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The Intensive Care Units (ICU) They are one of the key spaces to twist the arm of the Covid-19. It is in these dependencies where critically ill patients receive treatment with mechanical ventilation (VM), a physical resource that allows them to continue breathing while fighting the pathogen that attacks their lungs.
In general, doctors, nurses and kinesiologists are the ones who manage this equipment and guide its use to different therapeutic objectives. “However, in modern ICUs, no activity is envisaged that does not involve teamwork and, generally, the application of VM and its programming requires the participation of all professionals”, Explain Daniel Arellano (in the photo), president of the scientific committee of the Chilean Society of Intensive Medicine (Sochimi), and academic of Kinesiology at the San Sebastián University (USS).
The health emergency caused by the coronavirus, versus the number of health professionals instructed in mechanical ventilation -remarks- requires urgent training of personnel in the shortest amount of time, since between 5% and 10% of Covid-19 cases will need this ventilatory support.
This challenge has been addressed, among others, by Sochimi and the Digital Hospital division of the Ministry of Health, he adds.
“This alliance has enabled training to be given to a large number of professionals throughout Chile through videoconferences, the preparation of clinical guides and support material. More than 35 thousand health officials throughout the country have participated in these instances. In addition, an online assistance service has been developed, where they can count on 24/7 clinical advice from kinesiologists, doctors and nurses who are specialists in the area of critical care, ”says Arellano.
This training is not limited only to handling the equipment and programming parameters, but to the judicious use of the equipment and its interaction with the patient. “For this, comprehensive training in critical patient care is required, which takes between 2 to 3 years depending on the profession. On the other hand, under crisis conditions like the current ones, the basic instruction in the use of the device can be much less time consuming and can be directed by a more expert professional. What we are doing is trying to give the best training in the least amount of time, in addition to the greatest ongoing advice to professionals, “he points out.
“THE IDEAL IS TO FLAT THE CURVE”
Currently, the rate of new patients connected to mechanical ventilation is 20 to 30 cases per day, while between 5 to 10 are disconnected from this support. “This gives us a daily increase of 15 to 20 new patients in mechanical ventilation. If this trend continues, in a short time we will be reaching the capacity limit, ”says Arellano.
Against this background, Minsal, Sochimi and other institutions are evaluating all the possibilities to have the necessary amount of equipment. “Already invested in the purchase of new ventilators, the next step is the conversion of pediatric and veterinary equipment for the ventilation of adult patients, as well as the use of anesthesia machines. Then, we have the option of using the fans designed for non-invasive ventilation and, finally, the manufacture of nationally manufactured rescue equipment. There are already several groups working on the development of prototypes of mechanical fans. ”
“That is why it is so important to maintain social isolation and the measures in place, since the ideal is to flatten the contagion curve so that all patients who are going to require mechanical ventilation can be cared for, ”concludes the expert kinesiologist in intensive care.
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