KANSAS CITY, Mo. — It was a cry of desperation heard around the world: Please send ventilators. New York City, Italy, China – all were in short supply of that life-saving machine.
But as more is known about the coronavirus, doctors are becoming increasingly wary of using the machine — concerned that it’s costing more lives than it’s saving.
“Mechanical ventilation is a treatment of last resort,” said Gary Salzman, a pulmonologist and critical care doctor at Truman Medical Center.
But few know better than Salzman the miracles that ventilators can provide.
It did for Rhonda Fletcher who started gasping for air minutes after having a bad reaction to an allergy shot.
“My face was swollen up, and it was red,” Fletcher said.
She spent the next six days hooked to a ventilator unable to move. Five years later, she still credits the ventilator and the staff at Truman Medical Center with saving her life.
“I’m just grateful I was able to be put on a ventilator and able to talk about it,” Fletcher said.
Her experience was typical of most ventilator patients until COVID-19 where the prognosis is bleak.
Researchers studying patients placed on ventilators in Italy, China and the United States discovered the vast majority died — as high as 80%.
“So this is unique, and we are all trying to figure out the best way to manage these patients,” Salzman said.
That’s why pulmonologists are increasingly relying on less invasive and traumatic measures for COVID-19 patients with breathing problems, including PAP machines and nasal cannulas where tubes are attached beneath the nostrils and deliver air to the nose without having to sedate the patient.
However, Amelia Fitzpatrick, pulmonary and critical care doctor at St. Luke’s Hospital, cautioned that some of the bad outcomes in Italy, New York City and China may also be the result of hospitals overwhelmed with patients, something that hasn’t yet happened in the metro.
“So we are able to focus on each individual patient as they come in and make the ventilator changes and adjust to how their lungs are responding to the virus,” Fitzpatrick said.
Because of that, she believed the success rate was far higher in the Kansas City metro, though she was unable to provide us with any statistics to confirm that.
However, she could point to patients like 82-year-old Lanny Wilson.
After contracting COVID-19, he spent a week on a ventilator and is now home with his family in Indiana.
There’s no dispute that the earlier breathing problems caused by the virus are detected, the better the chance the patient will survive.
That’s why the oximeter is gaining attention. You clip it to your finger, and it measures your blood oxygen levels. A score in the high 90s is considered normal.
“We have seen remarkably low oxygen levels in patients,” of less than 70%, even in patients who don’t appear to be sick, Fitzpatrick said.
“They are awake and interactive,” she said. “They are texting their loved ones, and that’s an unusual thing to see.”
Now experts believe that anyone who has tested positive for COVID-19 should have their oxygen levels tested if they feel short of breath. That should be the new standard.
The goal is early intervention, giving patients the best chance to survive.
