Are Ventilators Mostly Useless?

[DanieRains]

The media isn't doing their jobs in my opinion.

I have seen what I think is evidence that they tell sick people to stay home until they get real sick. There is no drug treatment at a hospital even if they have the Coronavirus. Then when they get real sick, they go to the hospital by calling EMT's.

Now here is the problem.

I remember seeing a nurse talking about all the people on ventilators dying. Of course some survive, but by the time they are so sick they need a ventilator a large percentage of them pass away. Almost all of them from what I saw in this one interview. Watching all her patients die was heartbreaking for her, and all the people in IC.

Ventilators "extend and save lives" of course. I just wonder what percentage of the people put in ventilators survive.

Media?

I just don't want people to think that if they get real sick a ventilator will save them. It will of course save some but how many?

Let's find out!

[gibraltar72]

1. Alternative?

[getagrip_already]

4. more ventilators, hospital beds, and medical staff.......

And ppe of course.

A lot of people are dying at home. They are told to wait there because "they aren't sick enough" to come in and be admitted. Of course, if there were more resources, more people would be told to come in, and that early treatment would mean more survive.

So in effect, the hospitals are issuing die at home orders because they are rationing a limited resource.

But even with unlimited resources, a high percentage of people who end up on a respirator for respiratory failure don't survive.

But I stand by my "guess" that with more resources, more people would be admitted earlier, and more would ultimately survive.

[gibraltar72]

12. and slow and insufficient testing.

[we can do it]

2. Are you kidding? Really?!

[Blueplanet]

42. No-it is a legitimate question

Only 20% of 80% survive after being put on a ventilators.

[we can do it]

55. Way less than half that who get CPR survive, but we still do it.

[PSPS]

3. LOL. "Mostly useless?" Next it will be "Why bother?"

Put the question to someone whose life it saved, or their friends and relatives.

[ElementaryPenguin]

5. No. My wife is a respiratory therapist and just saved the life of a Covid patient with one.

[redwitch]

9. That has got to feel great!

Blessings to her !

[we can do it]

56. ❤️Love it!❤️

[Tanuki]

6. Useless? Ask David Lat

https://www.google.com/amp/s/www.washingtonpost.com/opinions/2020/04/09/my-near-death-experience-ventilator/%3foutputType=amp

"David Lat is the founding editor of Above the Law, a website covering the legal profession, and a managing director at Lateral Link, a legal recruiting firm.

The ventilator has become an object of national fascination — and controversy. The previously obscure medical device, which mechanically helps patients to breathe, has shot to worldwide fame during the coronavirus pandemic. Many patients with serious cases of covid-19 suffer respiratory failure and will die if they can’t be connected to ventilators.

I should know. I spent six days on a ventilator, in critical condition in the intensive care unit at New York University Langone medical center in New York City. I would not be here today without a ventilator."... (More at link)

[William769]

7. Why do some people survive cancer & some don't?

Let's find out!

[Ilsa]

8. Ventilators help provide more oxygen

than can be provided in a breath. That keeps the brain and body oxygenated vs dying. Ventilators keep the breathing going when a person's chest muscles are unnaturally exhausted by a respiratory disease. Ventilators give a patient's immune system and medications time to fight the disease.

Talk to a respiratory therapist if you need more information, or google medical ventilators.

[we can do it]

57. +1

[SidDithers]

10. I you get COVID-19...

Either your body fights it off, or you die.

Those are the only 2 choices.

Ventilators can help give your body strength to fight off the virus, by forcing oxygen into lungs that are operating way below normal capacity. They extend the opportunity for your body to fight off the virus.

The fact that sometimes the body still loses that fight doesn’t mean that ventilators are useless.

Sid

[uppityperson]

14. Exactly. Thanks, Sid

[peggysue2]

11. Ventilators are usually lifesavers

My son was on a vent for a week. He would have died without respiratory support.

With Covid-19 there's a sense that how the ventilators are being used may be a problem because of the way this particular virus attacks the body. Physicians are reporting better results with concentrating on delivering oxygen without high pressure levels in a lot of patients. But not all.

