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How is the “Awake and Walking ICU” keeping their COVID19 patients mentally and physically functional during severe COVID19? Do they face constant ventilator asynchrony and how do they deal with it? Geoff shares with us his vast experience as a respiratory therapist in walking patients on mechanical ventilation during critical illness and now COVID19.

Episode Transcription

Kali Dayton 0:28
Okay, before we jump into this really great episode, I need to share some updates my website, www.daytonicuconsulting.com is temporarily down for renovations. If you have questions or your team is interested in the webinar and or consulting program, reach out to me in the email listed in the show notes. Okay, now I have received really great questions about how the awake and walking ICU has been managing ICU patients with COVID 19.

This segment on ventilator management would not be sufficient without hearing from an expert respiratory therapists with extensive experience in the awake and walking ICU. Let’s jump straight to Geoff. Geoff, thank you so much for being willing to come on and share your expertise with us. Do you mind introducing yourself?

Geoff Corey, RRT 1:16
Geoff Corey, I am a respiratory therapist. I’ve been a therapist for 20 years. I work at the hospital in Salt Lake City. In the medical ICU unit we do walk or vented patients, we don’t sedate them, we find that they get off of the vent quicker and out of the ICU quicker that way their recovery is a lot quicker, even even the COVID patients that we’ve had seem to be off the vent and out of the ICU, if at all possible quicker. We don’t necessarily walk them but we do exercise them within their own room.

Kali Dayton 2:00
Yes, COVID has been a different animal. Because before COVID. Every patient on a ventilator was essentially walking laps around the unit but COVID change that opportunity. Right? So what are these patients doing? So let’s let’s kind of back it up. So we’re talking about the COVID unit. Because I think a lot of people are so afraid that COVID is so different, right? And these patients are extremely sick. One of the questions that you received through social media was, how are you able to mobilize patients on high flow nasal cannula or BiPAP.

Geoff Corey, RRT 2:35
Both the we use the BiPAP. It we just put tanks on but we’ve got hooked up so that they can the BiPAP will run off of its internal battery. But on oxygen tanks, unfortunately, they that is a bit of a problem because that they burn through the oxygen tanks really quick. But we know that at this point, and so we’re able to switch those tanks out in time to keep them walking.

And with the high flow nasal cannula, it’s the same thing. We have tanks that we put on the poles, we use the Fisher propel heaters and set up. And then we have a tank that we have what we call a quick connect the the the plug that goes into the wall just plugs right into the tank. And again, we run the high flow off the tank. Again, that also eats up the oxygen pretty quick. So we’ve got to be very mindful of how quickly we change out those tanks to

Kali Dayton 3:40
and how did the patients tolerate activity even on those higher levels of oxygen.

Geoff Corey, RRT 3:45
A lot of times our unit is basically a set up like a square with the rooms on the outside of the unit and the nurses desk on the inside for one lap around the unit is about 200 feet. So we will take patients on bands on bypass on high flows. As we’re walking them if they get tired, we allow them to sit, read, catch their breath and then get up and move on. And our goal is to try and get at least two laps in three times a day with each of these patients.

Kali Dayton 4:26
And now that I’ve been doing more webinars and consulting with teams outside of that little euphoric bubble, I’m realizing how amazing that is that everyone has that goal and that patients really are able to do that. So these COVID patients while they’re in their rooms, like you said they’re not walking taking the constant ambulation outside their room but doing squats in their room. Right.

Geoff Corey, RRT 4:51
Right. And we also physical therapy also has the little pedal bikes that they will go in they’ll work with them they’ll do exercises with them, then they’ll have them pedal on the bike so that they can get the cardio part of it in. And then they also do like arm lifts and leg lifts and other things like to keep their strength up and to keep the cardio going.

Kali Dayton 5:17
And there’s a lot of concern that when people are on higher set levels of high flow, that they desaturate so quickly and so easily. Are there patients that you have to put on BiPAP? before or during activity?

Geoff Corey, RRT 5:32
Yes, yeah. So if they’re on on high flow, I would say probably about 30% of the time when we walk them, instead of walking them on the high flow, we will, we will need to walk them on a BiPAP on 100%.

