Published on May 02, 2021
Ahmedabad: At a Covid ward in Civil Hospital, the staff from physiotherapy department is seen instructing the new patients in prone positioning and how to hold the position for every 30 minutes with various combinations. The technique is said to reduce the oxygen requirements by 20%, which can make or break a small hospital’s oxygen setup.
It’s not all – attendants check the oxygen saturation and oxygen flow (usually 5 to 10 litres per minute) for patients who don’t have severe symptoms and try to reduce the flow a bit to check whether the patients respond favourably.
These are not solitary examples. All hospitals, currently hand-to-mouth when it comes to oxygen availability, are trying to think out of the box to reduce oxygen dependency for the patients. This, in turn, reduces the oxygen demand. The city alone requires over 150 tonnes of oxygen for Covid patients, said industry experts.
The reason? Dr Shachi Dave, a city-based pulmonologist, said that compared to the last surge, more patients are coming to medical setting with higher oxygen requirement. “About 60% of the patients require high-flow (7 to 12 litres oxygen per minute) today. Thus, there are more patients who want more oxygen,” she said. “Thus, in the earlier surge, oxygen saturation below 95% would have sent alarm bells ringing, which in this surge can go up to 92% if the patient doesn’t have any other health issues. It’s because we are now regularly seeing patients who have saturation as low as 75%.”
Thus, experts are looking at other solutions. Dr Kaushal Gandhi, an intensivist, said that they are using Bain circuit, generally used by the anaesthetists to re-flow the air, for some patients to reduce their oxygen requirement. “Every litre of oxygen saved by the procedure can save some other patient’s life,” he said.
Dr Manoj Singh, a city-based pulmonologist, said there is more frequent assessment of oxygen requirement of patients to see if their intake can be reduced without hampering their condition. “Physiotherapy is encouraged in all patients along with diaphragm breathing to improve their breathing pattern,” he said. “In some patients, early use of ventilator is also required.”