BILLINGS - The number of patients on ventilators in Yellowstone County hospitals continues to rise. While it's a common treatment for the most severe cases of COVID-19, many people don't know the process of being intubated.

Billings Clinic Inpatient Respiratory Therapy Manager Barry Stahlman says the virus stops oxygen from reaching your lungs and blood vessels. So, as a last resort to help patients breathe, they'll intubate them, basically putting a breathing tube down their throat.

"It has a cuff on it, so we actually close your airway off so the only way you can breathe is through the end of this tube. Obviously, very uncomfortable for us to do this. We have to highly sedate you to allow us to put this in through your mouth and down through your airway," Stahlman said.

The tube is connected to a ventilator, pushing oxygen into their body. Respiratory therapists control the settings of the machine, which will regulate how often and how much oxygen is being pushed into to the patient's lungs.

The therapists will change the settings depending on each patient's needs.

"These machines are not comfortable and often we can not get people to tolerate them without having them sedated," Stahlman said.

Stahlman says their respiratory therapists check in on their patients every four hours. For more severe patients, they check in every hour to make sure nothing goes wrong.

"Imagine we are blowing up a balloon over and over and over again. So, if you blow the balloon over and over again it gets weak. Same thing is happening with your lungs. Your lungs however, tend to, instead of getting weak, they end up getting hard. This disease process is pushing that much much faster, so as soon as we intubate people we are already kind of in trouble and if we don't monitor them closely, we're eventually going to pop that lung," Stahlman said.

Like much of the hospitals across the nation, there's a staffing shortage at Billings Clinic. Stahlman says they get concerned when they have one respiratory therapist looking after eight ventilator patients.

"In the past two weeks I, as their manager, have been asking them to take up to ten, sometimes 12," he said.

Prior to the pandemic, on a busy day, Stahlman says they could start with 17 people on ventilators and then the number would drop during the day.

"Right now we're seeing anywhere on average 22 to 36 ventilators. So the problem is space and being able to handle that extra volume," he said.

Another issue the hospital is running into is the influx of patients who didn't get treatment last year. Stahlman says because many people were scared to go to the hospital last year, they put off necessary care and surgeries.

Now, many patients are coming in even sicker. Stahlman advises all patients to not put off their medical care. He says you should continue to see your doctor on a regular basis.

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