Prevailing wisdom tells us that if you’re disaster planning during a disaster, you’re probably too late. The Trump administration’s recent announcement that hospitals can split a single ventilator as "an absolute last resort" sounds like it’s too late.
The practice is rarely used and stems largely from scant scientific evidence, including a study conducted on four adult sheep. That's why it's important to stress that despite the greenlight from the federal government, ventilator-splitting must remain a hospital’s last resort.
Before hospitals get to that option, there's two things providers can do to procure ventilators.
First, contact alternative ventilator manufacturers. Calling ventilator manufacturers is not new advice, but consider the smaller players who produce different types of ventilators. University of Chicago Medical Center, Johns Hopkins Medicine, Massachusetts General Hospital, and the Veterans Administration have all placed orders for Sea-Long Medical Systems’ helmet-like, noninvasive ventilator. The device is FDA-approved and costs $162.
Hillrom is another company that’s increasing access to noninvasive ventilator options by quintupling production of their Life2000 noninvasive, portable ventilator. The device can be used across acute care settings for patients with mild to moderate respiratory needs, which can free up invasive ventilators for those most in need. The Life2000 is FDA-approved and manufactured in the United States.
Hospitals should also stay abreast of ventilator models in development. In Maryland, engineers are creating ventilator prototypes using FDA-approved breast pumps. The prototypes cost about $500 to build but still require biomedical testing and clinical review. While the device is not on the market, hospitals should cast a wide net to understand what is being developed in their own communities.
Second, partner with other hospitals to advocate not for yourself—but for the community. When local hospitals compete for ventilators, some will benefit at the expense of others. Hospitals will be better off banding together and sharing inventory data to care for community members.
Federal guidance to split ventilators is intended to be a hospital’s last resort. To avoid such dire straits, make sure that you’re thinking outside the box to look for alternative sources of ventilators and breaking down barriers to serve the community.