Kali Dayton 5:48
And you do that a little bit before they walk. And after.

Geoff Corey, RRT 5:52
Yeah, we try to pre oxygenate them before they walk and then we will allow them time to recover afterwards to. So we don’t just take them back in and throw them on the settings that they were on before we allow them to kind of catch their breath. And then we will wind down their settings back to what they were previous to their exercise.

Kali Dayton 6:11
And do you find success with that?

Geoff Corey, RRT 6:12
Yes, we do. We found that, Well, one, I think mentally it helps the patient to be able to not just be stuck in a room, either in the bed or in the chair 24 hours a day, seven days, you know until they can recover. It gives them a little purpose in their day gives them a little help, or hope that that they’re getting better. And then it actually does help them get better by the exercise. Whether it be walking or whether it be doing those exercises in the room.

Kali Dayton 6:46
Absolutely. And I I wish we had better data collection, I hope that we go back through the outcomes of these patients. My suspicion and I’ve heard this from other people is that perhaps mobilizing them so aggressively, before intubation, prevents intubation? What are your thoughts on that?

Geoff Corey, RRT 7:06
I would say that, yes, it definitely does help. I think that if if we were to go back to the way things used to be done 10 years ago, where we weren’t walking on, we weren’t exercising? And if we did, we weren’t allowing them to recuperate, we’re just throwing them back on their settings. I think that with the care that we take now. And yeah, it is labor intensive. I’ll give you that. But I think that the outcomes are much better for the patient in fewer days on the event, fewer days in the ICU and fewer days in the hospital.

Kali Dayton 7:43
I think you’re absolutely right. And I think you’re coming from a perspective of a team that is very comfortable in averse with this kind of mobility, your perspective of 10 years in the past is actually people’s current reality. Right there.

Geoff Corey, RRT 8:01
You know, it’s funny that you say that because even with, they still have that mentality, it’s some of the other hospitals where they just know their patients and hope that they get better.

Kali Dayton 8:10
Right, even even when they’re on BiPAP, that they already have them on a precedent strip and probably rasping lower than they need to be. Yeah, I think the variation in practices is really startling. And so I think that’s an important fluctuation too, is that your unit is very comfortable. So even though you have really sick lungs on your hands, and lots of them, you guys have been extremely overwhelmed. Yeah, yesterday we process is labor intensive. But man, it just opened our second ICU. Say that again.

Geoff Corey, RRT 8:42
We just opened up the second ICU again, we had it open for a while. And then when things kind of calmed down, we closed it. But we’re back up to I mean, we’ve been the main ICU that we have has been full for I mean, every room, we haven’t had even a crash bed for weeks. So they decided to reopen half of the other ICU that we were using down where wound care was.

So we have half of that unit now, which is another five beds. And when I left the other day they had just reopened it. They had one patient in there, but I’m sure that I haven’t been I was off yesterday and days. I’m sure that it’s full to capacity because we were getting calls we’ve been getting calls from as far away as Seattle. Looking for ICU beds.

Kali Dayton 9:35
Yeah, the situation is really difficult and your staffing ratios have not been ideal. The yes there have been compromises to standard of care, right as as with everywhere, but you guys started at such a high level. So the compromises have been they’re not walking 400 feet at a time. But no one’s running to deep sedation automatically, right after activation, which I Think as changes your outcomes and as a respiratory therapist, do you feel like these COVID patients need to be deeply sedated, right after intubation or all throughout their time the ventilator,

Geoff Corey, RRT 10:12
the only time I feel that they should be sedated is when we prone. I just, I really feel one that lessens the risk of unplanned excavations. And two, it just makes them more comfortable. I am not a stomach sleeper. So if I had to lay on my stomach on a ventilator, I don’t know that I could do that.

Kali Dayton 10:34
Throughout the history of the unit, there have been patients that have been able to lay on their stomachs and text their families, and be totally cool with it. But every not every patient is gonna be able to tolerate that. And you guys are proning people for 16 hours straight. Right, usually in that, and then on the other eight hours, you’re getting them up and mobilizing them. Right?

