Posted on 03/23/2020 4:57:40 PM PDT by rintintin
Hospitals facing shortages of ventilators and other supplies are “in creative improvisation and adaptation mode” to replenish their stock as the coronavirus spreads — MacGyvering new pieces of equipment together and enlisting the help of 3-D printing businesses.
Massachusetts General Hospital has about 150 ventilators, which are key to helping people with severe cases of COVID-19 keep breathing, though the hospital expects it can bump that number significantly up by getting creative with the other assorted devices they already have.
“Using all the extraordinary strategies we have, we can get close to doubling that,” said Dr. Paul Biddinger, MGH’s emergency preparedness director. He added that parent organization Partners Healthcare is looking at buying or renting up to 200 more ventilators. “There are things we can do like using anesthesia machines as ventilators.”
They can also repurpose travel ventilators to be more permanent, as well as rigging BiPAP and CPAP breathing machines to be used differently than they normally would be. These are unusual steps, Biddinger said, but, “There absolutely are models that suggest we need more than we have … When you know you need something, you waited too long and you missed your window.”
(Excerpt) Read more at bostonherald.com ...
If I needed breathing assistance, I figure my first line of therapy will be my APAP (auto pap) with the pressure set way up, and the exhale relief set to max (3). While it would not would not be a ventilator, it might be all that I need.
And, resetting one's pressure is a snap, much info online.
I rely on my two dogs walking on my chest at night to keep me breathing!
I have no idea about these other machines, but I read one article about the nursing home in Kirkland, Washington where they turned up the patient’s breathing devices (not ventilators) before they knew they had the virus.
Many freeper’s commented that this would have made the virus spread more easily into the air. Again - I have no idea what types of machines were used, but it might be something to look into if there are others living with you.
Thanks for the tip
Notice this article does not indicate there is a shortage currently, only that if there is one, they’re prepared...
This do it yourself video popped up today out of nowhere. Tidy it up and it might be ok.
They could pull some anesthesia machines out of the OR. Most are,idle because of the cancellation of elective surgeries. That is what I plan on doing.
Bkmrk.
It’s great they are being inovate in producing units to help patients with there breathing. The House of Representatives should follow suit and focus on the virus not all the other stuff they want. Sorry state of affairs.
Always good to be thinking ahead about these types of solutions, but the U.S. has a lot of ventilators. I saw Senator Barrasso (who happens to be a doctor) talking about our ventilator supply on Ted Cruz’s youtube channel. He said we have 32 times the number of ventilators of the UK while only being about 5 times the population of the UK. Sounds to me like the UK needs to be looking hard at the solutions presented in that article.
The Institute of Industrial Engineers is networking 3D printers that will print for free to make PPE and ventilator parts.
We talked about using CPAP and BIPAP machine here before. A lot of people said it wouldn’t work. Maybe on the not quite so serious cases it would; especially if oxygen could be worked into it. I think the BIPAP can already add O2.
http://www.freerepublic.com/focus/chat/3828191/posts?page=407
Not sure if any of this applies, but above is a link to some doctor talking about what they are seeing, what to do, and what not to do.
About the 6th paragraph from the end he says:
Proning vented patients significantly helps oxygenation. Even self proning the ones on nasal cannula helps.
Vent settings- Usual ARDS stuff, low volume, permissive hypercapnia, etc. Except for Peep of 5 will not do. Start at 14 and you may go up to 25 if needed.
Do not use Bipap- it does not work well and is a significant exposure risk with high levels of aerosolized virus to you and your staff. Even after a cough or sneeze this virus can aerosolize up to 3 hours.
The same goes for nebulizer treatments. Use MDI. you can give 8-10 puffs at one time of an albuterol MDI. Use only if wheezing which isn’t often with covid 19. If you have to give a nebulizer must be in a negative pressure room; and if you can, instruct the patient on how to start it after you leave the room.
Do not use steroids, it makes this worse. Push out to your urgent cares to stop their usual practice of steroid shots for their URI/bronchitis.
ping to post 14, doctor recommends not to use bipap machines, etc.
Interesting, and of course, this non-physician yields to the expert observations from Emergency Room Docs!
Not a good idea...unless they want to aerosolize it.
Isn’t that what happened at the WA state nursing home? Nurses were sharing CPAPs and blew that shat, everywhere.
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