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IN IT TOGETHER: Respiratory Therapy team at centre of COVID-19 response

Posted May 28th, 2020

IN IT TOGETHER: Respiratory Therapy team at centre of COVID-19 response

This is part of a series of stories profiling members of the Niagara Health team and the work they are doing as part of our response to the COVID-19 pandemic. Meet John Chirico, Senior Respiratory Therapist at the St. Catharines Site.

It’s the severity of COVID-19 in patients that has struck Senior Respiratory Therapist John Chirico the most about the virus.

John is part of Niagara Health’s Respiratory Therapy (RT) team that monitors, assesses and treats people who have difficulty breathing. They are highly trained in mechanical ventilation and airway management, CPR and oxygen therapy, and work with patients on a range of airway, breathing and lung problems, from sleep apnea, asthma, heart attacks to high-risk births.

COVID-19 can lead to pneumonia, respiratory failure and cause severe lung damage.

During the pandemic, John and his colleagues are at the centre of Niagara Health’s COVID-19 response, tracking patients’ oxygen levels, managing their breathing, and if needed, intubating patients -- connecting them to a mechanical ventilator that helps them to breathe.

“Patients with COVID-19 can present and be fine with mild symptoms, but then their conditions can get worse quickly,” says John, who has cared for patients with the virus in the Intensive Care Unit and dedicated COVID unit at our St. Catharines Site.

As part of our response to COVID-19, John was the RT lead who collaborated with other members of the multidisciplinary team to modify respiratory therapy procedures so they could be performed in a “protected” way to keep patients, staff and physicians safe and reduce the risk of virus transmission.

For John, the seriousness of the virus is also a reminder of why physical distancing, meticulous hand hygiene and other preventative measures to stop the spread are so important. “As we start to see things slowly reopen in the community and get back to a new normal, we do have to remain vigilant in our physical distancing and infection control practices,” says John, a member of the Niagara Health team for eight years.

Describe your role during the pandemic?

As a Senior Respiratory Therapist, I was heavily involved in preparedness for COVID-19. Although the team has always taken infection control measures, we had to create or amend practice policies to add other measures to prevent the risk of virus transmission, such as adding high-efficiency filters to equipment (to keep particles inside the equipment), limiting personnel and equipment in contact with suspected COVID-19 positive patients, ensuring we are wearing the appropriate personal protective equipment, and reduced or modified performance of aerosol-generating medical procedures (which result in the production of airborne particles or respiratory droplets). Examples include intubation (inserting a breathing tube), extubation (removal of a breathing tube), and non-invasive ventilation therapies (helping someone breathe without inserting a breathing tube). Another big task has been working with the purchasing and logistics departments to ensure we have the proper equipment and supplies and in the appropriate quantities.

What have you found to be most challenging during the pandemic?

Things were changing so rapidly, especially at the beginning. I would help work on writing policies that would need to be amended only days later because we learned or discovered new information. There was a lot of research done and continues to be done on a daily basis. There was and still is a lot unknown about this virus.

What is a learning you have gained professionally during the pandemic?

From a respiratory standpoint, there was so much unknown about the impact of COVID-19. At the beginning, we weren’t using initial therapies that we would typically use for influenza, for example. But as new information came in, we started to use these therapies. Now a couple of months in, from a respiratory therapy standpoint, we are using the same therapies and interventions that we would use on any other virus, like oxygen therapy, airway management and mechanical ventilation. We are performing these procedures in a protected manner to keep everyone safe. Patients with COVID-19 don’t always present as our typical ARDS-type (acute respiratory distress syndrome) patients would when on ventilators, where there is a more standardized approach. We have to determine what the best ventilation strategy is for each individual patient. We have been continually educating ourselves to remain up to date with best practices and recommended strategies for respiratory management.

Describe working with your team?

The Respiratory Therapy department has always been close. We are very supportive of each other and help each other out. We have good relationships with the rest of the Niagara Health interdisciplinary team. Everyone has done a great job of adapting to all of the changes in practices and working together to care for our patients during these challenging times. It has brought out the best in people.

What does it mean to you to see the outpouring of support from the community?

The expressions of support and appreciation from the community have been very inspiring and uplifting. The donations of equipment, supplies, food and the words of encouragement have meant so much to us. The people of Niagara are truly amazing.

How do you unwind from work?

At the beginning, it was very busy so I was working a lot and didn’t have as much time to be active outside, go for hikes and spend time with my girlfriend. Now I’m able to do more of that, which is great with the weather getting nicer.

Click on the In It Together button below to read more stories about our team.

Niagara Health System