulate matter from COVID-19 infected cases.

Accordingly, transthoracic echocardiography offers a safer approach than trans-oesophageal echocardiography (TOE) both in the unventilated and invasively ventilated patient where disturbance of the airway protective cuff of the endotracheal tube may occur during intubation with the oesophageal probe."

Now buywell stands to be corrected but does that not mean that the BRITISH SOCIETY OF ECHOCARDIOGRAPHY don't recommend that a 'specialized probe containing an ultrasound transducer at its tip is passed into the patient's esophagus ' ?

Transesophageal Echocardiogram

A transesophageal echocardiogram, or TEE (TOE0 in the United Kingdom and other countries such as Australia, reflecting the spelling transoesophageal), is an alternative way to perform an echocardiogram. A specialized probe containing an ultrasound transducer at its tip is passed into the patient's esophagus.

buywell thinks that others might follow the lead of the BRITISH SOCIETY OF ECHOCARDIOGRAPHY , since the safety of the dwindling number a highly trained and valued ( by buywell and by Boris) ICU front line staff is now paramount in winning the battle against the highly contagious Covid-19 killer coronavirus.

Perhaps someone can suggest another group of ICU based professionals that might look at this move ?



IMO dyor it pays

[nobbygnome] 19/4/2020 07:40

It really is disgraceful how buywell lies, manipulates and libels companies. What a shameful person he is....

[nobbygnome] 19/4/2020 07:04

And dear oh dear buywell is so slow at understanding how the Deltex monitor can function. In fact you might come to the conclusion that he is deliberately trying to mislead everybody as usual. The reality is that you can do multiple different measurements on the Deltex monitor including the same measurement as the LID monitor does (see link below) so it just doesn't matter if ODM is possible or not. The DEMG monitor is flexible whereas the LID monitor is not. That is the reality that buywell doesn't want you to know.....

[buywell3] 19/4/2020 06:25

'' Prof Mervyn Singer said if a tight seal is maintained on the mask or, even better, a helmet is worn, and clinical staff have adequate personal protective equipment (PPE) then this risk would be minimised. ''

This was said in connection with new CPAP ventilators being supplied to the NHS in order to minimise intubation associated with mechanical ventilators

buywell notes Mervyn likes the helmet option

Since this Helmet covers the head and the patient is awake

Qu How could an ODM probe be used ?


And the evidence that CPAP with Helmet is IMO the way the NHS must go

''Early reports from Lombardy in northern Italy suggest about 50% of patients given CPAP have avoided the need for full mechanical ventilation.
A type of CPAP ventilation using a hood, where pressurised oxygen is pumped in via a valve, reduces the risk of airborne transmission of the virus. ''

It is to be hoped that the NHS which is understood to currently have about 10,000 ventilators having added to the previous stock of just over 8,000 by increasing production and sourcing other machines from overseas. ( mechanical type)

It would seem the NHS is about to receive another 15,000 ventilators from Penlon of the fully intubated type ( sedated patient ) so this would take the mechanical ventilator total up to 25,000


Plus a completed order for the NHS has been carried out by F1 Mercedes and UCL London for CPAP ventilators 10,000 of , using probably full face mask with no vents ( helmets please )

Plus buywells hope is another CPAP order in the light of Italian success with NIV CPAP they
''used helmet CPAP on all patients with a pO2 <60 mmHg or a respiratory rate >30/min on 15 L/min non-rebreather masks, then shifted to non-invasive ventilation in patients with persistent respiratory distress and finally intubated patients non-responsive to non-invasive ventilation.''

'' 31% of the patients being admitted needed some form of ventilatory support (helmet CPAP 81%, NIV 7%, IMV 12%). Within them 18% had mild ARDS, 51% moderate ARDS and 31% with severe ARDS.''

The NHS are likely to suffer similar stats IMO (IMV is invasive mechanical ventilation which has VAP outcomes in many cases after 48hrs , 50% of VAP cases die ( Ventilator Acquired Pneumonia) .

This IMO means the NHS needs more CPAP with Helmet devices , at least another 15,000 to make 25,000 and match the 25,000 IMV's

Many experts are now getting concerned about IMV outcomes in association with Covid-19 use



IMO dyor

[gbenson1] 17/4/2020 18:09

With the results due any day now, it's nice to see the 500k person has bought shares yesterday & today.

[gbenson1] 15/4/2020 13:49

I would normally say that trades in black are internal company trades/movements. So why are there 5 x 200k trades from yesterday shown today? Are they director purchases/sells?

