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Ventilators: Who needs them? And does Australia have enough?

Source: Getty Images

COVID-19 patients who need a ventilator may be at risk of dying if they don't have access to one.

One in six coronavirus patients become seriously ill, according to the World Health Organisation, as they may present with symptoms such as breathing difficulties, fever, and a dry cough. 

In some cases, the virus can cause pneumonia which requires the patient to be placed on a ventilator, which is a machine that provides mechanical ventilation by moving breathable air into and out of a person's lungs. 

It delivers breaths to a patient who is unable to breathe on their own or breathing insufficiently. 

In countries hit hard by the virus, such as the US, Italy, and Spain, efforts are being made to acquire more ventilators through various means, while their healthcare systems feel the strain under mounting pressure. 

US President Donald Trump has exercised the authority of his office by invoking the "Defense Production Act", forcing automaker General Motors to build ventilators for American hospitals. 

This rising demand for these life-saving machines begs a few questions; including how do they work exactly? Who needs them? And does Australia have sufficient numbers? 

How do ventilators work? 

According to Dr Yahya Shehabi, a professor of intensive care medicine at the University of NSW, ventilators are necessary to keep a patient's lungs breathing in the long-term.

They could function on some patients for days, weeks, or even months. 

The expensive machine is available in every Australian operating room as well as in Intensive Care Units. 

“Essentially a ventilator does two things. The first is to oxygenate the patient's blood through feeding air mixed with oxygen [as needed] to the lungs through tubes attached to the nose and mouth,” Dr Shehabi says. 

“The second is to mechanically pump the mixture to maintain a certain air pressure.”

Without the help of a ventilator, a patient's damaged lungs may collapse, he says.

Dr Shehabi says the machine can assist in breathing but in some cases can completely take over the breathing process for the patient.  

What happens if there aren’t enough?

While some breathing masks provide a similar function to ventilators, they aren’t suitable for long-term use. 

According to Dr Shehabi, a patient who requires a ventilator will be at a considerable risk of death in cases where they may not have access to one. 

“What we’re learning from Italy, Spain and the US is that by the time a patient requires a ventilator, they have a 60 per cent chance of dying. That’s why we’re trying to focus on slowing down the symptoms and finding solutions to delay that point.”

Cages of ventilators at the New York City Emergency Management Warehouse on 24 March 2020.
Cages of ventilators at the New York City Emergency Management Warehouse on 24 March 2020.

Is Australia ready?

According to a study conducted by the Medical Journal of Australia released on March 30, Australia currently only has enough ventilators to partially meet that maximum surge capacity.

It also found that, if needed, Australia had the capacity to surge intensive care beds by 189%, or an additional 4261.

The report recommended that Australia places a priority on boosting ventilator availability and increasing the workforce needed to operate the machines. 

The additional ventilators would be sourced from local and international providers. 

According to Dr. Shehabi, the orders put through by the government will ensure no less than 7000 ventilators in the country within weeks.

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