Hi everyone, I'm a ventilator! I have just one job: to breathe when your loved one can't. I'm life support. But it's a big job, and I can't do it alone... [a #COVID19 thread by me & @ChrisWorsham]
Not everyone with COVID will need me- only those sick enough to die at any moment. Unfortunately, that is a lot of patients during this crisis. Most projections suggest we will have a lot of critically ill patients, and ICUs are already feeling the burden.
Unfortunately, it takes a long time to get through severe COVID infection, sometimes even weeks. Patients are truly that sick the whole time- 1/3 may still die (using a lower limit of ARDS mortality). It is truly critical care.
It takes weeks of ICU team effort to save patients with #COVID19. During that time, I support the lungs while they heal. I require careful management by an ICU doctor/PA/NP, ICU nurses, & respiratory therapists. Vents need lots of attention because we could hurt someone...
The lungs are beautiful & powerful, but also delicate. A little too much air or pressure can cause serious harm. Too little can cause the lung to collapse. When you're sick w #COVID19 every bit of good lung counts. If I don't get it just right, people could die. It's complicated!
Each person's lung reacts to injury a bit differently. So we tailor the way I work for each individual patient, sometimes changing minute to minute! You wouldn't use the same water pressure to shower as you use for a firehouse, right? It's the same idea...
Saving a patient with #COVID19 means we need interventions you can't just set & forget. I need careful attention from intensivists, respiratory therapists & nurses. Fighting COVID means we need lots of sophisticated ventilators, but also lots of experienced staff & time.
Perhaps more so than many other parts of the hospital, critically ill patients need extremely meticulous care. Close attention to detail, minute to minute. Too many patients all at once means our teams will be stretched thin- and people will get hurt while we're trying to help.
Think of me like an airplane. In great conditions, you might use autopilot for a little while, but it's still your life on the line. COVID is far from the best. You wouldn't use autopilot in a hurricane, right? And you certainly wouldn't want a plane no one has ever flown before.
Getting our sickest patients through #COVID19 needs ventilators that we know how to use - it's frightening to consider untested methods when a life is on the line. Unfortunately, we may need those as well. It also takes an extremely well trained ICU team with the TIME they need!
This is what we mean when we ask for time. Critical care for #COVID19 is meticulous, labor & resource intensive, and often prolonged. When we get overwhelmed, the sickest patients pay the price. Please do your part to buy us time. #StayHome to #FlattenTheCurve! /fin
Great piece that describes this in more detail by @danielalamasmd https://twitter.com/danielalamasmd/status/1243493034593079297?s=19