The hospitals protocols are changing almost daily, with new information and as they prepare for the onslaught of COVID patients. One of the things that's in the news right now is the need for ventilators and for N95 masks. N95 masks are a certain kind of mask that keeps out the smallest particles and are the recommended personal protective equipment (PPE) to keep health care workers from getting sick while treating COVID patients. They are in short supply right now. And then there are the ventilators — hospitals want to have on hand significantly more ventilators than they usually own for this epidemic. This has been a point of much discussion in the news, with people speculating why hospitals would need so many more ventilators. I mean, other flu varieties don't require this many people to be ventilated, why now?
Kristi explained in a phone call with our mother and I, and here's the reason:
There are no emergencies during a pandemic.
Nothing, not your loved one being unable to breathe or having a heart attack, is worth risking the lives of healthcare workers who are there to save them.
During normal times, if someone presented to the hospital in severe respiratory distress, they would be put on a bipap machine. It's like a c-pap machine that people use for sleep apnea, only with pressure on both the exhale and the inhale. Patients can be in a regular hospital room if they are on a bipap machine.
Except...
While someone is on a bipap machine their breath is aerosolized, airborne in the room for others to breathe in. Without enough N95 masks to protect health care workers, chances are high that those treating these patients will contract the virus.
If the person's breathing continues to worsen and their oxygen levels don't rise, then they are put on a ventilator, which is a much more serious intervention. The patient is heavily medicated because a tube is shoved down their throat. Without sedation, patients will try to grab at it to remove it, possibly damaging the airway. During the intubation procedure of someone who has COVID, everyone in the room is highly at risk for being exposed to whatever virus or bacteria the patient may exhale, so personal protection equipment is essential. After the intubation, a machine breathes for the patient and they are typically in the ICU so their medication and oxygen levels can be closely monitored. It is not pleasant.
During the coming epidemic, hospitals are skipping the bipap stage and going straight to the ventilation stage. Why? One, because they don't want to expose their caregivers to the disease by aerosolizing the virus with bipap machines. Two, if the patient worsens, the care team will be frantically donning their protective equipment outside of the room while the patient is in distress, unable to breathe. By the time the care team is able to enter the room, the person may be unconscious, suffer irreparable brain damage from the lack of oxygen, or have died.
From a nurse who was on the front lines of fighting the Ebola epidemic: There are no emergencies during a pandemic.
There is no rushing into a room during a code blue, nurses and therapists surrounding a patient and providing life-saving care. There is no treatment without first taking precautions that the patient may — MAY — have COVID if any symptoms are present. Right now hospitals beds are being taken up by people who are waiting for test results to rule out COVID, since it currently takes 48 hours to get results back. Until a patient is known to NOT have the virus it is assumed they do, meaning that each time a nurse enters the room they must gown up appropriately. It takes much longer to care for patients now than when a pandemic isn't going on.
So yes, there is a shortage of ventilators. There is a shortage of N95 masks. And scientific data is behind all of the changes that hospitals are making to reduce mortality during this pandemic. Science and facts.
*NOTE: This was published with the input of my sister. It is not a reflection of her opinion or that of her employer, only mine.
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