MIAMI (CBSMiami) – As doctors and nurses at Mount Sinai Hospital see more hospitalizations due to the spike in COVID-19 cases, they are making incredible progress when it comes to keeping patients off ventilators for as long as possible.
“We do it because this is what we train for. We train to help people. It takes sacrifice, dedication, and devotion to save a life,” said doctor David Farcy, emergency room chair.
Since March, Farcy and pulmonologist Ari Ciment have been on the frontlines of the pandemic, treating hundreds of COVID-19 patients.
While they say it’s been a tough battle, “our motivation is to bring them home.”
“It has been an emotional roller coaster mentally, but we are starting to see a light at the end of the tunnel,” said Farcy.
CBS4’s Jessica Vallejo got a first-hand look at how they are doing it.
Both doctors gave Vallejo a rare inside look at the emergency room.
Rooms were filled with patients and those with coronavirus were isolated in a separate pod of the emergency room.
However, throughout the pandemic, they say they have developed new protocols and treatments that have been successful at their hospital.
“Overall mortality is around 10 to 11 percent compared to the stagnating mortality rate in Florida is around 24 percent. One of the biggest differences is we do not rush to intubate.”
Dr. Farcy says at the beginning of the pandemic, they would intubate their COVID-19 patients. Now, intubation is a last resort.
“If you look at the data worldwide the mortality rate of intubation has been extremely high. From 47 percent to 92 percent.“
It was when they were running out of ventilators that they realized a high flow nasal cannula, which delivers oxygen, became effective.
And not just that.
“We have infectious disease doctors who start the medicine right away. Perhaps that’s what is making a larger impact on the outcome of patients. “
Dr. Ciment says if a patient is in need of oxygen and is showing symptoms of the virus, they get a combination of anti-viral medication and steroids.
“Once you need oxygen, you need a hospital stay, Dexamethasone as well as Remdesivir.”
However, they have found at Mount Sinai that 10 percent of their patients did not respond.
So what’s the next step?
These medical experts told us if a patient is oxygenating under 85 percent they then intubate. But if a patient developed A-R-D-S (acute respiratory distress syndrome.), they are then considered for an ECMO treatment.
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“ECMO consideration is extracorporeal membrane oxygenation- is basically an artificial lung,” said Ciment.
It’s considered a last resort to save a life, used when the branches of the lungs are damaged. The machine allows the lungs to heal.
“And the end of the branches are little microscopic clusters of grapes called alveoli that is the area where you mix the oxygen and it expels the carbon dioxide from the lung outside. If there is a defect then you need alternative means to do that. So we use an ECMO machine. Which is basically the lung and it expels the co2 and takes in the oxygen.”
Just two days ago, doctor Jacobo Elgozy walked out of the hospital after battling COVID for 120 days. ECMO was a treatment used to save his life.
“I am a witness of God’s miracle,” said Elgozy.
While Elgozy fought through the battle, both Dr. Farcy and Dr. Ciment said they will continue to fight in order to bring many more homes.
“It’s almost miraculous to see that.”
“I cry for about 20 minutes. Those are the moments that we need during this pandemic because those are the moments that are dedicated, our hard work and devotion works,” said Elgozy.
Now, there are complications with the ECMO. With tubes connected to big arteries, there could be complications of bleeding and immobility
However, in a recent study by the lancet, they found a 60 percent survival rate in more than a thousand patients.