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What interventions might be attempted in hospital to help someone with advanced COVID-19 disease?

Covid 19 is a disease that primarily affects the lungs, so hospital staff will primarily focus on providing the person with additional oxygen and helping them to breathe.

Oxygen can be given through a mask, and this will be enough to help some people to recover. Others will become more unwell despite the oxygen mask, and in this situation other more invasive treatments can be considered.

When someone is very seriously ill, they might be given high levels of oxygen and breathing support, using a device called CPAP (continuous positive airways pressure) or NIV (non invasive ventilation). Both CPAP and NIV are delivered through a tight fitting mask, strapped firmly to the person’s head. The mask must be worn continuously until the underlying condition improves or until it becomes clear that the person’s condition is not improving in response to the treatment.

A short video providing information about CPAP made by NHS Greater Glasgow & Clyde is available here: NHS GGC film about CPAP

Will I get a ventilator?

For some patients who deteriorate despite CPAP/NIV or who are critically ill on arrival at the hospital, the doctors will consider whether they might benefit from invasive ventilation. During invasive ventilation, the person is given anaesthetic drugs to make them unconscious and to allow a breathing tube to be inserted into their trachea (windpipe). The breathing tube allows connection to a ventilator that provides mechanical breathing support.

Invasive ventilation carries significant risks and will only be considered if there is a chance it will aid the person’s recovery. Ventilation is not a treatment in itself - rather, it supports the person to breathe, giving more time for the person’s body to heal itself. Unfortunately with COVID 19 it is increasingly becoming clear that a large number of people who receive invasive ventilation will not recover.

Photo by Martha Dominguez de Gouveia on Unsplash

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