4/19/2020 Chicago
As COVID-19 cases are rising, so is new information about what is best for patients and medical staff. But with short supplies and increasing patient demand, the urgency and effectiveness of non-invasive ventilation (NIV) is more apparent than ever before. Companies have been stepping up to the task of providing ventilation equipment to hospitals in need. Formula One engine manufacturer Mercedes developed Continuous Positive Airway Pressure (CPAP) face masks to treat patients with respiratory complications as a result of the virus. And Tesla CEO, Elon Musk, donated bilevel positive airway pressure (BiPAP) and CPAP machines to several California hospitals. Musk has been outspoken on Twitter, using his platform to share advice from doctors working on the frontlines of COVID-19. He is ahead of many of his counterparts. He is listening to the latest expert feedback - intubation is not the best option for COVID-19 patients.
Musk’s approach is on the right track with delivering these machines and acknowledging the importance of another option before intubation. However, a better alternative for Tesla to produce is non-invasive ventilation via the "bubble helmet". Why are non-invasive ventilation helmets better? Prematurely jumping to invasive mechanical ventilation has done more harm than good for patients. The reality is that it hasn’t saved many lives. The mortality rate for COVID patients on the ventilator is 66% - as opposed to 19% for those that used non-invasive ventilation (data from the UK). Its operational procedure is extremely painful and invasive. As a result, patients need to be sedated. However, sedation drugs are in short supply. Medical providers under strain are more exposed to the virus and need to follow through with intensive, lengthy protocols. And it may cause more risk to patients with already compromised lungs. A non-invasive ventilation helmet solves these problems. It’s a win-win solution. The time to take the next vital step is now - advice and data from around the world are evident. Helmet based ventilation is being used widely in Europe with sizeable, real results. Countries like Italy, Germany, and France are seeing patients with high success rates of recovery, fewer days in the ICU and reduced need for intubation. In fact, the use of a helmet avoided intubation in 54% of patients with ARDS (acute respiratory distress syndrome). Heavily impacted Italy is already seeing 20-30% of COVID-19 patients avoiding intubations. It’s clear. Using the "bubble helmet" is the most optimal way to help patients with COVID-19, while freeing up more ICU space for those illest. They cost less, shorten hospital stays and lower the mortality rate, according to a study featured in JAMA, 2016. They’re not only more comfortable for the patient, but provide a stronger barrier against cross-contamination with an antiviral filter. Rather than using a mechanical ventilator, patients using the helmet connected to oxygen and airflow. Even Pulmonoligists advise against non-invasive positive pressure ventilation face masks due to the higher risk for aerosolization of the virus. The last thing we need in the midst of this pandemic is higher rates of infection. Face masks have been the norm, but we need to do better than the norm. In the race against time to save lives, the saving grace will be non-invasive ventilation helmets.
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