So I think, yeah, definitely adjustments have had to be made for that. And yet, I’m just amazed that you guys have continued to keep patients strong and functional. And that is what is astounding. The critical care community right now, a lot of these questions are asking, how the heck do you do it? Because a lot of people are reporting, severe ventilator dyssynchrony or asynchrony. Right, for every COVID. Patient. So are you seeing high levels of a synchrony? And then how do you manage it?

Geoff Corey, RRT 11:25
To be honest with you? I haven’t. I mean, we’ve seen some, but not high levels. And I, again, I go back to the fact that I think that because they’re actually awake, and they’re not sedated that they have that ability to be able to sync with event better than if they had been

Kali Dayton 11:46
Geoff, I think you’re right. And I wish we had more studies on it. That is one of the big ones on my list. Because I don’t think there have been studies done with patients that have never been deeply sedated versus patients that are deeply sedated.

Geoff Corey, RRT 11:59
I haven’t seen any studies on that. So, but I

Kali Dayton 12:03
think your experiences are extremely powerful. Like you have so much experience in this and you’re well immersed in this COVID unit. I’d asked even cash and a previous how often he saw the synchrony. And he said, Really, mostly, this is pre COVID. Mostly with patients that come from outside facilities that have been sedated. Correct. So for the most part, we’re treating patients pretty pretty normally you allow them to wake up after intubation.

One of the big concern is, what do you say to them before they’re intubated? And what do you say that to them? After they’re intubated? How do you walk a patient through that process,

Geoff Corey, RRT 12:45
Having been having been on a ventilator myself, I find it a little easier to explain to them what it feels like, it’s not fun. And my process is, is I tried to give them as much information as I can before we intubate them, sometimes that’s not possible, but that it’s going to be rough, it’s not going to be something that’s going to be easy peasy, you know, it’s going to be, it’s going to be uncomfortable, that tube is going to gather them.

And it is going to be it can be painful. So I think that if we are able to be with them, you know, as let them understand that it’s not going to be an easy process. And then as they come out of the sedation after we intubate them, you know, of course we let them know, okay, you’ve got that tube in, we have to restrain your hands. You can’t pull the tube out. So basically, you just have to have empathy for them. I mean, you just have to be able to say, Okay, this is what we’ve done. This is what our goal is. And I know that it’s not comfortable. I know that that you don’t, that it scares you. But this is what’s going to get you better faster. So

Kali Dayton 14:09
and how long does it usually take for them to really acclimate to the tube and to be able to be unrestrained, if they can get to that point.

Geoff Corey, RRT 14:16
Each individual is different. But I would say that we have, oh, there are some patients that we get that right away. They’re just like, Okay, I understand what you’re saying to me, I won’t go for the two. Because you know, they’re awake and they understand. But there are some that we have to leave restrained longer.

Just because every time you take the restraints off, they go immediately reach up for that tube, which is what I would do if I was intubated, you know, for a long period of time. I’d want that thing out too. So each individual is different. I think that for the most part, though, if if I had to put a number on it, I would say generally takes four or five days of being intubated before they grasp the concept that they can’t reach up for it.

And that’s when I see that we start, even though we leave the restraints on their arms will, will untie him from the bed at that point, so I would say probably about four or five days, if we can.

Kali Dayton 15:26
And before COVID, that unit went almost two years without any unplanned excavations, correct. I mean, it was not a scary thing. I think everyone had a pretty good sense of who was reliable, who wasn’t. And I, I think people are really concerned about causing PTSD with restraints. Right? It seems like these patients that are with it, sometimes they ask for restraints, especially if they’re going to sleep, right? Because they, they want to know that they’re safe,

Geoff Corey, RRT 15:54
right? They don’t yeah, they don’t want to reach up in the middle of the night and grab that tube and pull it out.

Kali Dayton 16:00
Right? And that I think that’s the difference is the delirium, right? They’re not worried we don’t cause the delirium, right? And as a respiratory therapist, how much does delirium impact your workload extra significantly,

Geoff Corey, RRT 16:15
if, if the patient and we see this a lot, when we get patients in from outside facilities that do sedate their patients, their delirium is a lot, I would say, probably 60 to 70%, worse than the ones that we’ve had in our unit that we don’t state that their ability to grasp what we’re telling them is a lot faster.

