It’s a scary prospect, but it’s one some will have no choice but to face. A life-threatening illness can mean the need for radical intervention. In some cases, a ventilator is a person’s only chance at survival. And in the current pandemic, these tools are more important than ever. So what happens when we reach that point? What does it feel like? It only seems fair to warn you, though, that reading on may paint a frightening picture.
You can’t breathe. An infection has been ravaging your lungs, filling them with fluid, and the inflammation has you straining and gasping for air. Every attempt to breathe brings excruciating pain, and it feels as though you might drown if no one intervenes.
Severe respiratory distress can occur as the result of any number of illnesses, but influenza and now as we're seeing, COVID-19, are two common causes. Influenza puts between 18,000 and 96,000 people in the ICU each year. COVID-19 is proving to be even more formidable; in the midst of its first season, it’s already killed over 130,000 people worldwide.
According to Stat News, an estimated 1% of COVID-19 patients wind up on ventilators. That might not seem like a lot, but given 17 million people have already been infected with the virus, 1% becomes a terrifyingly large figure. So we should all consider that this could well happen to any one of us.
Intubation, being put on a ventilator, isn't what anyone would call pleasant. The New York Times explains that most doctors opt to sedate and give their patients pain medications to keep them more comfortable. However, no sedation can mean quicker recovery time, so many patients opt to remain awake and aware, despite the trauma, panic and discomfort. Having a good support network, or even an attentive nurse, can make a big difference.
The process is relatively straight forward. A tube is put down the throat. This process, however, does cause muscle spasms and discomfort. Which is why many doctors use sedatives to help people remain more comfortable. The breaths provided by the machine are often said to be shallow, making many people feel even more discomfort. Intubated patients cannot talk and often feel as though they might vomit from the tube triggering their gag reflex.
An estimated 66% of severely ill COVID-19 patients are dying, even despite going on ventilators. To put that number in perspective, that figure drops to about 36% for people put on ventilators for pneumonia, influenza and other respiratory illnesses. According to an NPR report, the amount of lung inflammation the coronavirus is causing in some patients may make the pressure exerted by a ventilator dangerously excessive. This means a ventilator could be doing more harm than good for some critical COVID-19 sufferers.
Health Leaders Media explains that the alveoli, the little air sacs in the lungs that move oxygen to the blood, are like balloons, and they can pop if they overinflate. Those who do survive their illness, the damage left from the ventilator itself can be long-lasting. And the longer someone is intubated, the higher their chances are of dying.
Should you ever find yourself in this situation, you do have a choice in the care that's being offered. It may really help to have an advance healthcare directive which can spell out exactly how you want your medical care to look in case you’re not in the position to speak for yourself.
Many people are unaware that they can choose not to be sedated (and even more are unaware of what that will feel like—so it's not something to take lightly). But there are other considerations, too. Under what conditions might you want the ventilator removed? Deciding in advance is a responsible choice.
Being on a ventilator may be a terrifying and life-changing event, but it does save lives. Knowing that if it comes to that, you have choices, can help us all to feel in control but when it comes down to it, we hope you never have to make this choice.