Cape Girardeau physician promotes a different way to treat COVID-19 patients

Note from Jon K. Rust, publisher:

The Southeast Missourian wants to be careful about reporting of medical procedures where our reporters have no expertise. In this case, a retired local doctor is offering a device – free – to hospitals or medical professionals that he believes may have a benefit. It has not been reviewed by other doctors for COVID-19 treatment or undergone any scientific testing related to COVID-19. The story reports that the procedure should NOT be done at home, and instead, “must be administered by a health care professional.” The primary benefit of the device, in Dr. Martin’s theory, is that the procedure may lessen the need for mechanical ventilation. It is not a cure for COVID-19, and Dr. Martin does not suggest it is. Other media, including the New York Times, have been reporting the downside of mechanical ventilation – and statistics are included in this story. The New York Times has also reported on techniques working in New York City such as doctors placing patients onto their stomachs as a way to help breathing and prevent ventilation, even including the advantage (especially for obese patients) of using special massage mattresses designed for pregnant women. The Southeast Missourian does not know if Dr. Martin’s theory has specific value to COVID-19. Meanwhile, here is link to New York Times article, which has the subhead: “Ironclad emergency medical practices — about when to use ventilators, for example — have dissolved almost overnight.” https://www.nytimes.com/2020/04/14/nyregion/new-york-coronavirus.html

Richard Martin, M.D., an ear, nose and throat physician in Cape Girardeau, says a procedure he developed years ago could save some of those suspected of having COVID-19 from needing to undergo mechanical ventilation.

Martin, with 49 years of experience as an otolaryngologist, calls his procedure AIM, the aspiration-irrigation maneuver.

“(AIM) could help save lives,” said Martin, 73.

Dr. Richard Martin displays the "aspiration-irrigation maneuver" device Tuesday at his home in Cape Girardeau County. Martin believes the device could aid in treatment of COVID-19 patients.Jacob Wiegand

Martin cites statistics culled from the first few weeks of the pandemic indicating coronavirus patients who require intubation have a high risk of not surviving.

“The numbers say of the (COVID-19) patients intubated, 50% will die,” Martin said. “The mortality rate is higher if a person is 65 or older.”

Indeed, NBC News and the Associated Press report some hospitals are reporting unusually high death rates for intubated coronavirus patients.

A mechanical ventilator pushes oxygen into patients whose lungs are failing.

An intubated patient is sedated and a tube is stuck into the throat to assist breathing.

Dr. Richard Martin displays a page showing the application of the "aspiration-irrigation maneuver" device Tuesday at his home in Cape Girardeau County.Jacob Wiegand

While the statistics change daily, the most recent U.S. data show up to half of those ventilated with severe respiratory distress die, according to AP.

In New York City, the wire service reports, more than eight in 10 intubated coronavirus patients have died.

In Wuhan, China, where the COVID-19 outbreak reportedly originated, a study released by the World Health Organization showed the intubated death toll as high as 86%.

Martin has used the AIM procedure for more than 30 years, treating acute and chronic sinusitis in children and adults, making them better candidates for anesthesia and surgery.

Often, the Nebraska native said, using AIM can help avoid surgery altogether.

Boxes containing "aspiration-irrigation maneuver" devices are seen Tuesday in Cape Girardeau County.Jacob Wiegand

“I think AIM can be used to help remove the ‘viral load’ from the upper airway and restore normal nasal breathing,” Martin said.

Normal breathing means no need for intubation, which for COVID-19 patients, has proven to be a dangerous intervention.

Martin gave the name to AIM and he also patented the instrument used in the procedure in the late 1990s.

“Obviously, we need to put the device where the epidemic is, in the hot spots,” Martin said. “With AIM, we can possibly keep people from going into intensive care to be intubated.”

Martin obtained the instrument while on a mission to Jamaica with Christian Medical Society.

“It sat on the shelf,” Martin said, “until one weekend when two of my kids had bad nasal congestion and I was desperate to get them relief.

“I thought if I couldn’t help them,” Martin recalled, “they might need surgery and of course I wanted to avoid that.”

Familiar with a procedure performed by former Washington University ENT physician Arthur W. Proetz, he planned to use Proetz’s displacement maneuver on his children.

“But Betsy and Jon were little, and Proetz’s procedure would have required the kids to lay down and hang their heads back over the table,” Martin recalled.

Remembering the device from Jamaica, Martin had his children sit upright instead, relieving their distress with what he now calls AIM.

“I had them repeat the letter ‘k’ over and over,” which Martin says pulls the palate up and closes the larynx.

The instrument introduces saline into one nostril with a bulb syringe and is aspirated or removed through the other side with the AIM apparatus.

Martin says the instrument quickly and thoroughly removes the contents of sinuses and improves breathing immediately.

“It takes about 6 to 8 seconds to work,” Martin said. “Betsy and Jon got better and tolerated the maneuver just fine.”

Martin said he has introduced the procedure to Southeast Hospital and Saint Francis Medical Center personnel.

“AIM became the most valuable and innovative part of my practice,” he added.

Martin said his patented instrument can also trap the viral load, which can be cultured or gram stained for COVID-19.

One of the big benefits of the AIM procedure is a sick child can stay in his mother’s arms while it is performed.

“It is safe, simple, painless, inexpensive, therapeutic and diagnostic,” Martin said. “But it must be administered by a health care professional.”

The ENT physician believes in the procedure enough he is willing to part with his stockpile of devices.

“I have 3,000 instruments ready to donate to any center who asks,” Martin said.

If a medical professional or hospital system is interested, Martin invites a call or an email: (573) 450-4189 or ramandsam9@gmail.com.