And I think it makes it a lot easier on them to be able to understand sooner, exactly what we’re trying to do. And you got to have good nurses, and you got to have good therapists that are willing to talk to the patients. That’s the important part is the communication work.

Kali Dayton 17:01
Absolutely. And I think that team, and you, especially you guys are experts with that. How does it impact ventilator management? How do you manage the ventilator with and without delirium?

Geoff Corey, RRT 17:15
Well, with delirium, it makes it a lot harder to wean down any settings, I find that without the delirium, which I feel, is, in most part, caused by the fact that they’re sedated for so long. I think that, without that sedation on board, we’re able to be more aggressive, we’re able to communicate with the patient better about what we’re trying to do. So that they understand.

And for the most part, I think a lot of them do, you know, you get the ones that you have the language barrier, or that are older that just don’t get what you’re trying to tell them. For the most part, I see that when we when we are working with patients that are not sedated that the communication factor with the nurses, between the nurses and the therapist, and the therapist, and the patient and the nurse, and the patient, makes it a much more cohesive, working environment where we’re able to talk to the patient, explain to them what we’re trying to do.

And I think that involving them in what we do, the decisions that we make is important that excuse me, it makes them feel like we’re much more involved, or that they’re much more involved with their care. Whereas the patients that have the delirium, we don’t really have that opportunity. They can’t, you can’t really make sense of what they’re trying to tell you. Or they can’t understand what you’re trying to tell them. So therefore, I think it hinders the weaning process dramatically.

Kali Dayton 19:05
Yeah, that’s a really good point. Because I, I think that delirium when they’re have they have erratic breathing, they’re back in the event. It’s alarming. That’s really difficult, but I didn’t think about the hindrance that it is to weaning, I have to think about how patients are often over sedated. And so they’re not going to be able to take do breathing trials, like that’s a barrier in a lot of units. But you make a good point when when they they really can’t recover in the same rate when their brains are.

Geoff Corey, RRT 19:33
Right, exactly it. You know, it’s it’s like someone that’s doing drugs, or someone who’s drinking, their judgment is impaired, their reflexes are impaired, everything’s impaired. It’s the same thing when you have them on ventilators and sedate them.

Kali Dayton 19:51
Yeah, that’s such a good point. And so when someone is delirious and they are fighting the ventilator, How do you manage that? You know, this isn’t a team that’s going to just naturally run to sedation to just make the ventilator turn off and the alarms. So what magic are you using to suit say the ventilators?

Geoff Corey, RRT 20:12
Well, we we have a tendency to try different mode I see, as you know, uses volume control, mostly with our ventilator patients, we have gone to modes such as APRV, even had recently a couple of times, we’ve gone to a pressure control mode, which seems to allow them to get more in sync with the bed for a short duration of time, then we can put them back on the volume control, so that we can run our protocols so that we can train we know. But when we have a patient who’s fighting the bent like that, we will try different modes.

Kali Dayton 20:50
And you have different successes with different people. Correct. Wow. And that, I would imagine that takes a lot of expertise, and insight and patients rather than just paralyzing them or sedating them.

Geoff Corey, RRT 21:03
Yeah, it does. Yeah, in fact, we have, we’ve got a very good group of therapists right now, especially on day shift, most of us are pretty, I mean, I’ve been a therapist for 20 years, Richard’s been a therapist for 30 years, you know, Clint, been a therapist for 25 years. So we’ve got some experience. And even the ones that are less experienced still have, you know, five, 810 years of experience. So there’s a wealth of resources that you can go to say,

“Hey, this is what my patients doing, I can’t seem to get them to sync back up with the vent”. Any suggestions, and with the amount of experience that we have, we can bounce ideas off of each other. And we can get, you know, down to the brass tacks and hopefully come up with a solution that will help them be more in sync with the event.

