Hospitals face severe shortage of ventilators amid COVID-19 outbreak
Thousands of ventilators from the U.S. stockpile are not operational, reports say; CEO of American Association for Respiratory Care, Tom Kallstrom weighs in on ‘America’s Newsroom.’
As the coronavirus pandemic rips through the U.S., governors have made public pleas for more personal protective equipment (PPE) for health care and frontline workers, and for ventilators to help treat those who become severely ill.
New York Gov. Andrew Cuomo, whose state has more COVID-19 cases than the entire country of Italy, has said that other states, including California, have sent ventilators to the region, and that a company down in Florida sent 2,400 BiPAP machines up to help lessen the demand.
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But what is a BiPAP machine, and can it really replace a ventilator?
“Ventilators are used when patients cannot breathe on their own, or when a patient suffers from respiratory disease,” Dr. Michael McLaughlin, assistant director of Rutgers Nurse Anesthesia Program, told Fox News. “They can be used as life support in the event of complete respiratory failure.”
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A BiPAP machine, along with CPAP machines, are typically used by patients who suffer from sleep apnea, McLaughlin explained. And while a CPAP machine is used for obstructive sleep apnea, forcing air into the airway upon inhalation to keep it open while patients sleep, a BiPAP machine is “a little more complex.”
Patients who use a BiPAP machine may also have obstructive sleep apnea but did not have success in using a CPAP machine, McLaughlin said. In addition to forcing air into the airway, it works to add pressure to the airway on inhalation and expiration.
Both a BiPAP and a CPAP require a patient to place a mask over their airway, which is not ideal for a coronavirus-positive patient, McLaughlin said.
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“This is not recommended for patients suffering from coronavirus as the mask can leak and send aerosolized virus into the air possibly infecting health care workers and others in close proximity,” McLaughlin said.
With ventilators, patients are intubated, which provides a secure airway with a seal as opposed to a mask.
“Ventilators are being used to treat coronavirus when patients need more than [an] O2 mask or nasal oxygen to maintain oxygen saturation,” McLaughlin said. “It applies pressure to help open infected lungs and better oxygenate patients.”
But amid the current medical crisis, BiPAP machines have been successfully converted into ventilator-like machines to help treat sick patients, but likely not those who are critically ill.
“BiPAP machines have been converted to ‘ventilator-like’ machines, but cannot offer the full support that a true ventilator can,” McLaughlin said. “It only offers partial support as the patient still needs to be breathing on their own. This could still be beneficial to a certain patient population suffering from coronavirus when a ventiator is not available.”
The conversion requires a specific part modification and special filters, he said, adding that, to his knowledge, CPAP machines are not currently being used to treat coronavirus. However, those who use a CPAP machine and have been diagnosed with coronavirus but are able to recover at home should take extra precautions in order to prevent aerosolized virus from entering the air and infecting others in the home when using the equipment, McLaughlin said.
And as far as who at the hospital is qualified to operate the ventilators and BiPAP-converted machines, McLaughlin said the usual staff, such as respiratory therapists, nurses and physicians who deal with such equipment, can continue to do so.
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However, he noted, ventilators are still the preferred method of treatment for coronavirus as they “offer more ventilation options and are capable of generating higher pressures.”
“Setting on a ventilator can be tailored to meet the needs of individual patients and have special modes for weaning patients to have the breathing tube removed as they recover,” he said.
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