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A Better way to Count The Number of Ventilators Required in a Pandemic
- Clarence Graansma (22 March 2007)
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Clarence Graansma, Sr. Renal Technologist Grand River Hospital, 835 King Street West Kichener, ON. Canada N2N2Z4
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I believe that many of the organizations that make plans for calculating ventilator requirements are looking at the problem from the wrong perspective. They try to estimate how severe the pandemic will be and then secure a few ventilators, say that it will not be adequate and then present their triage proposals. Now I certainly believe that planning for triage is a very prudent idea as it is very likely to be necessary even if the best planning and stockpiling is put in place. However any estimate of the potential severity at this time is little more than an educated guess. A better method of determining the optimum number of ventilators to purchase is to calculate the limitations of care due to staffing capacity vs. the limitation of care due to a physical shortage of ventilators. The method of calculating the number of ventilators that are required is to look at the staffing capability available in a region and estimate how much one could extend this capability by adding additional (non-certified) staff and by getting the existing staff to handle a larger case load (assuming no staff were sick). The sources of the additional (non- certified) staff could be veterinarians, EMTs, foreign trained (uncertified) physicians and other health professionals with some expertise in ventilatory therapy such as Biomed Techs. Now as the pandemic severity increases the demand for ventilators will increase and staffing resources will decrease due to staff illness and death. At some point these two projection lines will intersect and one will know exactly what the maximum ability to ventilate will be. Before this point there will be reserve capacity left and after this point, even though the demand increases, the actual number of patients the region is able to ventilate will in fact decrease. Once this calculation is done it is possible to know exactly how many ventilators is the maximum the region can support. If more ventilators than this number are acquired, they will never be used. If less than this number is acquired, then people may die unnecessarily. There is also a need to balance spending for future planning vs. current needs as another ethical consideration as well. I have been running the Pandemic Ventilator Project in an effort to address some of these concerns. Please visit my site at www.panvent.blogspot.com for more details. Competing interests: None declared |
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