Understanding what it means to be on the ventilator

Dr Sanjith Saseedharan, Head, Intensive Care Unit, SL Raheja Hospital, shares his insights about how ventilators in hospitals work, and how they have become an integral part of the treatment process

 

Image Courtesy : Freepik
Image Courtesy: Freepik

When the patient is unable to breathe well, the doctors put the patient on a ventilator, which assists his/her in breathing. At times, the ventilator is used inside an operation theatre to facilitate surgery.

The doctor does this process by passing a small tube (Endotracheal Tube), under anaesthesia, through the mouth which connects the patient to a machine, helping the patient to breathe. This machine is called the ventilator, and the entire process is called ‘Mechanical Ventilation.’

New generation ventilators are advanced and come equipped with software and microprocessor technology, which helps to make the entire process safe and effective.

They help make the process of ventilation much easier by effectively synchronising with the patients breathing. In this setting, Intensive Care Unit (ICU) nurses and doctors, called as Critical Care Specialist or Intensivists, care for the patients on a ventilator.

Generally, when the patient is put on a ventilator, they are sedated, and an ample amount of analgesia is administered to help them get rest, and remain pain-free, which is why the patients may also look sleepy.

However, it is crucial to understand that the ventilator is only respiratory support; while the heart and the rest of the organs function naturally. The flow of oxygen will help the other organs to function.

At such times, the patient will not be able to speak as the Endotracheal Tube passes through the voice box. Even though the patient cannot speak, he or she may able to see, hear, and understand what one says.

Patients, when recovering, may be able to communicate by writing on a pad of paper. They could also communicate with other techniques, for example by gestures, or by using software or iPad-based applications like the Vocaliser used in the author’s hospital.

As the patient starts improving the ventilator support is gradually reduced; this process is called – weaning from the ventilator. Non-critical patients are supported by non-invasive ventilation.

For non-invasive ventilation, the patient may be connected to the ventilator without an Endotracheal Tube, but through a mask.

Here the patient can speak, eat, and cough normally. In the author’s opinion, if there is something that has changed healthcare in a big way, it is the development of this advanced, safe, effective, lifesaving technology, called the ventilator.