LG Health respiratory therapists gather at Duke Street.
Caring for patients with COVID-19 requires a team effort. Working alongside the doctors, nurses and other specialists at Penn Medicine Lancaster General Hospital is a dedicated team of respiratory therapists (RTs) whose work is critical to the patients who depend on them to breathe.
“An RT is an expert in pulmonary physiology and the treatment of respiratory diseases. We identify and assess concerns with breathing and collaborate with our physician partners to devise a treatment plan to improve symptoms,” explained Matthew S. Pavlichko, MS, RRT-NPS, director, Respiratory Care and Pulmonary Diagnostics.
Prior to the pandemic, RTs mostly saw patients with chronic conditions such as asthma or COPD. They also cared for patients with acute respiratory illnesses, such as influenza. The pandemic has changed that dramatically.
Longer Hours, More Days
During this time of increased COVID-19 hospital admissions, an RT may be responsible for 20 patients on a floor. Most have COVID-19 and receive oxygen or nebulized treatments that can create aerosols. For protection, RTs wear full PPE — including N95 masks and gowns — for the duration of each shift. With higher patient volumes, they are working longer hours and more days.
COVID-19 is primarily a respiratory disease that causes the lungs to fill with fluid. This can lead to inflammation, shortness of breath and lung failure. The RT’s job is to oxygenate the patient’s lungs, support them through the storm of the virus, and help them recover.
On a typical day, the RT assesses each patient by measuring their respiratory rate, blood oxygen saturation, comfort and energy levels, and determines if their treatment needs adjusting. This may mean weaning the patient from oxygen or increasing the flow, or adding therapies to improve their lung function.
Using therapies like proning and Vapotherm, RTs have kept many patients off ventilators and improved outcomes. Proning involves placing the patient on their stomach for 12-16 hours a day to better oxygenate the lungs. Vapotherm is a high-flow nasal cannula that helps open the lungs and deliver a high dose of oxygen.
“RTs also manage patients who are on ventilators — a lifesaving treatment that is nonetheless difficult to endure and not without risk. We know how to customize ventilation therapy in intricate ways to provide the safest, most beneficial care to each patient,” Pavlichko said.
Finally, respiratory therapists, along with nurses and other members of our team, provide emotional support to patients at a time when family members are unable to be at the bedside.
“I’m proud of the respiratory therapists — not only at LG Health, but across our country — who have stepped up to meet the challenges of this unprecedented pandemic. They’ve done a phenomenal job sharing best practices for care, working longer hours to treat hundreds more patients, and putting the needs of those patients above all else,” Pavlichko said.