The Wall Street Journal is reporting that critical care departments are reverting to pre-pandemic ventilator protocols for treating COVID-19 patients, including when to intubate and what type of sedation.
Now hospital treatment for the most critically ill looks more like it did before the pandemic. Doctors hold off longer before placing patients on ventilators. Patients get less powerful sedatives, with doctors checking more frequently to see if they can halt the drugs entirely and dialing back how much air ventilators push into patients’ lungs with each breath.
“Let us go back to basics,” said Dr. Eduardo Oliveira, executive medical director for critical-care services for AdventHealth Central Florida, which recommends its doctors stick with pre-pandemic guidelines for ventilator use. “The less you deviate from it, the better.”
At the time, [Theodore Iwashyna, a critical-care physician at University of Michigan and Department of Veterans Affairs hospitals in Ann Arbor, Mich] said, doctors and nurses feared the virus would spread through hospitals. “We were intubating sick patients very early. Not for the patients’ benefit, but in order to control the epidemic and to save other patients,” he said. “That felt awful.”