There are so many differences of opinions and definitions of the “Standard of Care” that I had to put this podcast episode out. The medical field is one of the largest and most critical job fields in the world. The professionals that dedicate their lives are truly a blessing to everyone impacted by their care and expertise. There are also those in a smaller percentage that are not proficient in their job and cause more harm than good.
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The following is an automated transcript, and may be edited for grammar, and please listen to the podcast for exact verbiage.
Dr Matt Chalmers [00:00:03] Hey, this is Dr. Matt Chalmers and you're listening to the Dr. Chalmers podcast. We'll be covering how the body actually works so we can fix the things no one else can.
Dr Matt Chalmers [00:00:15] So we talk about this a little bit and this is this is going to come up because we've got some stuff coming up and things are going to be talking about. Standard of care is a double edged sword you know, I'm going to say a lot of negative things about us I want to touch on positive things. But first, not everyone should get to choose how people are cared for. Not all doctors are awesome. Some doctors are much, much better at being technicians than they are being the person who decides with the best treatment plan for someone else.
Dr Matt Chalmers [00:00:43] And so the idea that we figured out, hey, you know, you should give this person this much of this medication per gram weight per kilogram of body weight, and we should do things this way and treat people this way is good. Like at the end of the day, a lot of times it protects people more than it harms. And so I get it. It is it was a great guideline and I think it should be more of a guideline than a hardcore rule.
Dr Matt Chalmers [00:01:13] It becomes problematic when it becomes a hardcore rule, when it's you do it this way and only this way that's when we start having people die. But I think it's a phenomenal example of that we were all told, you can use these two or three drugs have to have they don't breathe right in advance like this is everyone has to run the exact same model the problem was the model was bad.
Dr Matt Chalmers [00:01:34] Now I get it You know, argue about if the model was bad on purpose, I think it was but that's what it is. And again, that's why it's bad, because as a doctor, if you're sitting there looking at somebody and they go, well, here's the standard of care and you look at your like, this makes no sense.
Dr Matt Chalmers [00:01:51] Like alright we're going to use COVID as the example, the vast majority of people there were people let me throw this out there were people who needed to be on meds. I'd say 95% of them didn't. The vast majority of people who had COVID, if you had just COVID and you didn't have other issues like emphysema, you need to be in a hyperbaric chamber or something it's obvious. It's so obvious I don't understand why we didn't do it.
Dr Matt Chalmers [00:02:15] It would be like, Hey, I need you to move these this 500 pounds of gravel five miles down the road but you can only put it in your pockets. Why can't I put it in a truck and just move it all at once? Nope got to use your pockets. Well, that's that's asinine that that's basically what they were doing.
Dr Matt Chalmers [00:02:31] So let me break that down for a little bit for those who aren't box ventilators, help you breathe breathing when explaining that what breathing is, is breathing is a mechanical function. So the reason we breathe isn't our lungs or the reason we breathe is our ribs. So your ribs are sitting kind of like this and in between the ribs are your intercostal muscles.
Dr Matt Chalmers [00:02:52] So the reason we breathe is that the muscles contract and it opens up the rib cage, creating a negative pressure on the inside of our lungs relative to the outside air pressure. So there's less pressure on the inside, more pressure on the outside that forces air to be sucked in and creates a vacuum, sucks air into the lungs.
Dr Matt Chalmers [00:03:11] And then when you want to breathe out, you contract those muscles and the ribs come together, creating a positive pressure on the inside versus outside, thus forcing air out that's that's how we breathe. That is not gas exchange that is breathing.
Dr Matt Chalmers [00:03:24] Ventilators are fantastic for people who cannot do the breathing like their ribs aren't moving and usually what we see is as people who have sticky stuff inside their lungs, so actual pneumonia inside their lungs, it's gluing the lungs together and making it hard for people to breathe. That's why we need vents the into it blows air in the lungs, blows them up, everything's good and then it sucks the air out and it does all the work for your muscles.
Dr Matt Chalmers [00:03:52] When your lungs get coated and they get heavy and it's hard to move, it exhausts the muscles in the ribs and people just can't breathe. Which is another reason why we should be doing cardiovascular work, because it helps build the stamina in the ribs to breathe but that's a obviously a different conversation.
