SOOPOO
SOOPOO
Joined: Aug 8, 2010
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TDVegasonenickelmiraclepetroglyph
March 17th, 2020 at 7:58:10 PM permalink
Just so you all have some perspective, my hospital had (guess) 50 ventilators and maybe as many ICU beds. It would be pretty easy to increase the number of ICU beds rather quickly. What makes a bed an ICU bed mostly is the dedicated nursing staff at low ratios. In an emergency the ratios can be adjusted of course.
The thing to remember is that on any given day there are 30-40 patients already on a ventilator. So thinking there are 50 spots available for extra cases due to coronavirus is not true.
Frankly, I go to conferences where some company is always trying to sell a newer, better, ventilator. I am surprised there aren't a reasonable number already made but not sold (prior to the crisis).
As I may have mentioned before, every OR has an anesthesia machine which has a ventilator. At my hospital that would add 17 more if they were not being used for surgery. Probably a couple hundred in Buffalo if you add up all the hospitals and surgicenters.
It would be interesting if somehow the hospitals wanted to confiscate the ventilators from stand alone surgi centers.
billryan
billryan
Joined: Nov 2, 2009
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March 17th, 2020 at 8:46:33 PM permalink
After the MGM shootings, most elective surgeries were postponed. I imagine that will be the case elsewhere soon. My neighbor is scheduled for cataract surgery in three weeks and is worried about it being canceled.
rxwine
rxwine
Joined: Feb 28, 2010
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March 17th, 2020 at 8:52:41 PM permalink
Quote: billryan

After the MGM shootings, most elective surgeries were postponed. I imagine that will be the case elsewhere soon. My neighbor is scheduled for cataract surgery in three weeks and is worried about it being canceled.



I wouldn't be surprised if they start asking all kinds of MDs from every profession to provide assistance, in areas they haven't worked in since a training internship.
Quasimodo? Does that name ring a bell?
coilman
coilman
Joined: Jan 29, 2012
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March 17th, 2020 at 9:00:39 PM permalink
What kind of ratio beds to nurses for people on ventilators?

Is Buffalo like Detroit dependent on a huge number of nurses from Canada? So much so that they would have to basically live in Buffalo should or when they shut the border/ bridges there down?

Friend here in Windsor area that's a nurse had a post on her facebook about Seattle area trying to get Nurses for a few weeks $3500 for 48 hr weeks . Crisis pay
onenickelmiracle
onenickelmiracle
Joined: Jan 26, 2012
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March 17th, 2020 at 9:02:24 PM permalink
Quote: SOOPOO

Just so you all have some perspective, my hospital had (guess) 50 ventilators and maybe as many ICU beds. It would be pretty easy to increase the number of ICU beds rather quickly. What makes a bed an ICU bed mostly is the dedicated nursing staff at low ratios. In an emergency the ratios can be adjusted of course.
The thing to remember is that on any given day there are 30-40 patients already on a ventilator. So thinking there are 50 spots available for extra cases due to coronavirus is not true.
Frankly, I go to conferences where some company is always trying to sell a newer, better, ventilator. I am surprised there aren't a reasonable number already made but not sold (prior to the crisis).
As I may have mentioned before, every OR has an anesthesia machine which has a ventilator. At my hospital that would add 17 more if they were not being used for surgery. Probably a couple hundred in Buffalo if you add up all the hospitals and surgicenters.
It would be interesting if somehow the hospitals wanted to confiscate the ventilators from stand alone surgi centers.



Maybe another country bought the surplus up before anyone here in the US even thought of it . Happened kind of but not really. Just read an article saying Germany ordered 10,000 machines and the US has ordered none. They can be made, but our government hasn't ordered them and hospitals haven't because they don't want to be stuck with expensive never will be used ventilators. It can be almost done enough.
In the land of the blind, the man with one eye is the care taker. Hold my beer.
ChumpChange
ChumpChange
Joined: Jun 15, 2018
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March 17th, 2020 at 9:03:46 PM permalink
The NYS Governor says there's 3,000 ICU's in the state and 80% of them are already in use pre-COVID-19. So that leaves 600 beds statewide. 65 patients with COVID-19 were already in the ICU a couple days ago. Cuomo wants the Army Corps Of Engineers & the U.S. military to convert SUNY campus dorms into ICU beds. A company that makes ventilators says they'll only make more if the Federal Government orders it. So that leaves the cliffhanger within the White House whether anything gets done. Ventilators are $40K each, so a thousand of them would be $40 million; 10,000 would be $400 million; and 100,000 of them would be $4 billion.

In other news, the Federal gov't is issuing expired N95 masks to hospitals for the staff to use in numbers about equal to single digit percents of what was asked for.
TigerWu
TigerWu
Joined: May 23, 2016
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Thanks for this post from:
tringlomane
March 18th, 2020 at 8:10:14 AM permalink
Quote: ChumpChange

Ventilators are $40K each, so a thousand of them would be $40 million; 10,000 would be $400 million; and 100,000 of them would be $4 billion.



Hell, if it came down to it, I would pay $40k out of my own pocket to have a ventilator built if it would save my life... We should be throwing money at building these things.
billryan
billryan
Joined: Nov 2, 2009
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March 18th, 2020 at 10:14:57 AM permalink
I will admit to knowing nothing about ventilators but assume they run on electricity. Would adding a few hundred of them in a hospital overpower their electric grid?
SOOPOO
SOOPOO
Joined: Aug 8, 2010
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March 18th, 2020 at 12:29:53 PM permalink
Quote: billryan

I will admit to knowing nothing about ventilators but assume they run on electricity. Would adding a few hundred of them in a hospital overpower their electric grid?


Not an engineer, nor an electrician, but I am nearly certain the answer is no. The number of electricity sucking devices used in a hospital is staggering. An extra 100 ventilators would be a blip. Assume also that the electricity heavy use location of the OR is now shuttered. Elective clinics shuttered. Etc....
FleaStiff
FleaStiff
Joined: Oct 19, 2009
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March 18th, 2020 at 1:18:53 PM permalink
precorona resource allocation was determined by Pandemic Protocols, largely SOFA based. SEQUENTIAL ORGAN ASSESSMENT SCORE, and never any demographic data.

CORONA seems to have prompted changes based on fragmentary, politicized data wherein possible, but unlikely events, are given undue weight and demographic stratification trumps a purely clinical-based triage response..

Ten days after infection the virus is detectable on mucousal surfaces, but the patient is probably not infectious. Political decisions regarding possible but unlikely consequences are being used to allocate resources.

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