New York is converting anesthesia machines to ventilators for coronavirus patients in an attempt to make up for the impending shortage of the life-saving devices, Governor Andrew Cuomo announced Thursday.
The state has become the the epicenter of the US epidemic of COVID-19, with more than 37,258 people who have tested positive for the virus.
Of those 1,290 are in ICUs across the state, where they need ventilators to support their failing lungs for as long as 21 days. Already, New York hospitals have been ‘splitting’ their ventilators, so that one machine supports two patients.
This week, the federal government sent 400 ventilators to New York City, which has the vast majority of the state’s cases – but Mayor Bill de Blasio has said that thousands are needed ahead of the expected apex of the outbreak in the coming weeks.
Although they’re not FDA-approved for long-term support, the Anesthesia Patient Safety Foundation (APSF) says that anesthesia ventilators ‘are an obvious first-line backup during the COVID-19 pandemic when there are not sufficient ICU ventilators to meet the patient care needs.’
A small shipment of ventilators was sent to New York City, but both the city and surrounding state are already trying to extend their supply by having two patients use one machine and converting anesthesia machine into ventilators
New York Governor Andrew Cuomo revealed Thursday that the state was pursuing every option to stretch its supply of ventilators further, including converting anesthesia machines
New York City is both the state’s and the country’s outbreak epicenter, with more than 21,000 people diagnosed with coroanvirus
Cuomo has said that New York has between 3,000 and 4,000 ventilators.
He anticipates it could need between 30,000 and 40,000 ventilators to support critically ill coronavirus patients at the peak of the epidemic in the state.
After the initial delivery of 400 ventilators, the federal government promised New York another 4,000 machines.
But that still won’t be enough – especially if cases continue to rise at the rapid rate that they have – to save the lives of the sickest New Yorkers.
Asked about ventilators in New York, Cuomo bluntly said that there was no stockpile great enough to meet the state’s needs, but that every option to get the devices was being pursued.
‘We’re talking to the federal government about more ventilators, we’re shopping for more ventilators, we’re splitting ventilators, we’re converting anesthesia ventilators to normal ventilators,’ he said.
‘So we’re all over the ventilators issue, but the number of ventilators we need is so astronomical it’s not likely [the federal government agencies] have them sitting in a warehouse.
‘They’re doing what we’re doing, which is you have to find those ventilators or convert those ventilators, or convince companies to make those ventilators.’
Already, the state has begun to ‘split’ ventilators, meaning health care workers are hooking two coronavirus patients up to one machine between their adjacent beds.
Anesthesia machines like this one are equipped to support breathing, but are not typically intended for long-term use. Cuomo said COVID-19 patients may need ventilators for 21 days
The Anesthesia Patient Safety Foundation said that the machines are obvious back up options for COVID-19 patients, but will require trained anesthesiologists to correctly set them to function as ventilators (file)
Now, Cuomo says doctors there are converting anesthesia machines meant to keep people unconscious during surgery into ones to keep COVID-19 patients alive.
Anesthesia machines are equipped with the same type of ventilators used in ICUs.
Typically, the component of the machine keeps a patient breathing regularly during procedures, rather than doing so for days on end, as many COVID-19 patients need.
But they work effectively the same way: A tube is snaked down the patient’s windpipe and the machine steadily pumps in oxygen and removes carbon dioxide from their lungs.
Anticipating this back up plan, the APSF published guidance for repurposing anesthesia machines as ventilators.
They noted that the machines may be found in hospital operating rooms and more be be at private medical offices or surgery centers.
Estimating the number of ICU ventilators in the state was challenging enough for government officials, and there’s no repository of how many anesthesia machines are spread throughout New York.
However, with all non-essential surgeries cancelled as of last week, there are likely many going un- or under-used.
‘Anesthesia professionals will be needed to put these machines into service and to manage them while in use,’ the APSF said in its guidance.
‘Safe and effective use requires an understanding of the capabilities of the machines available, the differences between anesthesia machines and ICU ventilators, and how to set anesthesia machine controls to mimic ICU-type ventilation strategies.’
That suggests that anesthesiologists may now be among the health care workers essential to fighting for the survival of New York’s coronavirus patients.