Covid-19 Infographics for patients and families

What is a ventilator?

A ventilator is a machine that helps you breathe when your body is having difficulty breathing on its own.

Why would someone need a ventilator?

Sometimes, when we have an infection in our lungs, breathing becomes more difficult. In response to this, our body tries harder to breathe. When this happens, the muscles that help control breathing can become tired. A ventilator then helps us breathe when our own body is unable to do so properly.

Ventilators can also help by preventing our lungs from collapsing. To use an analogy, lungs are a bit like sacks full of balloons. These balloons, which are constantly inflating and deflating as we breathe, are called ‘alveoli’.

When we exhale, these balloons partially deflate.

You may remember from when you were a kid that the hardest part of blowing up a balloon was the very beginning, when you were starting with a fully deflated balloon. In fact, it is much easier for a balloon to expand when there is already some air inside of it. Our bodies have adapted to this by never fully allowing the balloons in our lungs, or alveoli, to completely deflate.

With some viruses, such as COVID-19, our immune system can overreact and attack the virus with too much force. This can cause the lining of our blood vessels and our alveoli to become leaky. When this happens, our alveoli can fill up with fluid.

The extra fluid in the alveoli (the balloons) means that air cannot enter the alveoli and not enough oxygen will be delivered to the body. But to make matters worse, the build-up of fluid in the alveoli can cause them to collapse. Just like blowing up an empty balloon, it then becomes harder to inflate the lungs.

This is one reason why COVID-19 can make patients feel short of breath. In severe cases, this combination of events can lead to respiratory failure, which can progress to a condition called acute respiratory distress syndrome (ARDS). In this circumstance, a ventilator can help keep our alveoli “open” in addition to assisting the body with breathing.

How do you connect a ventilator to someone’s lungs?

This involves a process called intubation.

In order to intubate a patient, the healthcare provider uses a metal or plastic lever to hold their tongue out of the way. This device also allows them to make sure that they are inserting the breathing tube into the windpipe (trachea) leading to the lungs, and not the food pipe (esophagus) leading to the stomach.

There are some other interventions that may be needed when a patient is admitted to the hospital for COVID-19 or when they are intubated. These include:

1. Placement of an arterial line. This is a tube inserted in an artery with a hollow needle, usually in the wrist. This allows for more accurate measurement of a patient’s blood pressure as well as the amount of oxygen and carbon-dioxide in the blood.

2. Placement of a “central line”. This is a larger tube that enters a vein leading to the heart. A central line can stay in place longer than an ordinary IV and allows physicians to rapidly deliver fluids or medications to the patient.

3. Placement of a urine drain tube, called a urinary catheter. A urinary catheter is a tube that is inserted in a patient’s urethra (where the urine exits the body) and travels up into their bladder (where the urine is stored inside the body). This allows urine to drain freely from the patient’s bladder. If a patient is in critical condition where they need to be sedated or intubated, a urinary catheter is often necessary, as patients may be unable to use the bathroom. Furthermore, in critically ill patients, a urinary catheter also accurately tracks the amount of urine being made, which is an important measurement of hydration and kidney function. 

4. Placement of an orogastric (OG) tube. An OG tube enters the patient's mouth and travels down the food pipe (esophagus) and into their stomach. OG tubes are often used when someone is unable to eat on their own, and are necessary in patients who are intubated. They also allow for oral medications to be given to patients who cannot eat on their own.

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