COVID-19: The Purpose of Ventilators, Why There’s a Shortage, and What’s Being Done

Every day on the news we hear the pleas for more medical masks for doctors and nurses, more personal protective equipment, and more ventilators. We all know what masks are, but what exactly is a ventilator, why are they in such short supply, and why are they so essential?

What are Mechanical Ventilators?

Ventilators are machines which essentially temporarily act as the lungs for patients who can no longer breathe on their own. A tube is inserted into the windpipes, and air is pumped directly into the lungs. This machine is able to not only provide oxygen but remove carbon dioxide from the body.

Ventilators aren’t the first option for patients who are struggling to breathe. First, less invasive steps are taken such as an oxygen tube or mask.  When these are not adequate, the decision is made to use a ventilator. In other words, it’s a last resort. This is partially because the use of a ventilator does not come without its own risks. It increases the chance of pneumonia and injuries to the lungs.

These machines have various settings to specify flow, pressure, and volume. Patients who are on one are typically given pain medications. However, doctors do their best to avoid sedation so that patients can communicate. Unfortunately, due to the tube, patients can’t talk while on the ventilator. That means doctors must get creative with communication which can range from pencil and paper to computer programs.

The time a patient has to be on a ventilator varies. It could be just a few days or a few weeks, with most cases in the 1-2 week range. After a patient is taken off a ventilator, it can be used for another patient. The tubing is thrown away and the machine itself is thoroughly cleaned.

Why is there a Shortage?

It’s not that the United States typically does not have enough ventilators. This isn’t a normal problem. Unfortunately, the COVID-19 pandemic has created a drastic shortage in our country. Why? Because for the most severely effected patients, stress on the respiratory system causes the most damage. When oxygen cannot effectively reach the bloodstream, it cannot reach vital organs in the body. This is the ultimate cause of damage for serious coronavirus cases.

It’s critical to mention that the vast majority of patients experience mild illness. They don’t need to be hospitalized, and they can recover at home. Just 20% of patients are admitted to the hospital. Of these, approximately 14% have severe disease. For around 6% their condition is critical.

They seem like small numbers, and they are in the grand scheme of cases. But they are large numbers for our hospitals who are not used to needing that many machines. Further, just because we are in a pandemic, doesn’t mean people aren’t sick with other conditions which may also require a ventilator.

What do we do?

Currently, the United States has around 160,000 machines. If people adhere to social distancing protocols, and our curve its flattened, we should be fine. If we don’t, this won’t be near enough.

How do we get more? Various companies in a wide array of industries are switching their production from their typical product to ventilators. These include car companies like Ford and GM.

Other ideas are to use one ventilator for two patients. This has never been tried before. Doctors think there is a way to do it safely, but how long patients need the ventilator would be a crucial factor to this.

It’s time for innovative solutions.

We also need more PPE for nurses (especially as they are connecting ventilators), more respiratory therapists to care for patients on ventilators, and more nurses trained for the ICU.

We have options. People are having innovative ideas. We just need to implement these quickly.

You can read more about this issue here.

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