A CLOSER LOOK: ventilator use for COVID-19 patients

A Closer Look

Research shows about a 25% mortality rate once placed on a ventilator

ARKANSAS (KNWA/KFTA) — In the last 10 weeks, the word “ventilator” has been mentioned in just about every COVID-19 daily briefing by Arkansas Governor Asa Hutchinson.

“We have 22 on ventilators that’s four more than yesterday,” said Arkansas Department of Health Secretary Dr. Nate Smith on Wednesday, May 27.

Across the country, with only 20 states reporting, there are more than 4,000 people on ventilators as a result of COVID-19, according to The COVID Tracking Project data from May 27. New York and New Jersey have a combined total of 1,580 patients on ventilators.

A ventilator machine is used to help a patient breathe. An oxygen tube is placed in a patient’s mouth, nose, or a hole in front of the neck, according to the Centers for Disease Control (CDC).

UAMS Respiratory Care Services Director Jeff Halbert answered the following questions about patient-ventilator usage.

Q: What factors are involved for a person to be placed on a ventilator?

A: A ventilator is a machine that helps you breathe when you are sick, injured, or sedated for an operation. It is designed to mimic the natural ventilation of the body, which is the gas exchange from oxygen to carbon dioxide. When treating respiratory disease complications, such as today’s Pandemic environment, mechanical ventilators are used to decrease the work of breathing until patients improve enough to no longer need it.

Contributing factors for mechanical ventilation are primarily associated with illnesses that cause extreme disruption to normal pulmonary mechanics. Such illnesses are derived from chronic obstructive pulmonary disease (COPD), cardiac complications, acute respiratory distress syndrome (ARDS), and now COVID-19.  

Q: What is the patient survival rate when placed on a ventilator?

A: Patients with respiratory illness are on ventilators because they are able to sustain their own breathing and oxygenation. The survival rate has many factors that can contribute to its increase or decrease. 

The survival rate for NYC will be different from here in Arkansas. Recent research shows about a 25% mortality rate once placed on a vent. During peak COVID outbreaks, hot spot locations where plagued with not enough workforce or mechanical ventilators, which would result in a much higher mortality rate of about 88%. I believe for Arkansas, having enough equipment, workforce, and the ability to learn from others have aided in a decreased mortality rate.

Critical illness survivors that have comorbidities, an increase in age, and experienced long-term ventilator management are more likely to be at risk of physical or neuropsychological disabilities after their hospital stay. These patients may require a caregiver up to 1 year after discharge.

Q: How is the ventilator tubing maintained and cleaned?

A: Respiratory therapists perform airway management every day. The intention is never to replace the airway unless it’s deemed medically necessary. Management of the artificial airway includes securing the tube to prevent dislodgement or migration, the removal of secretions, as well as pressure sore prevention 

ARKANSAS VENTILATORS

Health Officer Dr. Nate Smith at the state Capitol in Little Rock. Smith announced Tuesday, May 26, 2020, he was resigning effective Aug. 28 for a job with the CDC. (AP Photo/Kelly P. Kissel, File 2018)

Arkansas Department of Health Secretary Dr. Nate Smith said the state has 785 ventilators, as of mid-April.

In early April, the University of Arkansas for Medical Sciences (UAMS) received transport ventilators courtesy of its hand surgeons — the team provided $25,000 to buy the equipment, “to meet the needs of patients at UAMS who develop respiratory compromise from COVID-19 or other respiratory disorders,” according to UAMS.

Since the start of the pandemic, UAMS bought five ventilators for the state at a cost of $29,000 per item, according to Associate Vice Chancellor Supply Chain Operations Curtis Broughton.

Baptist Health has 127 ventilators across the health care system. “These ventilators can be moved to one of our other Baptist Health hospitals, or a patient could be potentially transferred to a facility if there was a need,” said Baptist Health Region President Kim Miller. “Baptist Health has a surge plan to accommodate an influx of COVID-19 patients if needed that includes additional patient beds, appropriate staffing to cover those beds and potentially moving equipment such as ventilators.”

Currently, three COVID-19 positive patients are on ventilators in a Baptist Health hospital.

Currently, Arkansas has had 6,277 COVID-19 cases and 1,733 are active, according to Dr. Smith. One-hundred-eight are hospitalized and 22 are on ventilators.

Of the 1,733 active cases, 68 are in nursing homes, 466 in correctional facilities and 1,199 are in the community, according to the COVID-19 daily briefing.

More than 4,000 Arkansans have recovered, and 120 have died from the novel coronavirus as of May 27.

Northwest Arkansas seeing most growth in COVID-19 cases in the state

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