This virus comes with its own signature and is not presenting with the typical patient response of ARDS (Acute Respiration Distress Syndrome). Adjustments are being considered/made, using other oxygen-delivery methods for as long as a patient can tolerate the alternatives. But no one has suggested ventilators are useless.

[uppityperson]

16. Thank you peggysue

[peggysue2]

18. Most welcome!

[peggysue2]

54. That's certainly the case with Covid-19

In fact, the stats I've read survival rates are coming in at 20-30% which is why physicians are in the process of considering 'how' they're using the machines during this outbreak. The virus has its own peculiar signature in the way it's attacking the lungs and patients often require longer periods on the machines (11-20+ days) which increase problems of infection and weaning off. Also, the standard protocols on the pressure levels are damaging a lot of Covid-19/ventilator survivors. That's why doctors are questioning the 'one-size-fits-all' standard. Saving lives and saving lungs is what they're concerned about.

There's no doubt that age and underlying conditions increase the risk, ventilator or not. And yes, it's always a personal choice. For myself, I have a living will with a DNR directive. I do not want to languish in a hospital all tubed up. It was a decision I made several years ago and it was a decision my mother-in-law made more recently. When she started to fail, we made sure that palliative care was available so that her death was not some awful struggle, gasping for each and every breath, but as peaceful and gentle as possible. And it was. I watched her passing first hand.

But for other applications, a ventilator is a lifesaver. Brain trauma, for instance and a number of complicated surgeries ensure oxygen levels in patients until the person's body can resume functioning. In my son's case, the standard was get the patient off the vent as soon as possible (a week was recommended). And I vividly remember the doctor saying: "We're taking him off whether he's ready or not." And then holding my own breath.

My earlier comments were in reaction to the headline: Are Ventilators Mostly Useless?

As is often the case, it depends on the application. And, of course, the patient's wishes should figure into the equation.

[Azathoth]

13. ECMO is the answer

Ventilators are used because they are commonplace and intubating a patient is part of the standard ER skillset. Unfortunately, when lungs are severely damaged, forcing more and more oxygen into them has diminishing and even counterproductive returns. It's like forcing more and more food down the throat of a patient who is losing function in their small intestine.

ECMO, used early before the patient is experiencing organ failure, is the answer, as confirmed by the experiences of Chinese doctors. Unfortunately, we don't have even a fraction of the machines necessary, nor the people trained to use them.

Maybe one day we will reach a point when ECMO is widely available and highly safe. Sadly, it won't be for this pandemic.

[snowybirdie]

27. That machine

saved my grandson's life.

[Azathoth]

28. Which? ECMO or ventilator?

[snowybirdie]

29. ECMO

We are grateful.

[Azathoth]

31. Oh. Yes, it's an amazing piece of technology

And has been saving pediatric lives for years.

It's only been in the past few years where there's been a push to use it more widely in adult cases.

I think after this global catastrophe, it will become a lot more commonplace.

[Runningdawg]

34. ECMO is NOT the answer

In the largest hospital I ever worked for we had probably 500 ventilators and four ECMOS
In 38 years as an open heart nurse, the ONLY time I have ever seen and ADULT come off ECMO is when they have received the heart and/or lung transplant or the portable unit (artificial heart) they were waiting for.
I suppose if you want to shut down transplants and only save those who were healthy to begin with, you MIGHT save a few at the expense of many.

[Azathoth]

44. Jesus you didn't even read my post

I specifically said we don't have close to the needed ECMO machines or trained specialists. It's the answer but not an option, so no one is talking about it.

And VV ECMO is safer than VA ECMO.

I suggest you read some of the reports out of China where they were reporting something like 65%+ survival of COVID patients treated with VV ECMO.

[snowybirdie]

53. I don't know much about it, but my grandson had

been shot in the chest. He was airlifted after six weeks on a regular ventilator, and moved to a hospital that had an adult ECMO. After another six weeks, he was released and is slowly recovering. Perhaps medicine is finding new and improved ways to use the technology it already has? We're grateful.

