What to expect in severe COVID Hospitalization:
Oxygen methods (from least to most severe) Nasal Cannula > OxyMask > HighFlo Nasal Cannula > BiPAP > Ventilator
Monitor for evidence of Cytokine storm, Heart and Kidney Damage.
Chest Xray – Show infiltrates and diagnoses severity of lung damage.
Arterial Blood Gases - Measure effectiveness of oxygen delivery methods. Pulse oximeters show saturation, NOT perfusion and gas exchange, which is needed to maintain blood pH and functionality of metabolism.
Administration of Medications -
IV Antibiotics - to treat secondary infections related to COVID i.e Pneumonia
Convalescent Plasma - transfer of antibodies to help immune response
Vitamin C, Vitamin D, Zinc - Help regulate immune system
Steroids - to reduce overactive immune response
Blood thinners - Prevent formation of blood clots
Maintain oxygenation with equipment.
Adjust vent settings for optimal oxygen perfusion.
Maintain blood pressure and heart functioning with critical drips (continuous IV drugs).
Maintain kidney functioning with possible short term dialysis.
Maintain fluid and electrolyte balance.
Maintain nutrition with tube feeding or IV TPN.
Possible Sedation and Paralytics to increase ventilator compliance and patient comfort.
What Does it all Mean?
A thing to always remember is "good numbers" on the monitors often reflect the effort of the interventions, not the patient. For example,
Tim's blood pressure may be good! But we may be administering continuous life sustaining medications to maintain that blood pressure.
Tim may be have and oxygen saturation of 95% ! but that may be the effect of the ventilator or BiPAP device. Support is given to sustain a patients life while disease process is eliminated . Ventilators sustain life and take over the work of breathing so the body can focus on recovery and fighting the infection.
The infection or disease process essentially declares war on the body. Medical interventions combat the effects of that war and attempt to rehabilitate the patient to full recovery. Medical personnel always began with the least invasive measures and escalates as patient condition worsens.
How Long will Patient Receive Treatment?
Healthcare providers and workers exhaust all resources to assist the patient in recovery. The patient will and or family decides what life sustaining measures to continue and at which point to withdraw interventions. "Full Code" is automatically in play until paperwork is presented or POA makes changes, by changing patient to Limited Code or DNR/AND. This is the importance of Living Wills, Advanced Directives and Power of Attorney. Living Will templates can be dowloaded online for free and filled out for your state. Have it notarized! Theres are times every nurse can attest to that patients endure extreme, excruciating treatment against their wishes because they don't have necessary paperwork in place when family steps in. In the crisis, I have also seen where the patients POA was also intubated with COVID and unable to make decisions for intubated patient.
Example of Living will here > https://eforms.com/living-will/ > Things to consider; organ donation, decision makers, life sustaining measures, beneficiaries. Communicate your wishes to your family as well. Life insurance took me about 15 minutes to sign up for and can be purchased for about $30 a month. I don't have children, but I insured my burial can be paid for and that my niece and nephew will benefit. Insurance money can also be paid out over time in increments to beneficiaries.