Impossible Decision

Experts Say Putting Multiple Patients on One Ventilator Is Unsafe

For hospitals overwhelmed by coronavirus patients, this is bad news.

3. 30. 20 / Dan Robitzski
Victor Tangermann
Image by Victor Tangermann

In the areas hit hardest by the coronavirus pandemic, hospitals are facing a dire ventilator shortage.

In Italy, doctors have already had to turn patients away because they didn’t have enough ventilators to treat them, and the same could soon happen in the U.S. if hospitals are overwhelmed by coronavirus patients.

To make up for the shortage, some resourceful doctors have suggested splitting ventilators, a poorly-understood means of attaching and dividing new hoses so that one ventilator could theoretically treat four patients. But now the American Society of Anesthesiologists has a dire warning: it’s impossible to safely split a ventilator, and doing so would put all four COVID-19 patients at risk.

The warning, which was issued Thursday jointly with five other medical associations like The Society of Critical Care Medicine and the American Association for Respiratory Care, specifically warned that it’s impossible to safely split a ventilator and still provide quality care to the any of the patients using it.

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“The physiology of patients with COVID‐19‐onset acute respiratory distress syndrome (ARDS) is complex,” the warning reads.

“Attempting to ventilate multiple patients with COVID‐19,” it continues, “could lead to poor outcomes and high mortality rates for all patients cohorted.”

Instead of trying to intubate as many patients as possible, the medical associations argue that doctors will have to make the exceptionally difficult choice of prioritizing patients based on who’s most likely to pull through.

“In accordance with the exceedingly difficult, but not uncommon, triage decisions often made in medical crises,” the warning concludes, “it is better to purpose the ventilator to the patient most likely to benefit than fail to prevent, or even cause, the demise of multiple patients.”

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