US-based respiratory therapist from Kerala explains fight against COVID-19

Patrick (not his real name), aged around 80, has been tested positive for COVID-19. However, he was admitted to the intensive care unit of the hospital for asthma exacerbation. Normally, he would recover with drugs like albuterol and serevent but Patrick has been in the ventilator for three days now.

I came to check him at 9 am. After cleaning my hands, I wore the gown, mask and gloves with a prayer. Then I entered Patrick’s room. He was the first patient I had to attend to that day. There were 13 others in my unit. In another unit, there were more than 100 COVID-19 patients. As many 65 ventilators were in use and barely 10 more available.

I checked Patrick’s heart rate and other readings. Meanwhile, the sad expression could be read on his face, even under the mask. His eyes displayed helplessness. With a stethoscope, I heard his wheezing and felt the presence of fluid in his lungs. Nebulization is banned for COVID-19 patients and only metered dose inhalation is administered.

“How are you?” I asked Patrick. He replied with grunts and groans.

I told him we will meet again and went to the next patient.

Robert, a colleague in my unit, had shown symptoms of COVID-19 the previous week and was shifted to quarantine. Now, 15 of the 70 respiratory therapists in the hospital are bedridden. We are running on reduced staff strength. Those working are concerned about heading home after duty as aged parents and little children are there. However, the call of duty makes everyone busy, keeping all such thoughts away. It is walking the thin line between life and death.

I reached USA 26 years ago from Saudi Arabia with experience in human resources. The switch to my new profession was unexpected, but I have only satisfaction and am thankful to the almighty. I also wish to express my gratitude to many people.

Respiratory therapy is the only profession that combines the art of ventilation, the advice of science and the knowledge of medicine. Apart from licenced physicians, only respiratory therapists are allowed to provide mechanical ventilation.

With CORONA-19 striking the world, respiratory therapists have a busy time as artificial respiration is imperative for patients in an emergency. The therapists are also given training in cardio pulmonary care for the purpose and they work alongside doctors in the war against COVID-19.

Respiratory professionals having expertise in managing ventilators are mainly deployed to attend to COVID-19 patients and they take all safety precautions. However, the disease could affect them anytime. In fact, several respiratory therapists are fighting for their lives in New York and New Jersey.

Ventilators are life support machines and 5 per cent of COVID-19 patients would be unable to perform normal breathing. It is for these patients that respiratory therapists provide suitable ventilator support. The patients are then constantly monitored and suitable changes are made in the ventilator when the need arises.

There are 1,20,000 respiratory therapists in the US, of whom 3000 are in New Jersey and 7,000 in New York. In the current situation, this number is insufficient. Every health worker coming into contact with COVID-19 patients has to spend 14 days in quarantine. As a result, the need for more respiratory therapists is felt now.

Meanwhile, innovative methods are planned to overcome the shortage of ventilators; for instance, connecting four patients to one ventilator.

Before leaving home after duty, I checked Patrick again. With additional Nitric oxide therapy, he showed improvement. I looked at him. Maybe he smiled.

Let us hope for the best!

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