Wednesday 2 December, 2020

MoH expert explains use of ventilators in treating COVID-19 patients

Dr Anthony Parkinson, Technical Advisor Hospital Services in the Office of the Chief Medical Officer demonstrates the use of a ventilator

Dr Anthony Parkinson, Technical Advisor Hospital Services in the Office of the Chief Medical Officer demonstrates the use of a ventilator

Only about 2-5 percent of COVID-19 patients require mechanical ventilation.

This is according to Dr Anthony Parkinson, Technical Advisor Hospital Services in the Office of the Chief Medical Officer.

Speaking at the daily virtual media briefing on Saturday, Parkinson noted that only a small percentage of COVID-19 patients require ventilation support.

"It is the last aspect of treatment of COVID-19. It's only about 2-5 percent of patients who need this, but yet it is still a very important part. It's a part that is being confused over social media."

He explained that in few cases patients become seriously ill, have difficulty breathing and are put on ventilators.

Parkinson said when COVID-19 attacks the body, it causes an inflammatory reaction which manifests itself in the lungs.

"What happens when the COVID hits? Most people, over 80 percent of them, nothing much. You get a little fever, you get a little short breath, nothing much happens. But about 15-20 percent require a lot more oxygen, not just the oxygen in the air but supplemental oxygen. That would involve putting on a special mask, special nasal prongs to give a little extra oxygen. But there are about 2-5 percent of people who need a lot more."

Ventilators gently pump air through a breathing tube into the patient’s lungs and allow the patient to exhale.

Demonstrating the use of a ventilator, Parkinson said most times patients are sedated or paralysed.

"A patient who is on a ventilator most times has to be sedated. Sometimes we may have to paralyse these patients. Paralyse, that sounds frightening. But what that means is because you are so stiff your muscles are acting up so much, it resists the ventilation and that would cause a lot of problems for your recovery," Parkinson explained.

He added that ventilators have to be matched to the individual patients.

"We have to match this machine to the patients. We do not match the patient to the machine. Remember we are trying to copy the function of the lungs."

Parkinson said an intensivist would then observe the ventilation machine and the patient to see if the process was successful.

"Success is the amount of oxygen that reaches the patient's bloodstream has to be optimal. We call it a partial pressure of at least anything above 60 mm mercury. That's rather low but is acceptable for these patients. That is our goal. The lungs can get stiff in some instances of the COVID-19 disease which will cause higher pressures to be delivered by the machine to inflate the lungs to get the oxygen in. Some COVID-19 patients have looser lungs, we don't have to use as much pressure. Every patient we treat individually. It's not an algorithm we follow."

Questioned by reporters on whether 'bush medicine' such as Zabapique can be used to treat the virus, Parkinson said there is no scientific evidence to suggest that local remedies are effective.

"We have no magic bullet to treat COVID-19. The only weapon we have is separation. If that is not handled properly, you would end up with a lot of patients being on a ventilator," he said.

At present, there are no COVID-19 patients on ventilators in Trinidad and Tobago.

Health Minister Terrence Deyalsingh said there are currently 69 ventilators dedicated to the COVID-19 response throughout the country.

"I don't think we even have anybody on ventilators right now. In Tobago, there are five ventilators dedicated to the COVID-19 response. And yes, as soon as that shipment of 10 comes in, four goes straight to Tobago."

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