Vaping- Associated Pulmonary Injury in San Francisco
Introduction
VAPI (vaping- associated pulmonary injury) is also referred to as VALI (vaping- associated lung injury) or even E/ VALI (e- cigarette or vaping, product use that is associated with lung injury. The condition is a common lung disease that is related to the use of vaping products/. The condition can be life- threatening and severe. The symptoms tend t to mimic those of common pulmonary diseases such as pneumonia but people do not respond to antibiotic therapy if they are suffering from VAPI. Some of its common symptoms include cough, shortness of breath, body aches, fever, vomiting as well as diarrhea. Some of the additional symptoms are abdominal pains, chills, chest pain and even weight loss. In some of the patients, the gastrointestinal symptoms come before the respiratory symptoms (Chen, Siu, Chan & Rawal, 2020). People with this condition present for cater in the few days to weeks after the symptoms begin. From the start of September 2019, the CDC ( Centers for Disease Control and Prevention) located in the United States of America declared a nation- wide outbreak of severe lung disease that was linked to vaping. Vaping was the process of inhaling aerosolized substances that had e- cigarettes (electronic cigarettes) that were battery- operated. The community of San Francisco, which is in California, was affected by vaping- associated pulmonary injury and a health improvement plan was laid down.
Data Evaluation
The cases of lung injury dates back to April 2019. The 2019 and 2020 outbreak of vaping- related conditions has primarily affected the young people in the United States of America. On February 4 2020, the nation has had approximately 2758 cases of VAPI from all states. The median of these cases is 24 years and the deaths have continued to increase (Norris, 2020). All these reported cases had a history of using e- cigarette, vaping and even other products. Most of the samples tested positive for THC (tetrahydrocannabinol) to mean that they had used a product with this chemical. The outbreak peaked in September 2019 and there was a steady decline of the condition as ta January 2020. In February 2020, NEJM, a CDC publication stated that the VAPI outbreak was driven the use of products containing THC. Vitamin E acetate, an additive was strongly implicated in VAPI.
On August 27, 2019, the CDPH (California Department of Public Health) provided health data based on a health alert. The alert claimed that were 36 new cases of VAPI that required hospitalization. Most of the current cases of vaping- associated pulmonary injury are related to cannabis compounds CBD and THC. Some of the patients also used vaping nicotine products. Among these 36 cases, 24 of them were men while 12 were women. They were from the age of 14 to 70 and their median age was 27. The data suggested that vaporing was the cause of serious health concerns in the San Francisco community. People at all age groups were at a risk of getting the condition since even 14 year olds and 70 year olds acquired the pulmonary injury (Norris, 2020). Therefore, it is important to put strict measures to prevent further spread of the condition. Environmental factors have an impact on the health of the community residents. In this case, pulmonary Injury is caused by vaping and evidently, vaping has a negative impact on the environment. People may not actively smoke but they can be passive smokers and this shows that many people are at a risk of getting VAPI. Disposal of the e- cigarettes is also an environmental hazard and it destroys the environment’s aesthetic value.
Health Improvement Plan
Some of the patients may have a history of vaping and using e- cigarette can be evaluated as a way if finding out if they have constitutional, gastrointestinal or even respiratory symptoms,. They may be the candidates for the outpatient management. Correspondingly, candidates for outpatient management should have a normal oxygen saturation if less than 95% when breathing room air,. They should not have any respiratory distress and no comorbidities that may compromise pulmonary reserve. Asides from that, the individuals may have a reliable access to care and a strong support system. The people with a history of vaping should be followed up in 24 to 48 hours of the initial evaluation and in case their respiratory symptoms worsen, they should seek medical care (Tsirilakis & Sather, 2020). Hospital admission in the county should also be greatly considered for patients who have concurrent conditions like influenza and potential EVALI if the patient has respiratory distress and comorbidities that compromise the patient’s pulmonary reserve. The patient can also be hospitalized if he or she has a reduced oxygen saturation if less than 95%.
Additionally, as per the FDA and CDC recommendations, people should not use e- cigarettes and other vaping products containing THC especially if they are getting these products from informal sources such as from the online dealers, family, friends and in- person. For people who are recovering from EVALI should not resume using vaporing products since it slows down the recovery process , recurrence of the symptoms and even leads to lung injury (Tsirilakis & Sather, 2020). The adults who are using e- cigarette and other nicotine-containing products should consider using the ways that have been approved by FDA in facilitating smoking cessation. For example, of these people chose to use e- cigarettes as an alternative to cigarettes, they should completely switch to cigarettes. The individuals should also consult their healthcare professionals on how to quit vaping products. Evidence- based treatment is also important for the people who have suffered from VAPI caused by ongoing use of cannabis to prevent distress and impairment.
