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April 8, 2020

3 ways to bolster ventilator supply—when you can't access more traditional ventilators

Daily Briefing

     Across the country, U.S. hospitals are facing a growing threat to patient care: the global ventilator shortage. The shortage is a top concern for hospitals in states like New York where officials estimate the 2,200 ventilators in their stockpile could run out within the week—and it's prompting others who are a few weeks out from the projected curve to think creatively about ways to get their hands on more ventilators

    Our take: Why the new 'ventilator splitting' guideline should be a last resort

    In addition to accessing ventilators from existing vendor relationships and the federal stockpile, we've outlined three actions hospitals can take to shore up their ventilator supply.

    1. Identify alternatives to traditional ventilators already on the market.

    While ventilators are the traditional piece of medical equipment providers would use to treat severely ill Covid-19 patients, there are alternatives available on the market that health systems have started to implement. A few examples include:

    • Helmet ventilation from Sea-Long Medical Systems. This FDA-approved device, hooks up to the hospital's regular oxygen supply, and costs $162.
    • Non-invasive, portable ventilator from Hillrom. This product can be used across settings and can free up invasive ventilators for the highest-need patients. Hillrom is quintupling production.
    • Air-oxygen blenders from Bio-Med Devices. This product delivers air and oxygen that can be used in conjunction with a ventilator or on its own with a nasal cannula and humidifier. This product can be especially useful for patients who do not require full intubation.

    2. Convert existing machines.

    The FDA has issued emergency guidance allowing clinicians to re-purpose medical equipment to serve as ventilators during this public health crisis. Those machines include:

    • Bi-level positive airway pressure (BiPAP) machinesNorthwell Health converted BiPAPs to invasive ventilators using 3D printed T-piece adaptors and added two high-efficiency particulate air (HEPA) filters at both ends of the oxygen hose. 
    • Anesthesia machinesNorthwell Health also is in the process of converting 300 of their anesthesia machines, which they previously used to sedate patients during surgery, into ventilators.

    3. Monitor ongoing efforts and federal regulatory guidance

    Engineers are creating other makeshift ventilator options at a fast pace as the pandemic continues to evolve:

    • Reverse-engineered breast pumps. Engineers in Southern Maryland have reversed the suction of breast pumps to turn them into intermittent positive pressure ventilation devices and added safety valves and backflow filters. The engineers are seeking FDA approval for the product, which would likely cost a little over $500.
    • Simple ventilator using hardware store parts. A Mississippi doctor created a homemade ventilator with a garden hose, a lamp timer, and an electronic valve. It costs less than $100 and can be assembled in about 20 to 30 minutes.
    Additionally, hospitals can try to tap in to the supply of new machines coming from companies like Tesla, Ford, GE, and GM once they are available. That will likely be more useful for states that have yet to see a surge in cases and will hit their peaks in the coming months. No matter which position hospitals are in though, they will need to look down every avenue for potential new sources of ventilators to either meet the current need or prepare for future demand that has yet to hit many areas of the United States.

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