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Mr. B.’s hand holds Camille’s, on duty that night. In bed, the 72-year-old struggles to breathe. With each breath, his entire upper body rises. Obviously the large doses of oxygen that he inhales through a mask that envelops a large part of his face are no longer sufficient. Yesterday, however, Mr B. ate alone, sitting in an armchair, in his room in the intensive care unit of the Annecy-Genevois hospital. But his condition worsened within hours.
“Are you exhausted?” “Camille asks for a reaction. Mr. B. nods with difficulty. “We’ll have to intubate you, okay?” “ ” Do you agree ? “, the anesthetist-resuscitator repeats calmly, despite the urgency of the situation. ” All right “, Mr. B. replied breathlessly.
“We had your family on the phone. They love you “
The scene will then take place in about ten minutes, which will pass in the blink of an eye. Three assistants enter the room, protected by a yellow lab coat, an FFP2 mask, gloves, a cap and goggles. Mr. B. is in a coma. Patients often ask if they will wake up. Monsieur B, he no longer had the strength.
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Justine, nurse, provides care to a patient with Covid 19. 4C intensive care unit at Annecy Genevois hospital, November 13, 2020. / Sophie Rodriguez
Marjolaine, the intern, stands behind the patient. It is she who will remove the mask and proceed with intubation. The monitor beep indicating these constants is increasingly high-pitched. Marjolaine knows that time is running out. These gestures are precise, fast. A few minutes later, Mr. B is connected to the fan.
Before putting Mr. B., Laetitia, to sleep, the nurse approached his face, a hand on his shoulder. “We had your family on the phone. They love you “, he sent in a low voice. Alerted a few minutes earlier, his wife and children broke down when Camille told them they should have shaved off their beards before intubating him.
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Intubation, this is the turning point for doctors. The inflammation of the lungs caused by Covid-19 is so strong and the patient so tired of breathing that they have no choice but to intubate him. “It’s the last possible solution, explains the doctor. Because we know that the consequences of this invasive gesture are heavy and that the convalescence will be long. “
Laetitia, the nurse, has always worked in intensive care. Before joining a Covid unit, she was passionate about her job. It no longer makes sense. “It’s so difficult. Usually,” turn-based “, either the patient goes out or dies, he makes caricatures voluntarily, his features drawn by fatigue. With Covid the state of health of patients can improve, and then worsen suddenly, in a few hours, to the point of having to intubate them. “
Doctor Arnaud Tettoni with a patient with Covid-19. 4C Intensive Care Unit at Annecy Genevois Hospital, November 13, 2020. / Sophie Rodriguez for La Croix
Particularity of this pathology, which doctors still do not know how to explain, the times in which the situation changes are numerous for the most serious patients. The former often occurs after the seventh day after the infection begins. The patient’s state of health suddenly worsens, in 24 or 48 hours, without him really noticing.
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Installed two rooms after that of Mr. B., at the end of the small corridor that borders “pulley 4”, Mrs. S., 76 years old, was sent to the emergency room by her doctor. It was October 23rd. After several days of fever, diarrhea and a dry cough, he found himself increasingly short of breath. When she arrived at the hospital, her blood oxygen level was already critical and the doctors took her directly to a “sheaf”.
” Some clinical signs are absent for a long time in people who develop severe forms of Covid-19 “
“When a patient needs more than 6 liters of oxygen – which is huge – there are usually associated clinical signs, such as blue lips, describes Renaud Chouquer, the deputy head of the intensive care unit. But these signals have been absent for a long time in people who develop severe forms of Covid-19 and will initially withstand very high doses of oxygen quite well. “
Madame S. lasted 15 days on oxygen. Laetitia remembers the admission of this woman he calls by name. With much emotion in her voice, the nurse describes Madame S. as “A grandmother who makes her garden and takes care of her grandchildren. “ Slightly overweight, he suffered from hypertension but was in good shape.
Caregiver team. Intensive care unit at the hospital of Annecy Genevois, 13 November 2020. / Sophie Rodriguez for “La Croix”
Ms. S. refused to let her relatives come to see her in the ICU. To protect them. So he was talking on the phone with his children and grandchildren, whose drawings displayed on the wall in front of his bed catch the eye in this dehumanized world. Their words in stylized letters speak of the future. And then, two weeks ago, his condition got even worse, suddenly, at two in the morning. The guard team intubated her and since then the doctors who follow one another at her bedside have been pessimistic.
“After more than two weeks of intubation, we risk having a lot of problems. “
Until Arnaud, an anesthetist-resuscitator in cardiac surgery, was discovered “A slight improvement in the respiratory plan”. And that he insists with his colleagues to give Ms. S. a chance again. It was late last week and the following days proved him right: the medical team now intends to wake her up. “Stopping the sedation will take time. It is a late resuscitation, after more than two weeks of intubation. We risk having many problems. “
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The course of the disease is unpredictable and doctors are careful not to claim victory too soon. Because if the health status of the most serious patients with Covid-19 suddenly deteriorates, the improvement is much more gradual and fragile. “This lady was active before taking Covid, assures Arnaud. He still has ten years to live. It is worth fighting for her to the end. “
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