Kali Dayton 22:01
And so you all have a strong culture of sedation and mobility like that is ingrained in your own knowledge and your experience. Right, because I don’t hear I don’t know that I’ve ever heard you guys coming to the MDs or NP saying, “you have to sedate this person. This is the best thing for them” and advocate that way?

Geoff Corey, RRT 22:20
Yeah, cuz it’s not. You know, we, we may not agree. I mean, I think that there are times when when patients need sedation, yeah. But and we, we don’t always agree with the doctors or the MPs in that case, but I think we’re all on the same page that work in that unit, the less sedation we can get away with, the better off for the patient. So that’s our ultimate goal.

And we don’t we don’t go to the, to the end, you know, I can probably count on one hand, the amount of times I’ve gone to one of the doctors or one of the MPs and say, Hey, we really need to sedate this patient. And the most, I think, in those instances, most of those have been when they’ve been probed. So just because we don’t want them to excavate. Yeah,

Kali Dayton 23:13
they’re getting a little fidgety. And, you know, if you come to me, and propose that I would be all ears because I, I trust your wisdom, your expertise, you had that experience? One of the questions was, Do you feel that mobility is a productive use of your time?

Geoff Corey, RRT 23:31
I do. I think that the fact that it gets the patients, I mean, we’re there for one reason, we’re there to take care of the patients and help them get better. So I may not want to go walk somebody at a certain time. But I know that, that the patient will do better if we do walk them. So it’s not really even argument anymore.

I think as soon as you get the therapist and everybody to buy into the program, this is what we’re going to do. And this is what we need to do. I think we’re all on board now. And we’re just like, Okay, let’s just get it done and, and move on. And, and I think that because we’re there to help the patient, that if getting up and moving on, it’s going to get them off the ventilator and out of the ICU quicker than that’s what we’re all for. I

Kali Dayton 24:24
love that. And I’ve seen that in action so many times. I mean, nightshift, there is no physical therapy there and it is a nurse attack and the respiratory therapists you guys are the ones hassling them and you do it so well and so comfortable. And I think that comes with obviously the experience that you have. One of the other questions was, what what modes do you walk them on or move them on? Are there certain modes or settings that work better for activity than others?

Geoff Corey, RRT 24:53
Yeah, most of the time? Well, I would say all the time when we walk them they’re on And the well, I guess I need to backup there. Most of the time, they are on the volume control assist control mode. I have locked patients on CPAP, though, or on purchase support, just depending on where they are in their progression getting off the vent. But most I’ve, if I looked back at say probably most of the the times that we walked patients that are in the volume control, assist control mode,

Kali Dayton 25:31
Are there a big adjustments that you need to make before or during mobility?

Geoff Corey, RRT 25:37
If, if we owe, you know, we take the SAT monitors with us. So if they start to do that, we’ll we can bump them up, and we can bump up their peep if we need to. But mostly what will bump up will be there FY Oh, two, don’t really change modes in the middle of walking. Haven’t had to do that.

But I would say that it definitely if we need to, you know, bump up their oxygen, because what I try to do is I try to walk them on and say they’re on 70% in their room. That’s what I try to walk them on. But a lot of times I find that we have to go up to 100%. Well, especially with the new 980s. Because there’s no, I mean, we do put them on 100% Because there’s no air tanks with them. It’s just the oxygen. So we do increase that up to 100%.

Kali Dayton 26:27
If you have to disconnect from the wall, right, yeah, we’re disconnected

Geoff Corey, RRT 26:31
From the wall and walking around the unitThey’re on 100.

Kali Dayton 26:34
Do you find that they’re able to tolerate that? Yeah.

Geoff Corey, RRT 26:38
You know, like I said earlier, I think that the fact that we, you know, if they get really tired, you know, we’ve got somebody right behind them with a wheelchair, let him sit down, we let them catch their breath again, and we get them up again, and continue around the unit.

Kali Dayton 26:53
And that’s it really is, as you say, like I conveyed testimony to the process that you’re talking about. I just recognized that it’s really hard for people to enter. Or imagine what that looks like. A lot of protocols have this threshold, even for sedation vacations, that you can’t even give a patient a sedation vacation, if their fit is greater than 60%, or PEEP is greater than eight or 10. And so what kind of settings? Are you walking people on? What have you seen people be able to tolerate?

