The Science Journal of the American Association for Respiratory Care

2009 OPEN FORUM Abstracts

BIOTERRORISM; VENTILATOR ACQUISITIONS IN MASSACHUSETTS

Sigita Gsell, Paul Nuccio; Brigham and Womens Hospital, Boston, MA

Bioterrorism produces a public health emergency that requires several types of strategies to manage. With a bioterrorist event the victim’s clinical signs and symptoms could occur hours or days later depending on the agent and the incubation period. Many symptoms are misdiagnosed or share the same symptoms of other diseases. The respiratory problems associated with inhaled biotoxins would require long term mechanical ventilation, which would easily overload the ventilator resources available. Certain disaster ventilators can be useful for short term mass casualties but not for long term intubated patients. Would the hospitals have adequate resources to accommodate the influx of patients requiring ventilators? Methods Massachusetts hospitals were surveyed to find their ventilator availability. Questions posed include the following: 1. How many ventilators does your hospital have in house? 2. How many ventilators(average)do you run per day? 3. How would you obtain additional ventilators? 4. What vendor do you use for ventilator rentals? 5. How many ICU beds within your institution? 6.How many(RT)staff? Results In Massachusetts, the healthcare system includes 73 acute care hospitals. 29 hospitals responded to the survey including five major teaching hospitals in the metro Boston area. 1.The total ventilators for the twenty-nine hospitals are 800 (434 in Boston hospitals) 2.The total average ventilators that run per day are 367, Leaving 433 available ventilators for new patients(213 in Boston) 3.All hospitals stated they would rent ventilators 4.Three vendors were listed as contracted suppliers for all ventilators rentals 5.There are 855 ICU beds (441 in Boston) 6.734 Respiratory therapists (268 in Boston) Total available ventilator rentals from the three Massachusetts vendors are 52 and an additional 165 ventilators may be available from neighboring state vendors. Massachusetts does not have a strategic stock pile of ventilators. The Federal government has 1400 ventilators in their strategic stock pile with 81 ventilators allocated for Massachusetts. Conclusion The hospitals that replied to the survey appear to lack the resources to respond to a Bioterrorist event,they had limited number of ventilators and were relying on vendors to augment their supply. When there is a critical shortage of ventilators to meet patient demand, the difficult decision of ventilator allocation would need to be addressed. Sponsored Research - None

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