LOCAL CORONAVIRUS BULLETIN Respiratory therapists on the front lines

It’s a specialty that often flies under the radar, but respiratory therapists are playing a critical role in caring for COVID-19 patients nationwide.

“Respiratory therapy isn’t a super well-known specialty, but we’re the tip of the spear when it comes to respiratory illness,” said Rich White, manager of pulmonary services at Kootenai Health. “We’re there working right alongside the patient’s physician and nurse.”

Respiratory therapists (RTs) help patients who struggle with breathing. They work with any patient who is short of breath, from premature babies to elderly adults with chronic lung disease.

Breathing assistance can range anywhere from using a CPAP machine for patients with sleep apnea, to putting a patient on a ventilator when he or she can no longer effectively breathe on their own. Respiratory therapists are essential members of our trauma, emergency response and other care teams. They are trained to be quick thinkers, and assist in deciding appropriate treatments for patients.

“Patients needing ventilators are extremely sick and that ventilator is our last line of defense. At that point they are literally living breath to breath,” White said. “Breathing machines are complex and you need highly skilled professionals to run them. People have been talking a lot about ventilators and having a shortage. But rarely do we hear about the lack of RTs to run them. The physicians know the diseases and make the order, but RTs are the ones running the machines.”

White estimates there are fewer than 1,000 respiratory therapists in Idaho, and approximately 35 at Kootenai Health. He said on any given day, an RT may see 15-20 patients who need some level of breathing assistance. On the critical care units, that number is closer to eight to 10.

COVID-19 is a respiratory illness and can lead to severe breathing issues such as pneumonia or Adult Respiratory Distress (ARD). Patients who require intensive care can be on a ventilator for many days, which White describes as the patient’s last best hope to recover.

Because respiratory therapists work so close to patients with infectious diseases like COVID-19, respiratory therapy can be dangerous. RTs can often be exposed to airborne particles as they give breathing medications or are bent over a patient while inserting a breathing tube.

Patients admitted to the hospital for COVID-19 don’t always need breathing assistance; however, White noted that most hospitalized cases also have other underlying chronic conditions which can lead to more severe illness.

“We monitor the patient’s oxygen levels closely and that helps us determine which, if any, course of action to take,” he said. “We may provide them with additional oxygen, or use medications to help with their breathing, or external breathing assistance like a BiPAP or CPAP machine. Intubating the patient and putting them on a ventilator would be the next step if needed.”

Like many areas of the hospital, White and his team have been working diligently to prepare for a possible increase in COVID-19 cases. The team assesses supplies and resources daily to anticipate current and future needs.

“We’re working daily to ensure we’re as prepared as we can be,” he said. “I know there are companies out there working to produce more equipment, or working to create vents via 3D printing. I applaud the ingenuity and can’t wait to see what results from all their work. In the meantime we are doing everything possible to prepare and support our community.”

Kootenai Health and the Panhandle Health District are actively working to share information about COVID-19 with our community. You can find the latest updates and ways to protect yourself at cdc.gov/covid19. If you have questions about COVID-19 or think you may have the virus, call the Panhandle Health District COVID-19 hotline at 1-877-415-5225.