‘We’re tired of watching people die’: UNMC doctor details 6 stages of critical COVID-19 care

OMAHA, Neb. (WOWT) - We’ve shown you the horrific images and we’ve shared the gut-wrenching stories.

Still, a University of Nebraska Medical Center doctor says watching coronavirus ruin futures and families doesn’t seem to be enough to get people to do their part and help end this pandemic.

So, he wrote an eye-opening article, outlining not just the beginning or end of a battle with COVID-19, but detailing the often debilitating progression. It’s titled ”‘We’re tired of watching people die’: The 6 stages of critical COVID-19 care,” written by Dr. Shaun Thompson of UNMC, a critical care anesthesiologist.

He said that whether it takes days or weeks for the virus to worsen, many patients start similarly.

“They’ll come in, and maybe their oxygen levels may be a little low,” he said, listing common virus symptoms like fever, fatigue, and sometimes a cough.

Stage 1: EMERGENCY ROOM TRIAGE

To some, that may not sound severe, but it marks the beginning of critical care, which is emergency room triage.

He says, “for a normal, healthy person, a blood oxygen reading is 90% to 100%.” But they often see “people in the emergency room in the 60% to 70% range because of COVID-19.”

“Typically you’ll get put on oxygen just to see how you do,” Thompson added.

Stage 2: ADMITTED TO THE COVID-19 FLOOR

From there, regression may continue.

Being admitted to the COVID-19 floor means “a less invasive procedure to help you breathe, like a simple nasal cannula,” but it’s by no means the most comfortable.

For others who have to be put on a “high flow” oxygen system air is pushed up their nose at a rapid rate. From there, other normal functions become ten times more difficult. “The simplest tasks, like eating, can put them over the edge,” he said.

Stage 3: MORE INVASIVE PROCEDURES

That extra stress on your body can quickly catapult a person to require more invasive procedures, which is often when he’s called in to help.

Patients are often gasping for air and he says some even describe it like drowning. “As you work harder and harder to breathe, it can come to the point where you need more machinery to help you,” said Thompson.

At this point, a person may be breathing 40-50 times per minute which is nearly a breath every second.

Stage 4: GETTING INTUBATED

Stage 5: ON THE VENTILATOR

If a CPAP or BiPAP machine doesn’t help, then stage four; getting intubated and stage five; being put on a ventilator, is the last option.

Dr. Thompson says it’s scary for the doctors and nurses too. “We’re having people call their families saying you might not talk to them again.”

Stage 6: EXTUBATION

At that point, he says it’s a coin flip whether a person will recover or not. But if they do make it to stage six; extubation, it still isn’t a walk in the park.

For some, life after intensive care can leave permanent damage and for others, it means continued therapy or other health-related problems.

But the goal is to ensure patients make it out alive.

Dr. Thompson says his medical team and all health care workers desperately need the public to do their part; distancing, masking, vaccinating, and making safe and healthy choices.

He reminds everyone, frontline workers are just as much a part of the six stages as the people fighting for their lives.

“Having to do that over and over and over again now for two years has been very mentally and emotionally draining,” he said.

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