We are hearing about the need for ventilators during this Corona Covid-19 surge time so thought I’d explain how ventilators work in this crisis and why there is such a demand. It’s important to remember that theCovid-19 virus has no treatment.When a patient is admitted to the hospital we provide supportive care. That means we help the patient stay alive long enough for their own immune system to mount a defense and eradicate the virus.
Supportive care is provided by intense nursing with IV fluids, oxygen, anti-fever drugs, blood pressure support, anti-blood clot drugs and close monitoring for decompensation. Covid patients decompensate (get worse) very quickly and can develop a condition called ARDS (acute respiratory distress syndrome). This is a life-threatening pneumonia where fluid leaks into the lungs and does not allow the alveoli (pulmonary cells) to exchange air.
When patients go downhill and their blood oxygen saturation (O2 sat) falls, they will need mechanical ventilation to breathe for them for they will quickly die. Each of these patients needs a ventilator and experienced specialists, nurses and respiratory technicians to manage it. The patient is transferred to the ICU or critical care unit and is given special drugs to relax them or even put them to sleep so they don’t try to breathe on their own. (There is currently a shortage of these drugs). The patient is intubated with an endotracheal tube that is placed in the mouth down through the bronchus so oxygen can be mechanically delivered to both lungs. A feeding tube is placed in the mouth and esophagus down to the stomach to provide nutrition. The patient can no longer speak.
The mortality rate for patients with ARDS prior to the current Covid crisis was up to 45% depending upon age, underlying condition and time on a vent. The ventilator just buys time and keeps the patient alive while their lungs recover.
We are still gaining knowledge and statistics for Covid-19, but the majority of patients that need a vent do not survive. These patients need ventilators for a longer period of time and the longer a patient is on a vent, the worst the outcome. These are the most critical of all patients and the 24/7 resources required to care for them are extensive.
The need for ventilators, hospital ICU beds, medication, professionals (doctors, nurses, respiratory techs, critical care experts) are all in dire short supply. Small rural communities may have only 0-3 critical care beds and no critical care specialists. They routinely transfer very ill patients to larger hospitals in big cities. When those hospitals are full there is no place for patients to go.
Flattening the curve is an attempt to keep the health care system from being overwhelmed. Imagine the need for hospital ventilators and ICU care doubling daily. Ten becomes 20 and 20 becomes 40-80-160.
The system crashes very quickly. There is no community, no matter how small, that can escape this crisis.
This is why we want you to stay at home.