For many months they have been talking about the new developments around Corona every day: What is the situation in the intensive care unit in the Knappschaftskrankenhaus in Dortmund-Brackel? How many severe cases are there?
Always there: Ünzüle Kayar, who has been a nurse in the intensive care unit since 1996, has been the director there for four years, and Jürgen Jähn, who used to be a nurse on this ward and is now the nursing director of the entire hospital.
Weakened lungs do not provide enough oxygen
You will find out what the coronavirus triggers, how the Covid-19 disease behaves specifically. And the steps doctors and nurses take to save a person’s life.
“It’s mainly a lung disease,” explains Jähn. The lungs become weak and many patients do not get enough oxygen in their blood.
Step one: external machine ventilation
The first step on the other hand: external ventilation, “non-invasive”, but also using the power of a machine. The advantage of this: It is not an intervention in the body. The disadvantage that you just saw with regard to Corona at the beginning of the pandemic: The exhaled air full of coronavirus escapes and endangers the staff, perhaps also other patients.
Steps two and three: internal ventilation and prone position
But step one is often not enough, emphasizes Ünzüle Kayar: “Some patients have no symptoms at all, but then get worse quickly, in three days.” had to intubate him ”.
Step two means: Oxygen is given directly into the body, closer to the lungs.
If that is not enough – as in the case of the man – go into the prone position. That could stabilize the patient.
Step four: a bit like dialysis
Unfortunately not in this case either, Kayar continues. “He then came to the ECMO machine.” The abbreviation stands for “extracorporeal membrane oxygenation”: out-of-body supply of oxygen.
All of the blood from the body is gradually pumped out of the body like dialysis and then back again. The machine eliminates the CO2 and adds oxygen. So it does the work that the alveoli do in a healthy body.
But even with level four and the additional administration of medication, one cannot save all lives. “Unfortunately, this patient will not make it either,” suspects the experienced intensive care and anesthesia nurse.