The last couple months I have been participating with the development of our hospital's pandemic flu plan in compliance with recommendations by the Department of Health and Human Services. Among other issues, we discussed a critical ventilator shortage in even a mild pandemic. Restating the problem: the US has 100,000 vents, and the flu pandemic could produce 3 million or more vent-dependent patients. Since our meeting I have been researching simple vent designs which could be cheaply produced and stockpiled or "MacGyver'ed" from components found at a hardware store and in the hospital. So far we have been discussing:
Emerson ventilator http://www.jhemerson.com/pdfs/Branson%20-%20A%20tribute%20to%20John%20H%20Emerson%20
Bird mini-ventilator (Percussionaire/Oscillitron)http://www14.inetba.com/percussionaire/oscillitronpage.htm
Multiple people on single vent
Sommer DD, Improvised automatic lung ventilation for unanticipated emergencies. Crit Care Med. 1994 Apr;22(4):705-http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=8143481&query_hl=3&itool=pubmed_docsum
Magnet and Bobbin MiniventCohen AD, The minivent respirator. Anaesthesia. 1966 Oct; 21(4):563-8.
HFOV using modified portable air compressor
HFOV using modified oil vs diphragm air compressor
HFOV using modified shop vac or other vacuum
HFPPV using modified shop vac or other vacuum
HFJV using modified portable air compressor
Wednesday, March 08, 2006
Treatment for Pandemic Flu
http://www.medpagetoday.com/InfectiousDisease/URItheFlu/tb/2774 reviews info about using the chemotherapy drug etoposide as a treatment for pandemic flu. This drug is already effective for treatment of hemophagocytic lymphohistiocytosis (HLH), a disease which is a result of the over-reatction of the bodies immune system to EBV. Etoposide is human Cipro, targeting topoisomerase. It seems that young adults who die of H5N1 look exactly like young adults with HLH. This means it will be more important to have vents available so that victims of pandemic flu can get this medicine and recover.
Flu Pandemic Severe-Case Estimates:
1918 "Spanish" Flu
World Population = 1.8 Billion
US Population = 100 Million
Attack Rate = 20%
World Infected = 360 Million
US Infected = 20 Million
Death Rate = 1%
World Deaths = 20 Million
US Deaths = 675,000
2006 Flu Pandemic
World Population = 6.5 Billion
US Population = 300 Million
Attack Rate = 20%
World Infected = 1.3 Billion
US Infected = 60 Million
Death Rate = 1%
World Deaths = 65 Million
US Deaths = 3 Million
World Ventilators = 100,000
US Ventilators = 100,000
World Population = 1.8 Billion
US Population = 100 Million
Attack Rate = 20%
World Infected = 360 Million
US Infected = 20 Million
Death Rate = 1%
World Deaths = 20 Million
US Deaths = 675,000
2006 Flu Pandemic
World Population = 6.5 Billion
US Population = 300 Million
Attack Rate = 20%
World Infected = 1.3 Billion
US Infected = 60 Million
Death Rate = 1%
World Deaths = 65 Million
US Deaths = 3 Million
World Ventilators = 100,000
US Ventilators = 100,000
Friday, October 21, 2005
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