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Innovative Method of Increasing Ventilator capacity in NYC
[Yahoo] NEW YORK - At least one New York hospital has begun putting two patients on a single ventilator machine, an experimental crisis-mode protocol some doctors worry is too risky but others deemed necessary as the coronavirus outbreak strains medical resources.The coronavirus causes a respiratory illness called COVID-19 that in severe cases can ravage the lungs. It has killed at least 281 people over a few weeks in New York City, which is struggling with one of the largest caseloads in the world at nearly 22,000 confirmed cases. A tool of last resort that involves threading a tube down a patient's windpipe, a mechanical ventilator can sustain a person who can no longer breathe unaided. The city only has a few thousand and is trying to find tens of thousands more. The U.S. Food & Drug Administration, which regulates medical device manufacturers, gave emergency authorization on Tuesday allowing ventilators to be modified using a splitter tube to serve multiple COVID-19 patients, though manufacturers still must share safety information with regulators. Emergency doctor explains how to modify one ventilator for four patients
"Due to the COVID-19 pandemic, many health care providers are struggling with the situation where they may have more than one patient needing ventilation, and not enough ventilators to go around," Dr. Charlene Irvin Babkok. The design is based off of a feasibility study that was published in 2006 in emergency medicine called a single ventilator from multiple simulated patients to meet disaster surge, in a joint study by Dr. Babkok another emergency physician Dr. Greg Namis. The design is based off of equipment that can easily be found in emergency rooms and hospitals, accounting for the possibility of different equipment available to different hospitals. In this design they use a 'T-tube' taken from an emergency respiration kit from an respiratory therapist's cart, as well as 22mm adapters making an 'H' formation. One end of the ventilation tube is hooked up to a port on each end of the small 'H' device, which is inserted into the one ventilator machine. The other ends of the tubes can then be hooked up to the patients. The H device may be halved, to only be used for two patients. Despite only lung simulators being used in the study, and not real patients, the device was successfully used on patients during the Las Vegas mas shooting incident by Dr. Kevin Mannis. During the incident the hospital received an influx of patients needing respiratory therapy greater than the number of ventilators on hand. Dr. Mannis was able to successfully use the device for many hours before ventilators from outside sources were brought into the hospital. The study did not cover the possibility of potential cross contamination risk, although they assumed it to be low given, "this is a one way circuit and the air only travels one way," however this has yet to be proven. "If you envision this during a COVID-19 pandemic, everyone has the same infection, mitigating the concern for cross contamination," she notes. The physician emphasizes that this is an off label use, and that the ventilators are designed for only one patient, "I hope that you don't need to use this, but you can never predict what's going to happen in a disaster." Dyson builds ventilators for coronavirus patients Dr. Ben Carson: Plasma transfusion coronavirus treatment being tested by New York looks 'promising'
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