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Newest Reality

(12,712 posts)
Tue Mar 3, 2020, 04:26 PM Mar 2020

Ventilator supply is also very critically important!

While masks, gloves and even sanitizer shortages are in full bloom, along with drugs and Diet Coke, if we get into an extreme pandemic situation here, a vital machine that will be necessary to save lives may be in short supply and force life and death decisions, (death panels, anyone?) to be made as to who gets the ventilator and who doesn't.

I am not seeing much about the essential problem with this concerning preparation. If anyone has information, I would appreciate it. This is an older article about Avian Flu, but it makes a case for ventilators and their availability. If there is nothing ready to go as needed, then those in charge are certainly failing us big time. Their is no reason to believe that there won't be epidemics and pandemics in the future and act as if there is no need to be prepared, especially considering the potentially devastating impact. I mean, what in the hell? There is absolutely no credible excuse to be so unprepared, that is, if the safety of the population itself is any real concern. Maybe it really isn't?

Gee, I would think that would have some press as well as pressure to address the problem, as well as the many other things we might ASSUME will be available in a pandemic should we need them. Is there a problem with having stocks of absolute essentials ready to go in a wealthy country like this? Don't we have reserves for oil, etc., already? What good is that if you are deathly ill and can't be treated due to shortages? I thought we paid our taxes in order to ensure public safety, among other things?

This should be an outrage and totally unacceptable, i.e., to be treated as disposable pawns and mere fodder for disease or collateral damage and nothing more than a statistic.


Worth noting, the `severe' scenario presented - a 30% attack rate and a CFR of .5% - is nowhere near the severity seen in 1918 (CFR of 2%), and could potentially be dwarfed by an avian flu pandemic with even a higher attack or mortality rate.

Even so, their scenario finds without the unlikely rapid addition of 35,000 to 60,500 ventilators (and trained staff, oxygen, drugs, and electricity to run them), 200,000 to 300,000 Americans would die for the lack of ventilator resources.

And this opens up the thorny problem of who gets a ventilator, and for how long? When do you withdraw ventilator support from one patient in order to give it to another? Who makes these decisions? And how will the public react to the heartbreaking realities of triage during a pandemic?



https://afludiary.blogspot.com/2017/11/pandemic-realities-ventilator-shortages.html
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csziggy

(34,136 posts)
8. Let's check the specs for each
Tue Mar 3, 2020, 05:05 PM
Mar 2020
Most CPAP machines are able to go as high as 25 cmH2O, but that is far too high for the average sleep apnea sufferer. While the average setting is 10 cmH2O, your setting will likely fall anywhere between 6 and 15 cmH2O.
https://www.apneamed.org/blogs/info/how-when-to-have-cpap-pressure-settings-adjusted


Settingf for ventilators are harder to find but here - https://www.nursingcenter.com/getattachment/Clinical-Resources/nursing-pocket-cards/Mechanical-Ventilation-Settings-and-Basic-Modes/Mechanical-Ventilation-Settings-and-Basic-Modes-Tip-Card_January-2019.pdf.aspx - mentions settings between 3 - 35 cmH2O.

Of course ventilators generally provide oxygen support, but most CPAP allow supplemental oxygen added to the airflow.

So in an emergency, CPAPs might be a back up for patients who just need some breathing support to free up full ventilators for more seriously ill patients.

SDANation

(419 posts)
9. High flow nasal cannula
Tue Mar 3, 2020, 05:54 PM
Mar 2020

Is more standard practice. Bipap is in between less invasive but still requires ventilators to work.

csziggy

(34,136 posts)
10. Yeah, I've never been hospitalized for lung issues
Tue Mar 3, 2020, 06:01 PM
Mar 2020

And only been intubated during surgery. But I've had those annoying O2 cannula lots of times and use a CPAP nightly.

So I don't know much about the ventilators, just what I got from the research today. Mostly I was responding the the concern over sufficient pressure and apparently regular CPAPs provide plenty - but they will not do intubation.

By the way, I learned that not all hospital ventilators need intubation - some are very like the "pillow" masks that many CPAP users like. They sit on the nostrils and provide air pressure that way.

I was tested to see if I needed a BiPAP but did not. And I can't tolerate the pillow masks since I detest anything touching my nostrils. Since I don't need a full face masks I use a nasal mask, but go slightly nuts if a hair gets under it.

LAS14

(13,783 posts)
2. Have any of these shortages been definitely tied to Trump's cuts of budget ....
Tue Mar 3, 2020, 04:31 PM
Mar 2020

... and staff at CDC and NIH? I hope so!!!!!!

Newest Reality

(12,712 posts)
3. That's related.
Tue Mar 3, 2020, 04:37 PM
Mar 2020

I haven't checked that.

I am seeing all kinds of shortages emerging, (partially because of stockpiling and partially because of disruptions in supply chains as per, made in China).

I am hoping that this "potential" health crises exposes a vulnerability that a failure to assure public safety and health. Shouldn't that be on the JOB ONE list? All the talk about terror, safety, be afraid, and we are not really prepared for a pandemic? What? That's unconscionable and deplorable in itself, despite who is running things right now.

Maybe, when we get the despot and crew out we can get an act proposed to assure that at least the most essential items for a disease outbreak are stockpiled to some degree? Maybe that would add something positive to this crises in the long-run?

Leghorn21

(13,524 posts)
4. Reality, I read the other day how many vents are in the US and didn't save it...(and now can't
Tue Mar 3, 2020, 04:38 PM
Mar 2020

remember, of course)

But I googled to see how many vents a typical hospital has, and of course it depends on the hospital’s location, but anyway, typically 12-72 vents.

So I’m picturing a hospital with, say, 40 vents available, then I’m picturing, say, 150 desperately ill people who can’t hardly breathe and...

hlthe2b

(102,234 posts)
6. The truth is that a triage system will be put in place. That said, I'd bet a lot of DNR's get signed
Tue Mar 3, 2020, 04:44 PM
Mar 2020

if things were to become that dire. (and especially--not being facetious-- if Trump were to be reelected just prior)

Baitball Blogger

(46,702 posts)
7. I was going for the poor man's incubator.
Tue Mar 3, 2020, 04:44 PM
Mar 2020

Plastic sheets and a humidifier.

The problem in my house is that the best room to quarantine a family member is also the first room off the air condition system. So I would have to block out the vents and maybe rely on fans or open window for ventilation.

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