The rapid spread of the corona virus has led countries to scramble to buy ventilators to prepare for the coming peak of the case.
But the ventilator does not operate alone. And meanwhile lack of ventilator remains a serious problemMoreover, attention has been paid to health care workers needed to operate machines: respiratory therapists.
“It’s not only this machine that they talk about on TV that we don’t have enough. This is very complex, “said Julie Eason, director of the respiratory therapy department at University Hospital in Brooklyn, part of SUNY Downstate University of Health Sciences.
“If you don’t set it right, the patient’s results are different. You need skilled people who have a lot of experience doing this to get good results with this patient, “he said.
Enter breathing therapists, who are specially trained to treat people with respiratory problems. Amid the coronavirus pandemic, their role as mechanical ventilators has brought them to a new level of recognition for what has long been an unknown work.
“When I tell people that I’m a breathing therapist, they look at me blankly,” said Lisa Shultis, a breathing therapist and director of the Long Island University’s respiratory care program. “To date. Now they look at me with fear. “
Respiratory therapists are people who track oxygen levels of Covid-19 patients, regulate their breathing and, if necessary, intubate them and make mechanical ventilators.
There are 155,000 licensed respiratory therapists in the US, according to the American Association for Respiratory Care (AARC). However, their work remains “almost unknown,” said Tom Kallstrom, CEO and executive director of the AARC.
“On the doctor’s (TV) show, they never really showed a respiratory therapist,” he said. “They show others what we do. I am grateful to know that at least people know who we are (now). “
What the respiratory therapist does
As the name suggests, breathing therapists focus on breathing – a problem at the core of a pandemic.
In normal times, respiratory therapists treat acute conditions, such as premature babies with underdeveloped lungs or adults with heart attacks, as well as chronic problems, such as asthma or chronic obstructive pulmonary disease.
Now, Coronavirus is the focus. Coronavirus causes Covid-19, which affects the lungs and can cause pneumonia, shortness of breath and, in the worst case scenario, acute respiratory distress syndrome, known as ARDS.
“These patients are very different from patients we’ve seen before,” Eason said. “We usually have several patients who are sick at this level. (Now) Our ICU is filled with it. And full of them. Nobody can breathe. “
One treatment for this problem is providing additional oxygen through the nasal cannula, an instrument that enters the patient’s nose. If that doesn’t work, a more extreme treatment is to insert a tube into the patient’s throat, known as intubation, and connect it to a mechanical ventilator that breathes them. That is often the last hope of a deteriorating patient to recover.
Respiratory therapists are assigned to track the patient’s oxygen levels and work with the doctor to decide whether and when to use the treatment.
“It takes a lot of knowledge, experience, and skills to be able to advise doctors about the best way to ventilate,” said Tom Barnes, chair of teaching staff and consultants for the Master of Science at Northeastern University in the Leadership of Respiratory Care program.
Their work helps ease the responsibilities of doctors and nurses.
“No one really has the background and training in mechanical ventilators that respiratory therapists have,” Kallstrom said. “This is really a three-legged stool. You really need your doctor, nurse, and respiratory therapist to continue working together. “
Respiratory therapists are sometimes people who physically intubate. They regulate and manage ventilators. They then work their controls to match the patient’s needs: breath size, number of breaths per minute, oxygen concentration, airway pressure and more variables. And they set an alarm on the machine so that, if something goes wrong, the ventilator will warn the nearest worker quickly.
“I think if you sit in the cockpit of an airplane, you won’t know what to do,” said Kallstrom. “I don’t think ventilators are too confusing, but there are many buttons and modes that modern ventilators have.”
That can be dangerous too. Because respiratory therapists sometimes intubate, hovering over the open airways of infected patients, they are very at risk of contracting the virus.
“You have to see where you are going with the tube in the trachea, not the esophagus. It’s very difficult when you have a mask, glasses, everything lights up,” Shultis said. “The patient exhales on your face. So that is why it is very dangerous. That is why it is very important that we have the right (personal protective equipment) for anyone in the room, but especially for respiratory therapists. “
Shultis, Kallstrom and Barnes said they had been frustrated watching officials and the media discuss the need for a ventilator without acknowledging the role of a respiratory therapist.
“They are out there working with their hearts and it’s very difficult when people don’t recognize them,” Barnes said.
That’s not just a national number, too. Shultis said that even in hospitals, respiratory therapists are often not recognized as equals with other health workers.
“Contact us with our names. We are not just people who run ventilators. We are respiratory therapists. We are an important profession in the health care team, “he said.
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