COVID-19 cases have been keeping up everyone around the globe on their toes. The medical teams have been trying to come up with the best ways to fight the virus at every level. Up to this point, the viral infection and its symptoms have claimed 6.53+ million lives. About 614+ million suffered from this disease as per the database. Oxygen concentrators, pulse oximeters, oxygen tanks, and different types of ventilators have been used to maintain stable respiration and monitor it.
We are going to expand on the protocol for managing COVID-19 at an advanced stage. The physicians are however bound to take the patient’s unique condition and past ailments into consideration when they work. The protocol is not set in stone. It is necessary though that the treatment is decided upon by the whole team working with the patient. The patient is usually fully alert when the following treatment is initiated. Here we will only cover the CPAP method of delivery from the non-invasive ventilator.
Know your Non-Invasive Ventilator
The most important thing to do is know how the machine works in what are its requirements.
Depending on the necessity, the healthcare worker will have to attach the Non-invasive ventilator to a high-pressure air source or high-pressure oxygen source. Often the machines work with the oxygen concentrators at the hospital.
Selecting the Intake Instrument
For every patient, the health situation is different. The healthcare workers will see to it whether or not the patient needs to spit out the sputum. The healthcare workers will use nasal cannula in such cases. Thanks to the evolving technology, there are many options like nasal cannulas, face masks with nasal extensions, helmets, full face masks, HFNC, and CPAP.
Starting CPAP and Balancing the Procedure
The procedure will kick off with CPAP on 5cm H2O that has FiO2 at 100%. The H2O levels will go up 2 to 4 cm after a passage of 5 minutes till they see changes in the patient clinically. If the doctor is dealing with a child, the H2O level will go up 1-2 cm after 5 minutes. Remember that the H20 will not go above 12 cm. They can reduce the FiO2 percentage but make sure that it is enough to keep the oxygen saturation level more than or equal to 90%.
The patient is observed throughout the procedure because the parameters like saturation, breathing, patient’s blood pressure, and mental stability drive the treatment.
CPAP and Source of Oxygen
The goal is to make sure that the patient is relaxed after the treatment has started. The normalization of oxygen saturation is the other main goal.
CPAP technology has different settings when it comes to oxygen flow rates. It becomes important to use pressure and FiO2. Depending on the proper placement of the interface, the healthcare workers will maintain the FiO2.
Patient Position to Help With the Treatment
The awake-prone position is highly recommended for patients getting treatment for COVID-19 via an oxygen concentrator or CPAP machine.
This position is suggested because some studies show a lowering in the need for invasive ventilators.
Getting Off the Treatment
Once the patient has become stable on the CPAP machine, one of the three ways is utilized to end the treatment.
- Decreasing the CPAP pressure till a decided level and then taking the patient off the machine.
- The time on the CPAP machine is lessened day after day till the time when the patient is finally taken off the treatment.
- The immediate ending of the CPAP treatment. The physician deems the patient good enough to breathe healthily on immediately ends the treatment.
When to Move the Patient From CPAP Non-Invasive Ventilation Treatment
Patients might not give a good result with this modality. The doctors can note it in the following ways:
- Continued and worsening hypoxemia
- Acidosis
- Seizures
- Difficulty in breathing
- Fast breathing
- Altered consciousness
- Shock
The appearance of these symptoms will lead the doctors into deciding that the patient needs invasive ventilation to assist in proper breathing.
The Non-Invasive Ventilation treatment is tested out for an hour at most and if the patient’s health shows any of the signs mentioned above, the patient has to be intubated.
Issues to Consider When Using Non-Invasive Ventilator for Treating COVID-19
The patient might have to face one of these issues if proper care is not taken by the team.
- The tight mask fixed onto the patient’s face starts irritating their skin.
- The patient may feel dehydrated or their nutrition levels may be affected because the mask is tightly fixed onto their face.
- Ventilation may cause damage to the lung tissue because of tidal volume irregularities.
- The mask is improperly placed and the effect of the ventilation is negatively affected.
- The decision to start the treatment is late because the patient was not properly monitored.
Remember that the treatment is 360 and you cannot just focus on the respiratory system.
COVID-19: Evolving Healthcare
The medical treatment for COVID-19 care is constantly evolving and so it is good to practice constant vigilance regarding its treatment. The virus is mutating and infecting thousands daily, it is up to the healthcare sector to fight it in the best possible ways.