Nonetheless, the San Francisco government should ensure that vaporing products are banned in the country. This is critical since it helped prevent more cases of vaping- associated pulmonary injury. From the data, it is clear that people from all ages are victims of this disease and even children are being introduced to it. Banning could be the best solution to this case. If banning is impossible, it is better for vaping to have an age limit. For instance, it can be used by adults who are more than 18 years old and those who are less than 70 years. It will assist in reducing the number of people with this condition. Mass sensitization on the negative impacts of vaping and e- cigarettes can also be taught to the people (Health alerts, 2020). For instance, vaping leads to the presence of nicotine in the body and nicotine is highly addictive. Thus, it leads to slow brain development, it affects the memory, learning, mood, self- control attention and even concentration. E- Cigarettes are also disadvantageous in the fact that they irritate the lungs, cause severe lung damage and they even lead to death. Individuals get addicted to the substances and this leads to an increase in criminal activities since they cannot do without the drugs.
The caregivers can follow a certain patient plan to ensure that they understand the state that the patients are in. They can conduct patient interview in several ways,. For instance, when evaluating patients with respiratory, gastrointestinal and nonspecific constitutional symptoms, several things can be looked at. The patient can be asked about the recent use of vaping products and e- cigarettes. The caregivers can ask the patients these in a nonjudgmental and confidential way (Health alerts, 2020). The patients must also confirm the substances that they have used. The caregivers can also carry put a physical examination on the patients based on assessing the pulse oximetry. The proposed criteria is useful since it will play a huge role in ensuring that there is a reduction in cases of VAPI in the region. The criteria are also important ince they help show the seriousness of the issue at hand and they look at the issue from an environmental, health and even governmental angle.
Communication with the community members and colleagues will be done in an ethical, inclusive as well as culturally sensitive way. These individuals will be given a chance to give their views on the healthcare improvement plan and the ideas will be assessed. They will be urged to promote confidentiality among the people whom they interact with in the community as they try to get information on what the people thing about vaping practices.
Conclusion
In summary, there has been a problem of VAPI (vaping- associated pulmonary injury) in San Francisco, California. The condition is also referred to as vaping associated lung injury. The condition is a lung disease related to the use of vaping products. However, the condition could either be severe or even life- threatening. The case of lung injury in San Francisco dates back to April 2019. The people with this condition are between 14 and 70 and the median is 24 years. On February 4 2020, the nation had about 2758 VAPI cases and 64 deaths and the condition had been because of using THC products. Vitamin E acetate was an additive that was also related to VAPI. A health improvement plan is important in ensuring that there are reduced cases. The caregivers must interview the patients based on their vaping history, and assessing the vital signs and pulse oximetry as physical evaluation. The patients must also follow the FDA and CDC recommendations on how to quit taking E- cigarettes and other vaping products as a way of promoting smoking cessation. Evidence- based treatment is also crucial for people who want to quit vaping products since they learn on the disadvantages of these products such as impairment and distress and they understand how to prevent getting VAPI. The San Francisco government can also sensitive the people on how to prevent vaping. The vaping products can also be banned and if this is hard, they can be restricted to a certain age, which is over 18 and below 70 years.
References
Chen, J., Siu, M., Chan, B., & Rawal, H. (2020). Diagnostic dilemma of vaping associated pulmonary injury. D39. Case Reports In Vaping Induced Lung Disease. https://doi.org/10.1164/ajrccm-conference.2020.201.1_meetingabstracts.a6676
Health alerts. (2020, June 2). Disease Prevention and Control, San Francisco Department of Public Health. https://www.sfcdcp.org/health-alerts-emergencies/health-alerts/
Norris, M. R. (2020). Vaping-associated pulmonary injury. Annals of Internal Medicine, 172(12), 841. https://doi.org/10.7326/l20-0279
Tsirilakis, K., & Sather, E. (2020). Pulmonary function testing in vaping associated lung injury. D98. VAPING EFFECTS ON STRUCTURE AND FUNCTION. https://doi.org/10.1164/ajrccm-conference.2020.201.1_meetingabstracts.a7684