Caring for Coronavirus Patients

A look inside our hospitals during COVID-19

In this video, Scripps nurses from the emergency room and intensive care units share what is involved with caring for COVID-19 patients. They discuss the severity of the symptoms brought on by coronavirus and the extreme measures being taken to save lives.

You may also view this video and transcript in Spanish:Cómo es atender a los pacientes con COVID-19.

Video Transcript

Lornna Hopping, RN, Scripps Mercy Chula Vista ER: You have patients that have respiratory symptoms and you have patients have a little bit of GI symptoms. And then you have patients that come in that have the respiratory symptoms… the sore throat, the cough, the shortness of breath. And some of those symptoms can become quite severe.

Terry Taylor, RN, Scripps Mercy Chula Vista ICU: But they come here and it might start off as something very benign, but they quickly decline in their health so they might come in from the emergency room, they might be admitted to our one of our medical surgical areas. They get sicker and sicker. Most of the time the patients need to have a breathing tube, what we call “intubation.” They may be on that machine for weeks or a month. 

You and I might breathe 24 or 25% oxygen normally. These patients are requiring 100% oxygen just to get them by. 

Because they are so sick and we want them to rest, we have to put them in high amounts of medications to paralyze them and sedate them just to keep their body from trying to fight the ventilator. 

The data has been showing anywhere between 70 and 80% of the patients that ended up intubated or with a breathing tube in their lungs do not survive. 

In order to potentially save patients. We do something called proning – we call it “tummy time.” Your lungs expand better when you're on your belly. Most of us are not belly sleepers. But in order for that patient to get as much oxygen exchange in their lungs as possible, we put them on their on their belly. This is called proning. So, we prone our patients for anywhere from 16 to 18 hours at one time, and then flip them over on their back. And if they don't do well, if their oxygen levels are not very good. Then we'll flip it back over on their tummy.

I think the longest that we've had somebody on their belly was almost 44 hours, because they were just too sick to even move on their back.

Juliann Eigner, RN, Scripps Health: COVID-19 causes severe respiratory failure in a very isolated group of patients. These patients would inevitably pass away if we didn't have the ability to offer them some other form to oxygenate their blood and remove CO2. That's why they end up on ECMO.  Because ECMO is an artificial lung, it allows the patient's lungs to rest. They are no longer required to do the work that they normally do, which would be to oxygenate and ventilate or remove CO2. 

I think the toughest COVID patient who we've placed on ECMO thus far has been a young patient. There were many, many days where we thought he was going to pass away. And I remember saying at home, if he doesn't make it, I don't know if I can keep going with this job, because it's so heartbreaking. He pulled through. H he went home after 46 days on ECMO and it was really, really amazing to see.

Taylor: It's been extremely hard professionally, personally, emotionally. We're used to being able to help people and when you are not able to do what we went to school with what we went to, we've been trained for. It's heartbreaking.

Eigner: You are with patients who are at the brink of death, and you are physically demanded of beyond what we've ever been trained to do in the past. I'm inspired by the team that does this.

Please note: This transcript was lightly edited for clarity.

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