[ramnik007] 15/4/2020 07:11

Full link to article: https://www.thelancet.com/action/showPdf?pii=S2213-2600%2820%2930161-2

[ramnik007] 15/4/2020 07:09

Management of acute respiratory failure and haemodynamics is key? - key findings based on report in The Lancet regarding Covid 19 intensive care management: https://www.thelancet.com/action/showPdf?

[buywell2] 15/4/2020 00:14

The NHS have just stated the following regarding Covid 19 including intubated patients

link supplied at bottom of this post

On the 8th April 2020 Version 2 the NHS under sub heading



Prone positioning


• Recent experience suggests a beneficial response to prone positioning in awake patients, those with pneumonitis and in ARDS.
• Utilising prone positioning to improve oxygenation is advised in patients failing conventional supine ventilation.
• Recommended 16 hours (longer may be acceptable) – multiple episodes may be valuable – (eg up to a week) Development of a ‘proning team’ is advised to improve efficiency

Bearing in mind current NHS and WHO guidelines on intubation and Covid-19 if somehow a ODM probe had been inserted through a full face mask and alongside the airway tube that is used where a mechanical ventilator is keeping a patient alive

One would have thought proning the patient every shift as some NHS Hospitals are doing would upset the ODM probe placement ?

Catheter based Hemodynamic monitoring with equipment 2M or more away from the patient would IMO be ok and tolerate this with lines being disconnected/reconnected after proning.

Proning is also being practised regarding Covid-19 in the USA so one can deduce this treatment for ICU patients is widespread.

see







Regarding the use of nasal oxygen supply to Covid-19 patients the NHS have stated


High flow nasal oxygen
• High flow nasal oxygen or similar high flow devices should be avoided


Regarding the use of CPAP using a helmet the NHS have stated

• CPAP devices (via a non-venting face mask or helmet) may be trialled to assess whether invasive mechanical ventilation can be avoided


CPAP using a disposable helmet does seem to be the way to go IMO as mechanical ventilation has been around for yonks and things have moved on , plus patients staying on this develop ventilator acquired pneumonia (VAP) after around two days and 50% of those that develop VAP from the use of a mechanical ventilator then die.

The reason I say this is because the NHS in HEAVY type state

• For some patients, CPAP or NIV will form the appropriate ceiling of treatment. Identify these patients early to prevent inappropriate escalation to invasive support.

The USA are starting to use CPAP with helmets and they have proved successful in Italy so one would expect the NHS to fully adopt their use and faze out old mechanical ventilators which because of intubation dangers IMO see



Over 100 doctors were lost in Italy and rising , more nurses and other hospital staff , now the same is happening in the USA and the EU and now the UK.

A doctor who used the CPAP with Helmet in Italy recommended that ICU staff should not go within 2M of a Covid-19 patient in the ICU. That is how lethal front line experience has become.

The NHS state

• Due to a risk of environmental viral contamination, where possible deliver mask ventilation in an isolated environment (negative or neutral pressure room, switch off pressure in positive pressure room, or cohort in restricted access areas).

So negative pressure ICU's will be the future one would expect

[ramnik007] 14/4/2020 21:34

'Management of acute respiratory failure and haemodynamics is key' - key findings based on report in The Lancet regarding Covid 19 intensive care management: https://www.thelancet.com/action/showPdf?pii=S2213-2600%2820%2930161-2

[schloo] 14/4/2020 11:14

Myosite

Let me just go over and fact check the points which you dismissed as complete b@llocks:

1. ODM is an ICU monitor. It is
2. ODM is safe. It is
3. GMC takes a dim view of doctors posting anonymously on chat rooms. It does
4. ODM measures central blood flow. It does
5. LID products do not measure central blood flow. It doesn't

Can not see a single b@llock there, but many thanks for your considered and incisive response

Schloo

[nobbygnome] 13/4/2020 11:29

LOL I think we all know who is talking libellous b@llocks here...and it's not schloo!

[myosite] 12/4/2020 22:01

Schloo
You talk complete b@llocks

[schloo] 11/4/2020 10:17

Myosite is, of course and as ever, lying when he says ODM is not an ICU monitor

It is indeed an ICU monitor as well as a surgical one and has an unrivalled safety record in both settings. The BBC feature on the UCL ICU shows world leading doctors using this world leading technology on the front line to help CoVid patients. It will be interesting to compare their outcomes with those that choose not to use ODM after the dust settles

The insinuations about safety are, naturally, preposterous and precisely the sort of reason why the GMC would strike Myosite off if only they knew his real identity

Good to see that he has highlighted ODM's particular strength: ODM measures central blood flow. This is why ODM keeps getting the positive evidence in both surgery and ICU.

LID products do not measure central blood flow and keep on failing to get the evidence. This does not mean they have no value: if nothing else, they may tell doctors when to raise their games and deploy the ODM

Schloo