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Respiratory Care and COVID-19

April 22, 2020

Since COVID-19 is a respiratory virus, many people who already use a ventilator and have a compromised respiratory system may be concerned for their safety. In addition to our general COVID-19 Brain Injury and Spinal Cord Injury information sheet, this guide is intended to address the needs of those who have particular respiratory concerns during the COVID-19 outbreak. For more general resources on respiratory care, you can read our tracheostomy guide and information on mechanical ventilation.

What is COVID-19 (coronavirus)?

COVID-19 is a virus that affects the respiratory system and can lead to pneumonia; its primary symptoms are fever, cough and shortness of breath. Illness can be severe and require hospitalization, but most individuals recover by resting, drinking plenty of liquids and taking the medications their medical provider may advise them to take.

How does COVID-19 spread?

The virus mainly spreads from person to person through respiratory droplets from coughs or sneezes. These droplets then land on surfaces — even on people if close enough — and can live on these surfaces for various amounts of time. When you touch that surface, you then carry those germs on you; this is why good handwashing or sanitizing is so important in preventing the spread of COVID-19.

How does COVID-19 affect the lungs?

COVID-19 often begins as an upper respiratory tract infection with a cough and a sore throat. The virus then travels down the throat and enters the lower respiratory tract. There, it damages the lung’s tiny air sacs, called alveoli, where oxygen enters the blood and carbon dioxide leaves.

Think of your respiratory system as an upside-down tree. The trunk is your trachea, or windpipe. It splits into smaller and smaller branches in your lungs. At the end of each branch are the tiny air sacs called alveoli where oxygen goes into your blood and carbon dioxide comes out. With COVID-19, the lining of the respiratory tract can become irritated and inflamed all the way down into your alveoli. The alveoli air sacs can fill with mucus, fluid and other cells that are trying to fight the virus. This can make it harder for your body to take in oxygen.

Using a ventilator and COVID-19

Living with a spinal cord injury and using a ventilator is already a daily challenge, and the threat of COVID-19 is a new obstacle that the medical community is still working to fully understand. People with certain pre-existing conditions may be more susceptible to complications from COVID-19; depending on your level of injury and if you require assistance to breathe, you could be more at risk as well.

Craig Hospital ventilator

There are certain things to keep in mind and practice to reduce the chances of catching the virus.

Remember the basics:

  • Hand washing: Wash your hands regularly using soap and water for 20 seconds. If soap and water are not available, then use hand sanitizer with at least 60% alcohol.
  • Cleaning surfaces: Regularly disinfect high-touch surfaces with soap and water, a cleaning spray or disinfecting wipes. Some examples of high-touch surfaces are: bathroom sink, kitchen counter, wheelchair arms, etc. If you don’t have disinfectants, make a bleach solution: mix four teaspoons bleach per quart of water or use a 70% alcohol solution.

If you use a ventilator, you will want to be sure you are keeping it clean by using disinfecting wipes and cleaning the filters and trach tube adapters. There are currently issues with some equipment for ventilators being back-ordered, so you may want to be conservative in getting rid of disposable parts. As long as you have backup parts in case something breaks or malfunctions, you could go a few months without changing any parts since you are staying at home, which is generally a safer environment from germs. Especially if you are not changing parts as often, it is very important to remember to wipe everything down regularly with disinfectant wipes. However, if you have an active infection, you should continue to change your equipment.

In addition to changing your equipment less, you can use in-line suction only and no cuff deflations to keep the system closed. Do not break the circuit and potentially expose the ventilator to germs. You might also want to consider using meter dose inhalers instead of nebulizers, if possible.

Another important consideration is your caregiver if you have one. Ask your caregiver to help with errands so you can limit going out in public, like for grocery shopping and purchasing equipment. They can also assist in cleaning household items and equipment and preparing meals to help you save time, now that you have to do more thorough and frequent disinfecting. Your caregiver should wash their hands and use hand sanitizer when they arrive at your home and each time prior to touching or feeding you or helping with your equipment. The Center for Disability Rights has put together a comprehensive list of things to consider if you have a caregiver that is worth reviewing.

Finally, planning ahead can help you reduce exposure to COVID-19. Meal prepping at least a week in advance can help you avoid multiple trips to the grocery store, and stocking up on supplies, like prescriptions, cleaning agents, catheters and gloves, can keep you or your caregiver from needing to leave the house as often. If your stock of equipment is running low and you’re having difficulty accessing more supplies, call our Nurse Advice Line to troubleshoot your specific situation.

How to call the Nurse Advice Line:
Phone: 800-247-0257 or 303-789-8508
Hours: Monday to Friday, 9 a.m. to 6 p.m. (MT)

For more information on living independently with a spinal cord injury, check out our Independence and Being Home Alone with a Spinal Cord Injury resource.

The content in this document is intended for general informational purposes only and is not a substitute for professional medical advice or treatment for specific medical conditions. No professional relationship is implied or otherwise established by reading this document. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Many of the resources referenced are not affiliated with Craig Hospital. Craig Hospital assumes no liability for any third-party material or for any action or inaction taken as a result of any content or any suggestions made in this document and should not be relied upon without independent investigation. The information on this page is a public service provided by Craig Hospital and in no way represents a recommendation or endorsement by Craig Hospital.