COVID-19 Patients in ICU require extra-special care

−Anesthesiologist outlines how the COVID-19 ICU lends support to its patients

−Recovery from COVID-19 ICU is possible

DPI, Guyana, Thursday, April 16, 2020

The COVID-19 Intensive Care Unit at the Georgetown Public Hospital Corporation (GPHC) is reserved for patients who have more complex respiratory issues related to the virus.

Appearing on the Ministry of Public health’s daily update to the nation, Dr. Alexandra Harvey, Anesthesiologist and Director of Medical Education at GPHC explained that these complex issues can be classified as severe shortness of breath, worsening ability to breathe, worsening oxygen levels in the blood

Dr. Harvey explained when a patient who has been tested positive for COVID-19 and is worsening, they are no longer treated for the underlying symptoms but instead placed in intensive care.

Upon admittance to the COVID-19 ICU, the patient is put on a ventilator that supports the patient’s oxygen intake.

“Once the patient is in very severe distress it is very possible that they will need a mechanical way of supporting the ventilation because they can no longer do it for themselves… to be attached to this machine, the doctors in the intensive care often need to intubate the patient,” Dr. Harvey said.

Intubation is the process of inserting a plastic tube called an endotracheal tube into the patient’s mouth, then into the airway. The tube is then attached to the ventilator so that added oxygen can get straight into the patient’s lungs.

Some patients require ventilator support for a very short period while others will depend on it for a longer period.

While on the ventilator, the patient’s vital signs are monitored while continuous tests are conducted to ensure they are responding well to the support given by the machine.

“There comes a time when the doctors feel that they have reached a point where they may be removed from the ventilator. This removal from the ventilator occurs when the patient’s oxygen level and other aspects that we monitor are improving,” Dr. Harvey added.

Once positive signs of breathing are demonstrated by the patient, they are then extubated – i.e., the tube is removed. After extubating, however, the patient is not immediately discharged from the ICU.

“It is a process and they may still have to wear an oxygen mask as added support for various periods,” Dr. Harvey said.

She noted that not all patients transferred to the ICU need to be put on a ventilator. Breathing support is given to those patients in the form of oxygen masks of various types.

Also, there are ways in which the patients can work along with the medical practitioners to make the recovery process easier.

“The patients are also asked to cooperate in other ways by taking deep breaths, by assisting with turning. Sometimes they have to be put on their stomach instead of lying on the back, sometimes on their sides. With COVID-19, they are often asked to lie on their stomach because this is what has been shown to improve oxygenation.”