[blitzen]

47. My son was saved by ECMO when he was a newborn...

the respirator (not ventilator) was damaging his lungs. ECMO is fantastic. Of course, you're right--there aren't many. My son had to be hand-pumped in an ambulance from Baton Rouge to New Orleans to be put on one of the only ECMO machines around. The next closest was Houston. That was more than 20 years ago; I'm not sure how many are around now.

For those who don't know, with ECMO (Extra-Corporeal Membrane Oxygenation), one's blood is directed through a machine, where it is oxygenated, then back into the body. The lungs are given a rest so that they can heal.

[we can do it]

58. Like dialysis.

[Arazi]

51. Yes, there's a growing number of doctors who agree this is an oxygen problem

Not necessarily or entirely a respiratory problem.

Here's a NYC emergency room doctor:

[peggysue2]

62. Yes. And this young ER doctor is not alone in thinking exactly this

He admits he's not a pulmonary specialist but that through his own observation patients are not exhibiting the classic symptoms of ARDS. Strangely, they look more like those who are suffering high-altitude sickness, hypoxia. The same has been observed in Europe, even by the Italian doctor who I read wrote the original ventilator protocols. So, there's a real discussion going on about 'how' to use the ventilators and concentrating on the oxygen delivery when a patient's oxygen saturation begins to decline.

We're watching and reading scientific research and progress in real time as doctors try to get their arms around understanding this virus and how best to treat their patients.

Personally, I find it hopeful. There's an extraordinary amount of medical/scientific talent in the country and around the world.

[Celerity]

15. They aren't useless at all, BUT as Cuomo has said so many times, if you go on one with COVID-19, 80%

of the time you are not coming off it alive or you are triaged off (and die within a few minutes to an hour or so) for a more viable patient.

If you are never put on one (when you need to be), or are triaged off one for viability reasons, the death is often gruesome too, with many patients needing to be tied down and restrained, as they ofttimes move into convulsive spasms and death throes.

Nightmarish.

[HarlanPepper]

17. From what I have heard anecdotally is if you go on a ventilator with CV19

You are more likely to die than someone who doesn’t need one which is sort of stating the obvious. The only “stat” I’ve heard was Cuomo saying that only 25 percent that go on vents with CV19 in NY are surviving but not sure where he got that info.

It’s a good question, despite all the rage filled responses in the thread.

[Celerity]

20. "If you go on a ventilator, there is about a 20 percent chance that you will survive,"

https://www.cbsnews.com/news/transcript-michael-dowling-on-face-the-nation-april-5-2020/

MARGARET BRENNAN: Understood. If a patient has to go on a ventilator, what is the chance of survival? What are you seeing?

DOWLING: Well, what we're seeing, and I think it's across all areas, all of- all facilities, that if you go on a ventilator, there is about a 20 percent chance that you will survive. We have had obviously patients survive off ventilators, but it's about a 20 percent chance. And as you know, people are on the ventilators a long period of time. But we've had successes. And the other thing I'd just like to mention here, because I think the public sometimes gets- can get not always the right information. We've had lots of people discharged from the hospital successfully after they have been treated, many after they have been on a ventilator. So in our system alone, about three hundred people each and every day after successful treatment for the COVID virus actually go home. That is success. That's what we've got to also be talking about and thinking about and celebrating. That's the good news. And I think good news is what everybody needs right now.

[Hortensis]

21. A lot depends on the health of the patient. A 56yo

healthy man with a bad case and a 90yo with hypertensive heart disease and congestive heart failure probably do not have the same shot at being among that 20%.

[Celerity]

50. yes, of course the 80% death rate is a total for all cohorts, thanks

[Hortensis]

59. My husband's heading for 80, but I read something like 85%

of those dying in that advanced age range have significant comorbid conditions, while his arthritis in his shoulders puts a kink in his outdoor activities but that's about all. Except the little issue of age, of course. What a bookie would place his chances at I don't know, but the plan is no COVID and no finding out.

[Celerity]

60. I so hope both of you stay safe!

[Hortensis]

61. You and yours also, Celerity.

[JenniferJuniper]

19. My sister works on a vent ward.

Anecdotal, of course, but she says most people don't survive after going on a vent, especially the elderly. She questions whether they do any good at all. We just don't know enough about how this virus works.

