COVID 19 Respirators

Respiratory therapist Dave Smith adjusts settings on a ventilator in one of Blount Memorial Hospital’s critical care units.

When the COVID-19 pandemic entered the lives of Tennesseans in March, the Blount Memorial Foundation reacted by purchasing three hospital-grade BiPAP machines that can be converted into ventilators if need be.

Blount Memorial Hospital Chief Medical Executive Dr. Harold Naramore said ventilators are “sophisticated devices to support the respiratory system while the body heals from an acute or critical illness.”

The devices have reached the forefront of Americans’ minds as more people hospitalized for COVID-19 are put on them. According to the Tennessee Department of Health, as of May 14, some 1,435 Tennesseans had been hospitalized as a result of COVID-19. TDH does not report the number of hospitalized patients put on ventilators.

While the number of people hospitalized for the virus has been comparatively small in Blount County, the local hospital has made an effort to stay on top of its resources by purchasing additional equipment before a potential crisis arrives, officials said.

“The decision to purchase this equipment was made by the foundation board as it wanted to do something to help support the future needs of the community, should a significant outbreak of COVID-19 occur in Blount County,” BMH Public Relations Manager Jennie Bounds said.

Funds for the BiPAP machines came from the foundation’s COVID-19 Community Response Fund. The total cost of the equipment was $38,436.90.

The three new BiPAP machines will be added to the response equipment the hospital already has on deck, including 17 fully functional ventilators.

Blount Memorial’s number of ventilators fares well in comparison to the amount of positive coronavirus cases in the county, officials said. There were only 14 active cases in Blount County on May 14.

But fears surrounding ventilators stretch farther than whether the local hospital has enough. Naramore said many people assume a ventilator is an end-of-life treatment, but he added, that’s not necessarily true.

“(A ventilator) uses positive pressure, meaning it pushes air into the lungs, allowing for better oxygen/carbon dioxide exchange when the patient either can’t, or is struggling, to do that on his own,” he said.

Essentially, Naramore said, ventilators do the breathing for the patient while respiratory functions are impaired or impossible — a common occurrence with COVID-19, a virus that directly affects the respiratory system.

“With pulmonary illness, the work of breathing can increase significantly,” Naramore said. “By decreasing the work of breathing, respiratory muscle fatigue is reduced. This allows a more effective exchange of oxygen and carbon dioxide throughout the body.”

Being hooked up to a ventilator for a short period of time usually is not a cause of concern, Naramore said, adding that 10 days is considered normal and does not necessarily mean the need for rehabilitation in a nursing home.

“The longer you are on a ventilator, the weaker the diaphragm and respiratory muscles become,” Naramore said. “Short-term ventilator support typically does not result in a need for prolonged rehabilitation.”

One of the biggest fears in patients having to be connected to a ventilator is the inability to communicate, Naramore said.

“In most cases, patients may have a tube inserted into the trachea, which isolates them from being able to use traditional communication methods,” he said. “Sometimes, we have to use medication to ensure that the patient doesn’t fight the ventilator, based on their anxiety and fear of not being able to communicate.”

Despite these fears, Naramore said ventilators don’t mean a death sentence.

“Many people think that when a ventilator is introduced as part of a patient’s care, that it means the patient is at end of life,” he said. “That’s not necessarily the case: The ventilator is helping the body maintain normal ventilation, normal body chemistry and normal oxygenation while healing efforts can be focused on the main health problem.”

Follow @sshreports on Twitter for more from county government reporter Shelby Harris.

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