Matthew S. Pavlichko

Matthew S. Pavlichko

Caring for patients with COVID-19 requires a team effort. Working alongside the doctors, nurses and other specialists at Lancaster General Hospital is a dedicated team of respiratory therapists whose work may not be familiar to the public, but is critical to the patients who depend on them to breathe.

A respiratory therapist is an expert in pulmonary physiology and the treatment of respiratory diseases. We identify and assess concerns with breathing and collaborate with our physician partners to devise a treatment plan to improve symptoms.

Prior to the pandemic, respiratory therapists mostly saw patients with chronic conditions like asthma, chronic obstructive pulmonary disease or cystic fibrosis. We also cared for patients with acute respiratory illnesses, such as seasonal influenza. The pandemic has changed that dramatically.

During this time of increased COVID-19 hospital admissions, a respiratory therapist may be responsible for 20 or more patients on a floor. Most of these patients have COVID-19 and receive oxygen or nebulized treatments that can create aerosols. So we wear full protective personal equipment — including N95 masks and gowns — for the duration of each shift. With higher patient volumes, respiratory therapists are working longer hours and more days.

COVID-19 is primarily a respiratory disease. It causes the lungs to fill with fluid, which can lead to inflammation, shortness of breath and lung failure. The job of a respiratory therapist is to oxygenate the patient’s lungs, support the patient through the storm of the virus, and help the patient recover. We are committed to achieving the very best outcome for every patient.

On a typical day, the respiratory therapist assesses each patient by measuring his or her respiratory rate, blood oxygen saturation, and comfort and energy levels, and determines if his or her treatment needs adjusting. This may mean weaning the patient from oxygen or increasing the flow, or adding therapies to improve the patient’s lung function. Each assessment takes 15 to 30 minutes.

If you are in the hospital with COVID-19, a respiratory therapist is the best friend you’ve got.

We are with you at every step — from the emergency department to the inpatient unit, from preparing you for discharge to supporting your long-term recovery.

Respiratory therapists have the training and expertise to help you avoid a ventilator, using highly effective therapies like proning and Vapotherm.

Proning involves a team of providers placing the patient on his or her stomach for 12-16 hours a day to better oxygenate the lungs.

Vapotherm is a high-flow nasal cannula that helps open the patient’s lungs and deliver a high dose of oxygen. With Vapotherm, we’ve successfully kept many patients off ventilators and improved outcomes.

We also manage patients who are on ventilators. While a ventilator can save your life, it is a difficult treatment to endure and not without risk. Respiratory therapists know how to customize ventilation therapy in intricate ways to provide the safest, most beneficial care to each patient.

Finally, respiratory therapists, along with nurses and other members of our team, provide emotional support to patients at a time when family members are unable to be at the bedside.

I’m proud of the respiratory therapists —\!q not only at LG Health, but across our country — who have stepped up to meet the challenges of this unprecedented pandemic. They’ve done a phenomenal job sharing best practices for care, working longer hours to treat hundreds more patients, and putting the needs of those patients above all else.

As a community, we can thank them by remaining diligent and continuing to take precautions like social distancing, washing hands and wearing masks.

With the approval of new vaccines, there’s a light at the end of the tunnel, but we are not there yet. It’s important to recognize that hospitals are not infinite resources. By reducing the spread of coronavirus, we can decrease hospital admissions, which helps ensure there are enough ventilators, Vapotherms and healthy hospital workers available for the patients who need them most.

By protecting yourself and your family, you are also protecting your neighbors and making sure we can continue to care for your loved ones.

Matthew S. Pavlichko is a registered respiratory therapist and the director of Respiratory Care and Pulmonary Diagnostics at Penn Medicine Lancaster General Health.

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