Ventilation for Covid-19 Patients

With the increase in the numbers of covid-19 patients, there is a high need for medical equipment such as protective clothing, ventilators, masks and gloves. These items are helpful to both the doctors, nurses and the covid-19 patients in fighting against the pandemic.

The rise in confirmed cases has led to a shortage in materials hence slowing down the war against the deadly virus. The shortage of ventilators is one of the most challenging conditions in this war.

Stages in COVID-19 Treatment

So what’s a ventilator and what does it do. Let’s go through the processes a covid-19 patient passes from infection to recovery. It starts from a fever with a cough and worsens to breathing challenges which would, in extreme circumstances force doctors to use ventilators on patients.

  1. Patient using oxygen mask.

Most infected persons begin with symptoms such as body aches, high fever, losing their sense of smell, taste or both, and a cough.

At this stage, the patients are advised to stay in quarantine, stay hydrated, treat the symptoms with the over-the-counter drugs such as Mucinex 12 and Acetaminophen (Tylenol), and most importantly, have enough rest.

Through this time, the patient should be near their doctor for close consistent examination, or keep in touch with their doctors in case they are away. When the patient recovers fully, they are released to go home. This helps in monitoring the Covid-19 patients closely, and also preventing further infections among the members of public.

In some cases, the patient may develop trouble in breathing this calls for a medical care such as supplemental oxygen, which is many times accompanied by breathing treatments.

If the patient isn’t put in an emergency room or an urgent care program, they are taken to their quarantine places with oxygen therapy facilities, which come in diverse forms and sizes for easy administration of different oxygen concentrations.

In countries where infection cases are high, the covid-19 patients can be trained to manage their oxygen therapy and without the help of an expert. Still, they should be monitored closely.

Breathing treatments to open small blocked air passages, and/or reduce inflammation can be offered in the form of inhaled medications. Again if the patient recovers, they are released from the hospital or treatment center.

2. Patient using oxygen tube with nasal prongs.

When the patient develops more difficulty in breathing when under oxygen therapy, they are taken to an intensified care unit. In this case a non-rebreathe mask, which looks like an oxygen mask that’s not connected to ventilator is used.

It is attached to a plastic reservoir bag which is full of highly concentrated oxygen. This mask has a one single-way valve which ensures that the patient doesn’t inhale the highly concentrated carbon dioxide they have breathed out.

This masks are used in emergencies where the patient is unable to breathe enough oxygen to sustain the blood oxygen level. They are then commonly used for a short time and the covid-19 patients becomes better or worsens, when they are then taken to a mechanical ventilator.

If the patient becomes better, they are then released or taken to a quarantine site where they are observed until they fully recover.

3. Patient receiving oxygen in bed.

When the lung issue persists despite the use of rapid oxygen therapy using a non-breathe mask, then prone positioning is implemented. The patient is made to lie on their belly in bed, and then continue receiving the oxygen therapy.

This position is highly recommended and has been known and used to help covid-19 patients with breathing difficulties even prior to covid-19. It is therefore used to hopefully reduce the need for intubation, and help avoid the use of a ventilator to the corona virus patient.

When the patient develops a respiratory failure due to a lung infection related to covid-19, several things have to be done. If the patient has not yet lost consciousness as a result of oxygen deficiency which leads to limited amount of oxygenated blood in the brain, then they need to be sedated.

This sedation medication helps the patient in maintaining vital body functions such as heart rate and blood pressure, as well as helping in muscle relaxation. There is therefore a need of enough sedation medication to sustain the patient throughout mechanical ventilations.

4.Patient receiving oxygen from a bag mask ventilation.

The next step in the process is the use of a bag mask ventilation. This time, the patient receives a positive pressure ventilation, issued by the hands of a medical professional, and the oxygen is administered to the bag through a tubing. The patient’s airway is also supported by the person by squeezing the bag.

This is also a form of ventilation, because the patient is ventilated by an external force. The only difference is that in this ventilation, it is not a machine supplying the oxygen, but persons who are majorly paramedics and Emergency Medical Technicians (EMT’s).

The bag mask is used temporarily until a safer and reliable step is taken. This because its offers indefinite support to the patient’s airway, theoretically.

5.Patient receiving oxygen from Laryngoscope and endotracheal tube.

In this step, a laryngoscope and an endotracheal tube are used. The patient placed as if they were under a mechanical ventilator.

The medical personnel uses a laryngoscope to push the tongue down by placing it in the patient’s mouth with the mouth open. Using the laryngoscope’s tip, the healthcare specialist visualizes the patient’s vocal cords, and places a plastic tube which is used to transmit the oxygen through the cords down into the trachea.

After the endotracheal tube is well placed, the patient is now hooked to a ventilator using the tube. This tube, which is approximately the size of a pinky finger’s diameter, is the patient’s lifeline at this point.

In case the patient wakes up and starts coughing, the tube pops out and the whole procedure has to be done again from the bag mask ventilation. This is one of the disastrous outcomes of using improper or limited sedation medicines.

6.Patient is intubated on mechanical ventilator.

This is the last stage in the procedure, and it requires a lot of knowledge about the patient before using it.

One’s medical past matters hear because in this case the machine does everything to supply the patient’s lungs with oxygen. Most of the settings on the mechanical ventilator will therefore depend on both the functioning of the patient’s lungs, and the reason of intubation.

This means that the settings will be different in a patient who is suffering from central nervous system problem and one suffering from an acute heart failure, chronic lung infection, or an acute respiratory failure.

The ventilator settings, which include the percentage of oxygen reaching the lungs, the amount of air administered, the pressure of the air administered, and the rate of flow, are continuously modified according to the patient’s condition.

The settings are done by highly trained medical specialists, who also change the patient’s medication and their position after doing moment-to-moment clinical check up on the patient. Even though this is a critical situation, covid-19 patients can still recover from this point and fully recover from the disease.

7. Extubation

Coming out of a ventilation after recovery or health progress towards recovery is known as extubation. In this situation, the endotracheal tube is taken off, and then the patient spends some time with an anesthesiologist.

This is because the patient is still in a state of consciousness whereby they aren’t really awake such that they can cough or sputter, but they are unable to breathe on their own. In this state, close monitoring from professionals is highly recommended.

The patient is receives high level of supplementary oxygen supply (through masks) with close monitoring. Close monitoring ensures that the patient does not go back to the intubation state. When the patient progresses, they are shifted for lesser amounts of oxygen supply, systematically according to their health, until they recover fully.

We Must Train Operators as We Seek to Supply More Ventilators.

Though ventilators are useful in treating the covid-19 patients, we need highly-trained ventilator operators to benefit from them. As evident in the above medical procedures, these tools are essential in ensuring a patient continues to breathe, and therefore, have to be operated by a specialist.

While we augment our inventory to supply more ventilators, we should remember that to train more operators if we are going to witness its full potential.

Proper diagnosis is also vital in ensuring we issue the correct procedure all the time. Accurate treatment normally starts with the correct diagnosis of the extent of the effect of the diseases on a patient. Lastly, enough sedation is essential in ensuring a patient does not wake up in the middle of ventilation and move from better to worse

Finally,

Governments in affected nations and the administrators in medical institutions must work to provide enough ventilators, as well as other materials.

The essentials include masks, gloves and other protective wears, covid-19 symptom treatment medicines and sedation medicines in the hospitals and treatment centers.

Enough supplies will quick response in cases where patient need help breathing and perk up the chances of full recovery.