Journal de médecine pulmonaire

Fighting the world’s newest threat-Covid-19, a respiratory therapist’s perspective

David R Orloff

Respiratory Therapists are the world’s leading non-physician experts in delivering respiratory care in the acute and non-acute care settings. Their scope of practice ranges from medication delivery to ICU care (which includes mechanical ventilation), to client education and beyond. They are key stakeholders on the healthcare team and provide insight on a case-by-case basis. Covid-19 has taken the world by storm, affecting an estimated 106 million people and caused approximately 2.3 million deaths to date. Our healthcare systems had little time to truly prepare for what was to come with respect to patient census, affliction, and volume. Covid-19 is primarily a respiratory ailment that, if progresses to an advanced stage, requires moderate to high levels of oxygen therapy along with invasive and non-invasive respiratory support. We are still learning how this virus affects patients’ lungs, but from what I have seen, recovery, even from a mild case, takes weeks to months. Preparation stressed healthcare systems because of the increased demand for equipment and supplies. Rolling backorders became an issue and our health systems were stretched to their limits and beyond in many cases. RT availability was also an issue. Therapists were working five to six days a week for 12+ hours at a time. Stress was and still is at an all-time high. Post-Traumatic Stress (PTS) is also a concern as the healthcare teams were seeing a tremendous amount of death and dying which could not be prevented despite all the team’s efforts. We have had many successes with proning, early oxygen therapy intervention, and slightly delaying intubation. Statistically, we were able to prevent intubation in 28% of our patients in the first wave of the pandemic (Mar-Jun 20), most of that patient population required an escalation of oxygen therapy that did not lead to mechanical ventilation.