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Wednesday, 29 April 2020

Respiratory care and people who care for patients with COVID-19

When people experience severe symptoms with COVID-19, they are urged to seek medical attention. But what happens to patients when they are hospitalized and who helps them?
Because COVID-19 heavily affects the respiratory system, respiratory care is an important part of the care and healing process, says Dr. Daniel Diedrich, an anesthesiologist and critical care specialist at Mayo Clinic.
All clinicians play an important role in providing lifesaving care while patients with COVID-19 are getting treatment. “Respiratory care starts in the emergency department and follows through a patient’s recovery process,” says Dr. Diedrich.
The level of respiratory care or support can start out by providing the patient with additional oxygen. Then it can advance to the next level of placing a patient on a mechanical ventilator. And then there’s an even higher level of support, where other machines are used that entirely take over all the function of the lungs.
“Respiratory therapists determine the need and level of oxygen support. If the patient deteriorates and they require breathing tube placement, they’re the ones assisting in that. They really manage the mechanical ventilator to the goals set out by the providers, and they really make sure that the patient is getting the right level of oxygen and we’re doing the therapies that are protective to the lungs,” says Dr. Diedrich.
“Usually the respiratory therapists are the first ones who get a sense this patient has recovered and doesn’t need the mechanical ventilator. And when the patients are along their recovery pathway, the respiratory therapists are the actual ones that are doing a lot of the rehabilitation,” he says.
The understanding of how COVID-19 affects the lungs and the body is evolving, says Dr. Diedrich. He explains there are two parts.
“There is an acute infection stage, and this is really where the virus is causing the damage as well as the damage that the body is doing fighting this disease, too. There’s collateral damage as the lung is certainly that type of an organ. Later on, as we get past that acute phase, the body gets control of the virus, but there can be fibrosis or scarring of the lungs, which can cripple the lungs long term. And that’s a scary thing.”

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