She also describes work as a horror show of epic proportion, and says the media is not even remotely accurately reporting how bad things are on the front line.

[DanieRains]

22. Thanks For The Comments My Point Is A Vent Is Probably Not Going To Save You

I want to make sure the media lets everyone know this.

So Cuomo said 75% expire.

Better to not get the bug.

Stay safe my friends.

[SidDithers]

24. A vent will save you 20-25% of the time...

If you need a vent and don’t go on one, you die 100% of the time.

Your point is wrong.



Sid

[mucifer]

30. I appreciate the study they are doing at Rush University Hospital of Chicago:

What they are doing is using oxygen nasal cannula and positioning patients face down and seeing if this way less of them will need ventilators. I really hope this helps ease some suffering and helps people's lungs.

https://www.rush.edu/clinical-trials/study-high-flow-nasal-cannula-prone-position-covid-19-acute-respiratory-distress

[GemDigger]

32. Why? What purpose would it serve?

[Iggo]

40. But 25% don't. And those are actual living human beings.

What. The. Fuck.

[ismnotwasm]

23. That's...not how ventilators work

When you can’t breathe on your own, for any number of reasons, they breathe for you. So no, they not useless.

[Marrah_Goodman]

25. Even if they save a small percent of the people on them, I would still want my loved one on it

This is like people who refuse to get a flu shot because it doesn't cover every strain of flu.

[mucifer]

33. Depends ethically speaking with overcrowded hospitals and no visitors understaffing

I would not choose a ventilator for an elderly relative with underlying diseases. But, that's me. These are complicated and horrible decisions.

[Takket]

26. i think i'm willing to trust the judgement of medical professionals without needing a media

investigation. we have enough fuel for conspiracy theorists out there already.

[Demsrule86]

35. I heard 50 50 so it is worth it.

[Iggo]

36. Useless? To whom? For what? Are you insane? It's right there in the name what they're useful for.

[Blueplanet]

37. I hear you DanieRains

Apparently, only 20% of patients who are put on ventilators survive. I've wondered about this myself. Eighty percent of patients who are put on ventilators die?

[Iggo]

38. Shootin' for a hundred, are we?

Jee. Zuss. Fuck.

What's wrong with people?

[DanieRains]

43. We Need Enough Vents To Treat All Who Need Them

My sick point is to make sure the media informs people if they don't stay safe, and get sick, and need a vent, they probably won't survive.

It is better to stay home, go to the store safely once a week, and don't get within 10 feet of anyone.

A vent may not save you.

[Iggo]

48. So they're not useless, then. There ya go! (n/t)

[LaurenOlimina]

39. That's what I am reading.

[Runningdawg]

41. By the time I had finished nursing school, I understood fully there were things worse than dying.

At 22 I made my first living will or as they call it some places, advance directive. By the time I was 40 I had updated it to include, NO intubation for anything other than surgery. Even if I get the virus, it would be pointless to go to the hospital with that still in place. I would rather die gasping for air in my own bed with my animals and husband for comfort rather than choking on a tube in a forgotten basement hallway alone.

[Chainfire]

45. If they save one out of twenty people

You would have no doubt in the value of the machines, if the survivor was your child.

What price life?

[fescuerescue]

46. Umm yes they make a big difference.

Of the people that get COVID19, 5% will require hospitalization.

That's 5 out of 100.

2 will recover without needing a ventilator.
2 will recover with the use of a ventilator.
1 will die even with a ventilator.

If you are in that 5%, yes, a ventilator triples your chance of survival.

If no ventilators are available, then 3 of the 5 will die while 2 will recover without it.

That's not mostly useless.


(Source is my brother who is an RN working with COVID19 patients)

[DeminPennswoods]

52. Wonder how many people put on ventilators

actually have advance directives/living wills saying they do not want it. I have one, but how would the hospital know? My uncle had it in his will that he was not to have any extraordinary life support, yet when he was at the end, probably from sepsis, the nursing home where he was did not send that directive to the hospital with him. They put him on a feeding tube, which he specifically said he did not want, and did other measures to keep him alive. When I found out, I had to fax his directive to the hospital, they removed the tubes and he passed peacefully shortly thereafter.