Dr Matt Chalmers [00:04:07] A lot of the guys we can breathe you read the notes if you were a doctor treating the patients, they'd come in, they talk, they'd laugh, they'd be all dizzy when they're standing up then you lay them down and they'd be pretty good and you could talk to them and they tell you all this wrong with them they tell you how they're feeling the whole deal.
Dr Matt Chalmers [00:04:23] They didn't have a lot of issues breathing, what was actually going on was that they couldn't get the oxygen from inside their lungs into their blood vessels. So they couldn't do gas exchange they could breathe they couldn't do gas exchange so they're two different things. So basically what was happening was lets use car terms the gas tank was full of gas, but the engine couldn't get it.
Dr Matt Chalmers [00:04:45] And if you ask me, can you imagine I got any gas in the gas tank there's nothing in the engine what's wrong? Maybe like, well, it could be fuel pump or fuel line cool. Well, in this case, we had to get it into the fuel line before heated the fuel pump part of your heart and that's where it was that's where the breakdown was.
Dr Matt Chalmers [00:05:02] All right. So how do we increase the oxygenation of tissue? Hyperbaric oxygen increases tissue oxygenation by 1,000% using Boyle's law. So that's just physics you put pressure into a gas that gasoline emulsify into any fluid this is how we make carbon carbonated water that's the thing.
Dr Matt Chalmers [00:05:21] So if you oxygenate the air, so you but you're having breathing oxygen, then you do that under pressure. One atmospheric pressure will do at one point where it is easy enough and then forces that oxygen in the plasma that's what I was using to treat COVID that's how we started getting these guys with PulseOx in the high seventies, low eighties that's how we got them back up and that's how we kept them all alive, was using the hyperbaric chamber, not ventilators.
Dr Matt Chalmers [00:05:45] So the standard of care was to use a ventilator and that wasn't the problem that most of these guys were having. And that's why a lot of the people who were on ventilators died, not because they didn't later didn't do this job. The ventilator was doing a phenomenal job of doing its job. The problem was that's not the job we needed done. We needed the oxygen from the lungs to go into the blood vessels and then throughout the body not get air from outside in with the air, outside air and that was fine.
Dr Matt Chalmers [00:06:10] The air from the lungs into the body that's where our problem was and that's why I was using hyperbaric. So like I said, the standard of care should have been hyperbaric, and should not have been ventilators and that's, I think, a big problem.
Dr Matt Chalmers [00:06:23] And the reason I think that that was an on purpose is because I am not smarter than every cardiovascular cardio cardiologist, vascular specialist, respiratory therapist and in the U.S. Just not and a lot of our hospitals have hyperbaric chambers there's four or five of them here in Dallas and they chose not to use them and that that order had to come down from somebody. So, I mean, that's the problem.
Dr Matt Chalmers [00:06:47] That's that's what we get into with is a lot of the docs have they follow the standard of care and everyone died there okay. Like they can't get in trouble if they didn't follow the standard of care and 99% of the people they worked on lived and 1% died they can lose their license they can be sued they can also do terrible things haven't done.
Dr Matt Chalmers [00:07:05] So that's that's kind of the issue When I started when I talk about the standard of care and my issues with it, that's why. So yeah, it's a double edged sword, I think it does a lot of good, but there's a lot of easy ways we can look at it and be like, Well, this is obviously where we should allow for abandonment of the standard of care.
Dr Matt Chalmers [00:07:23] So the way I would like to see it done is in an emergency situation anything you can justify with research or physiology that that that covers standard of care would be physiologically based , and things like like we didn't know what COVID was for a long time. It's still not being discussed what it really is, it's a vascular issue it's not so much respatory issue, That's just the administration it's vascular we didn't know what it was a lot of people still don't, like I said.
Dr Matt Chalmers [00:07:50] And so they should've been like, look, you guys can whoever you want to, you can use ivermectin. You can use, you know, different steroids, you can use hyperbaric, you can use your quinine, you can use whatever you want. And if it works, tell other people and whatever works the best is what we'll use. But that's not the way we would decided to go, which is again, kind of why I said we did it on purpose we did this to ourselves.
Dr Matt Chalmers [00:08:11] So that's that's why I'm not a big fan of standard of care people have asked me all questions about that I thought I'd it a couple of times, so I want to make sure I went over it one more time. So that's kind of the big deal on that one.
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