Care of COVID-19 Patients in the Critical Care Unit

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Patients with COVID-19 who are in the Critical Care Unit, or CCU, are under the care of a hospitalist, a physician who specializes in the care of hospitalized patients. Many of our COVID-19 patients over the past year were in the CCU. COVID-19 patients in critical care have a higher risk of needing a ventilator because their ability to get enough oxygen on their own is compromised. Low oxygen levels over too long a period of time cause strain on body systems and put the patient at risk of many complications.

Prior to a patient being placed on a ventilator, respiratory therapists are responsible for assessing the need for intubation. Intubation is when a hollow plastic tube, called an endotracheal tube, is placed in the patient’s trachea or “windpipe” through the mouth. This allows oxygen to get into the patient’s lungs and helps the patient to breathe when he cannot breathe adequately on his own.

When necessary, respiratory therapists assist physicians when placing and securing the endotracheal tube in the patient’s mouth and throat. The tube is attached to the ventilator, which gives the patient oxygen and breathes for him. This allows the patient’s body to rest, not having to work so hard just to breathe.

When we have a CCU patient on a ventilator with COVID-19, they are in an isolated room all by themselves. Respiratory duty is to maintain the airway and monitor and adjust the mechanical ventilator. We adjust the ventilator based on the patient’s atrial blood gases. Respiratory therapy is responsible for drawing these gases, which can show us that we are adequately ventilating the patient. We also are suctioning out the airway and proning patients, which means to put the patient on their stomach. This helps with air exchange and mucus removal. We also monitor the patient’s vitals while on the ventilator, especially their oxygen saturation, which tells us that the ventilator is working well and allowing the body a better chance to heal.