# 1822
The New York Times this morning is giving some welcome coverage to a serious issue; Who gets a ventilator during a pandemic?
With somewhere over 100,000 ventilators in this country, and with between 80% and 90% in use, the number of available ventilators at any given time is probably no more than 25,000-30,000 nationwide.
In a severe pandemic, the US government has estimated that as many as 750,000 people could require a ventilator. Obviously, many who could benefit from a ventilator, won't have access.
Decisions will have to be made as to who gets a ventilator, and who does not. And harder still . . . when do we decide to remove a patient from a ventilator in order to give that resource to someone else?
These are ethical dilemmas that need to be confronted now, before a pandemic strikes.
Guidelines for Epidemics: Who Gets a Ventilator?
By CORNELIA DEAN
Published: March 25, 2008
It may sound unthinkable — the idea of denying life support to some people in a public health disaster like an epidemic. But a new report says doctors, health care workers and the public need to start thinking about it.
PLANNING AHEAD There is no shortage of ventilators now, but what if there was?
Allocation of Ventilators in an Influenza Pandemic: Planning Document (PDF)
The report, by New York State health officials, grows out of the work of a group formed in 2006 to plan for the possibility of an influenza pandemic. The group focused on the breathing machines called ventilators.
Right now, there are enough ventilators to go around. But in an epidemic, there could be a severe shortage of machines and, more important, doctors and nurses to run them. At that point, the new report says, doctors and hospitals would have no choice but to start taking some people off the machines so that others could live.
Removal “is absolutely the crux of the problem,” said a lead author of the study, Dr. Tia Powell, who has spent much of her career studying medical ethics. “There are people who might survive who won’t get a chance at a ventilator if someone who is likely to die even with a vent is using it.”
Before an epidemic strikes, the report says, the public should confront the issue to ensure that any such triage decisions reflect community views, as well as ethical and clinical standards.