Geoff Corey, RRT 27:24
Well, I mean, we’ve, like I just said, when we get them up there on 100% If they’re disconnected from the wall, and I’ve I’ve walked patients on people, 14 people 16. So I mean, we walked them on some pretty high settings.

Kali Dayton 27:42
Yeah, we interviewed Megan Wakeley, you probably remember her. She was on a peak of eight teen and 100% walking. And she talks about what she talks about that I mean, it wasn’t she wasn’t doing cartwheels, but she definitely did it and was so grateful that she did there are no studies showing that there’s any harm to occupations on higher ventilator settings. As a respiratory therapist, what are some of the assessments that you do during that process to make sure that patients are safe and tolerating mobility even on higher set settings?

Geoff Corey, RRT 28:10
Well, you know, it’s a constant assessment as you’re, you’re walking with them, the way I do it is I walk backwards defense between me and the patient. So I have them, I can see if they’re starting to get fatigued, I can see if they start to wobble. So at that point, then I you know, make the suggestion that maybe we should sit down and rest. Or if they’re able to just go straight through we’ll do that. I mean, it’s basically you have to be able to just keep doing those quick 10/22 assessments of the patient to make sure that they’re still, you know, stable enough to be walking,

Kali Dayton 28:54
someone made the analogy of how the pruning process was so overwhelming and daunting to the critical care community when COVID hit. And now, most units do it so smoothly and naturally, and it’s not scary anymore. And they wondered that maybe the same will be for early mobility and walking patients on ventilators where it seems like this big daunting task, you’re having to really think through every step of the way analyze every little movement you make, but with experience, it becomes like how I see you guys doing it, walking backwards, like that’s your second nature and watching patients and you’re you’re just naturally assessing them, you know what you’re looking for. It’s not scary to you anymore.

Geoff Corey, RRT 29:37
No, it’s not. I mean, it’s pretty run of the mill expected that that’s what’s going to happen if you’re working in the unit that day you’re gonna be walking patients or at least helping them exercise or dangling them or whatever, wherever they are in their progression. And it’s not daunting,

Kali Dayton 29:57
and you guys do it pretty quickly. You know, it’s because it’s so engrained now it doesn’t take as much time I don’t think, or even people or energy to do it as maybe units that have are trying to do after a patient’s been sedated for a few weeks.

Geoff Corey, RRT 30:13
Right. Yeah, that’s exactly right. It’s because, well, I think that, that you’re right, we have had a lot of experience doing it. So it’s, it’s almost Well, it is second nature anymore. But I could see were a unit that’s just starting to do this, like, you know, you gotta get, make sure you got everything that you need, you got to make sure you got your Ambu bag and make sure you got that your settings are all right, that you’re connected to the oxygen that you know, all, all the the things that once you’ve done it a few times becomes second nature. But I can see where if they’re starting that program, then yeah, it could be very daunting and very, very anxiety, you know, make you very anxious to make sure that you’re not forgetting something.

Kali Dayton 31:01
And I think there’s a lot of question as to how do you get your respiratory therapists to buy in? I mean, every discipline that, you know, even some physical therapists, I think they’re having a hard time getting them to buy in, what would you recommend to teams that are trying to unify their teams, to get them willing to try this or adapt this process of care,

Geoff Corey, RRT 31:22
I’m a hands on kind of guy. My feeling is, if they were able to see the process at work, they wouldn’t be amazed at how really simple the whole thing is,

Kali Dayton 31:37
I believe and I, they probably have a lot of the skills already. They just need the confidence and experience.

Geoff Corey, RRT 31:44
Right. And I, you know, I really think that you send a couple of key people for somewhere that does the early mobility, spend a shift with the patients doing, getting him up and moving them. And I think that by the end of that shift, they would be fairly comfortable and knowing okay, this is what we have to do. This is the process we have to go to, in order to get that patient out of their room and walking around the unit. But like I said, once they do it quick, you know, enough times it becomes second nature. And you’re just like, Okay, I gotta do this, got to do this got to do this. And within, you know, a couple of minutes, you’re ready to go from the time you walk in the room to getting them out to walk you.

