My main concern is making sure we have enough hospital beds. And ventilators. But I feel like ventilators are basically a death sentence, we need more and earlier interventions. I'll check indiana stats, but we are nowhere near overwhelmed.
Dr's are starting to use nasal cannulas, CPAP and BIPAP machines.
Virus victims develop a mucousy-yellow gunk in their lungs that prevents oxygen from transferring to the blood. Forcing more air into their lungs with a ventilator, doesn’t help that process, it just damages the lungs.
The branches are your bronchi and at the end of each small branch are leaves — clusters of 600 million tiny microscopic sacs, called alveoli. That’s where oxygen and carbon dioxide are exchanged.
During the immune overreaction, called a “cytokine storm,” the alveoli drown in a gummy yellow fluid.
When those air sacs become clogged, the lungs stiffen up. Oxygen levels in the patient dramatically fall, and the heart struggles to function properly. A ventilator can help, but only so much. Said one doctor who’s treating COVID-19 patients on ventilators:
He says these patients with more normal-looking lungs, but low blood oxygen, may also be especially vulnerable to ventilator-associated lung injury, where pressure from the air that’s being forced into the lungs damages the thin air sacs that exchange oxygen with the blood.
“Because U.S. data on treating Covid-19 patients are nearly nonexistent, health care workers are flying blind when it comes to caring for such confounding patients.
"Doctors are making their decisions based on “blood oxygen levels”, but blood oxygen levels might signal the need for a different treatment for coronavirus patients than they do for pneumonia and acute respiratory distress syndrome (ARDS) patients. In other words, one size does not fit all. The problem is that too many people are ending up on ventilators when ventilators are undermining their chances for survival.
But in a subset of patients, for reasons unknown, things go horribly awry during the second week of illness. Even though levels of virus fall, the immune system goes into dangerous overdrive, flooding the lungs with inflammatory cells. In these people, it’s their body’s response, rather than the virus, that’s lethal.
This is often when people will deteriorate and become much more ill and end up in the ICU,” said infectious disease expert Dr. Annie Luetkemeyer, associate professor of medicine at UC San Francisco.
Patients struggle for air. Oxygen levels plummet. Blood pressure drops. Kidneys fail. The heart stops.
But anecdotally, Weingart said,We’ve had a number of people who improved and got off CPAP or high flow [nasal cannulas] who would have been tubed 100 out of 100 times in the past.” What he calls “this knee-jerk response” of putting people on ventilators if their blood oxygen levels remain low with noninvasive devices “is really bad. … I think these patients do much, much worse on the ventilator.”
Even as hospitals and governors raise the alarm about a shortage of ventilators, some critical care physicians are questioning the widespread use of the breathing machines for Covid-19 patients, saying that large numbers of patients could instead be treated with less intensive respiratory support.
Ventilators are overused for Covid-19 patients, doctors say - STAT
Doctors Puzzle Over COVID-19 Lung Problems
Are Ventilators Killing More People Than They're Saving?? - Global Research
Mortality rate of COVID-19 patients on ventilators | Physician's Weekly