Hospitals can split a single ventilator between two patients infected with the coronavirus, the Trump administration said Tuesday, but it cautioned that the practice should be done only if there are no other options.
A shortage of ventilators, machines that allow seriously ill patients to breathe and stay alive, is one of the top concerns amid the coronavirus crisis. Hospitals across the country could soon be facing situations where they need to prioritize treatment with limited resources.
New federal guidelines from the surgeon general said the strategy of ventilator splitting “should only be considered as an absolute last resort” since the reliability and safety are not known.
However, the guidelines noted that many institutions are evaluating the practice and that protocols are being developed, tested and, in some places, preliminarily implemented as hospitals become overwhelmed with COVID-19 patients.
In an open letter to health workers, Surgeon General Jerome Adams and Assistant Secretary for Health Adm. Brett Giroir gave technical guidance to hospitals that may be exploring ventilator splitting.
They cautioned that using one ventilator for two patients is technically possible but has never been tried on humans. The practice “should only be considered if a hospital cannot provide clinically proven, reliable, and safe methods to manage acute respiratory failure.”
At least one hospital in New York has reportedly started splitting ventilators between patients in preparation for when it has no choice.
The letter from Trump administration health officials is a tacit acknowledgement that states and hospitals will not have enough ventilators to care for the number of COVID-19 patients they expect and runs counter to the public messaging from administration officials.
Governors have been pleading with the administration for more supplies. New York Gov. Andrew CuomoAndrew CuomoPress: America’s governors lead the way on virus The Hill’s Morning Report – Presented by Facebook – Trump blends upbeat virus info and high US death forecast Cuomo grilled by brother about running for president: ‘No, no’ MORE (D) has said his state needs 30,000 additional ventilators by the time the peak of the crisis hits.
Louisiana Gov. John Bel Edwards (D) on Tuesday said he anticipates running out of ventilators by April 4. He said the state needs at least 14,000 ventilators but has secured fewer than 300.
But administration officials have been downplaying the possibility of ventilator shortages. President TrumpDonald John TrumpCuomo grilled by brother about running for president: ‘No. no’ Maxine Waters unleashes over Trump COVID-19 response: ‘Stop congratulating yourself! You’re a failure’ Meadows resigns from Congress, heads to White House MORE last week questioned whether Cuomo really needed 30,000 ventilators.
Dr. Deborah Birx, the top health official leading the White House’s coronavirus response, also pushed back on the possibility of shortages.
“To say that to the American people, to make the implication that when they need a hospital bed, it’s not going to be there, or when they need that ventilator, it’s not going to be there — we don’t have evidence of that right now,” Birx said last week.