Kali Dayton 32:34
Absolutely it is I mean, it’s a learning curve. But once you’re, you’re over it, it really, I think it’d be hard to for anyone to go back to a different way. I’m sure. I know that some of the nurses that have left to travel from that unit have been really mortified by what’s going on out there.

Geoff Corey, RRT 32:50
Well, even when I’ve gone over and worked in the ICU over there, where they still sedate their patients, it’s just like, really, what why are we getting these people up and moving on? We’re like, Oh, we don’t do that here. It’s like, Well, why don’t you

Kali Dayton 33:05
so and Jeff, I’m hearing from a lot of listeners. And we even had an interview with a nurse in Colorado who started an ICU 18 months ago, immediately, it turned into a COVID unit that whole time she never saw patient be excavated for 18 months. But what are you seeing in the COVID unit there?

Geoff Corey, RRT 33:28
I we’re seeing I would say probably 60 to 70% of the COVID patients we have ended up eventually getting extubated. And, you know, getting put on lesser devices, not extubate to pass away but actually recovering. And walking out of the unit and leaving the unit. Yeah, we had we used we used to there when that pediatrician can have he was on the podcast who sent a card to the unit that showed him up skiing last winter. He said without you guys, this would not have been possible.

Kali Dayton 34:11
He walked a miles, two months after his discharge. Wow. Incredible. And he went golfing six weeks after discharge for his 70th birthday. So yes, I mean, and those are common stories there. Right? You have had deaths because COVID is lethal disease. But how often have you been tricked and or sent to Eltech?

Geoff Corey, RRT 34:34
Not very often, honestly. I mean, I would say of all the COVID patients that we’ve had maybe and you know, we’re talking hundreds of patients over the last two years, maybe even 1000 patients, I would say probably maybe 10 of them have been draped and sent to Norfolk.

Kali Dayton 34:53
That’s amazing. I know that Louise quoted one of them was in end-stage ILD and didn’t want to withdraw care? So Yeah, sounds like really unique circumstances. And I just think that is such a testimonial to the culture of the team and expertise that you will have. I don’t want to speak prematurely, but part of the webinar and consulting services that I’m trying to develop, I would love to send out a Dream Team. Have you guys as the experts go and walk people teams through this process, and I think that you guys have so much to share with the community, and I’m so grateful that you’re willing to come on and share your expertise, is there anything else you would share the ICU community,

Geoff Corey, RRT 35:35
I would just share that if your unit is trying to implement this, buy in buy in immediately. And, you know, give 100% effort to getting your your protocols in place and everything so that you can implement these kinds of programs because they work. I mean, as you can see, they work. I mean, we we have so many people that we that there’s been so many people that I when they first came in, we’re on the ventilator, it’s like, I don’t think they’re gonna make it.

And yet they do. They end up you know, yeah, they’re on the ventilator for a while, and they are sick, but they end up making it out of the unit. And I mean, we even have had a couple of our BMT patients that have been on ventilators that just like, you know, what, they’re not gonna make it, implement this early mobility stuff with them. And we’ve had, you know, even a couple of them walk out of the unit off the ventilator. Yeah, they still have cancer, but at least that part of their ailment is gone. They don’t have the ventilator anymore. They don’t have the breathing problems anymore. So

Kali Dayton 36:54
it’s functional enough to keep fighting their cancer.

Geoff Corey, RRT 36:56
Right? Exactly.

Kali Dayton 36:58
I hope that you guys really recognize the lives that you truly do, save and preserve. I hope you guys are proud of all that you do and have accomplished throughout your careers. And I am excited to be able to utilize you guys more in order to share this with the community because you guys have a lot to contribute. So, Jeff, thank you, and we will definitely be in touch. And if you have more questions for Jeff, reach out to me on social media, let me know and I will hook you up and we’ll keep learning from Jeff and his team. Thanks so much. If you want to join in on the conversation, leave a voicemail at 801-784-0472 or reach out to me on Twitter.

Transcribed by https://otter.ai

 

 

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