Ventilation

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water shortage dogging The Fight against the coronavirus. At the Bradford Royal Infirmary (BRI). it is only a test is still possible, six employees for The Virus per day, the consultants have their own personal protective equipment, and - da BRI-s Dr John Wright reports, There is an urgent need to save oxygen.

6. April 2020

We are about a week away from the estimated peak of the epidemic. Our most important pillar of the treatment is to simply hold the patient's breathing, and the two questions employees of us - fans and oxygen.

It became clear that the United Kingdom is. Although we meet in urgent orders more, it seems a bit on them, and we are concerned that our order will arrive on time, the Covid-19 peak.

However, There is increasing evidence that a simple machine used by patients with sleep apnea (snoring and interrupted breathing), which can be in your own bedroom is an effective alternative. And Dr. Tom Lawton , one of our brilliant, intensive care consultant, has managed to get its hands on 100 of them from a local manufacturer.

oxygen is The Other priority.

The producers are working around The Clock , with the demand to keep up, but the hospitals are not built, the flow of oxygen required, as many patients on ventilators and we find that our infectious "Red Zone " communities can only have a maximum of 10 ventilated patients the oxygen flow falls, triggering an alarm.

Front-line-diary

Prof John Wright , a physician and epidemiologist, is head of the Bradford Institute for Health Research. He cares for patients in epidemics around The World , including cholera, HIV, and ebola outbreaks in Africa South of the Sahara. In The Next few weeks he will be reporting for The Bbc , such as The Hospital , the Bradford Royal Infirmary, is dealing with Covid-19.

read his first two diary entries: and

If we have extra equipment to deal with coronavirus cases, we expected that the increase Can come, but Covid-19 has is as a more easily transferable, as predicted, and The Peak comes much earlier ordered. So the additional fans are not going to be here In Time .

The form seems to work best with Covid-19 patients called Continuous Positive Airway Pressure (CPAP), but some of the clinic CPAP devices use 50 litres of oxygen per minute for a single patient. This was never a problem before, because the oxygen is usually In Short supply. But in Italy it was a problem, because The Number of patients in need of Ventilation .

The army has drawn up a draft to supply oxygen for hospitals

"One of the problems is that, while the beds have oxygen in addition to them, we have never needed, such a large flow of oxygen to the municipality," Says Tom Lawton . "We have about 250 litres per minute available for each municipality, and about 3,000 are available for The Hospital - which has, again, never a Problem. But if it is with 50 litres per minute for each patient, the need to then all of a sudden only five on a Station, and 60 in a hospital - and we are More Than that.

"It's not just for us, it is also the hospitals around the Country - They were not specifically for this level of oxygen. "

Watford General Hospital , declared that a Critical Incident on Saturday as it approached The Point , if it had been in the location, to the provision of oxygen to patients, it needs.

Listen to John Wright

looking for ways around The Problem , Tom has to use, in cooperation with the University of Leeds, which was mounted on a 3D printed valve, in order to reduce The Hospital fans, the amount of oxygen you are.

But he also saw CPAP devices to treat sleep apnea At Home . This will keep the air in a continuous pressure within a mask that the user keep the airway Open - They must be used, to the provision of oxygen for use in The Hospital , but you use much less than with standard-hospital-fans.

Tom called a local company to check the availability.

Tom Lawton testing, continuous positive air pressure device, in General, apnoea

used For Sleep ,"she said, 'Yes, we have a€ 2,000, and how many do you want?"' he Says . "And so our plan is to start with 100 and see if, if we stay this early enough in the patient, we can prevent people from deteriorating and need to Go On to the more complex fans and have come to the intensive care unit. "

We have been testing over the weekend, and There is evidence from China and from the USA, that They seem to be effective. They just help inflate the lung, and that seems to be beneficial.

They are also very easy, which means that There is no need for a lot of training.

The First delivery of a simple CPAP devices

Debbie Horner, the Advisor in the amount of Covid-19 intensive care-planning - who is now back at work after the infection The Virus itself, around Says hospital doctors in the Country , and took a sharp intake of breath, when They heard that it is based in Italy, the oxygen.

"One of the issues that you had originally, we realise that we go to, is actually the diameter of The Pipes come into the clinic," she Says . "It is not only the total amount of oxygen, which has a hospital, it is also how much you can get to the bed? Or how many sides of the bed can, get oxygen to all the time?"

We had to examine how the distribution of patients around The Hospital "is based on the size of The Pipes ," she Says .

What everyone wants to avoid through this type of planning is The Situation in Italy, where hospitals were unable to provide intensive care for all patients, because of the lack of equipment or personnel.

3D printed Venturi valves designed in Italy (left) and in Leeds (on the right) - the design will>be posted on The Internet , The Situation when it arises.

"One of the things we want to do is in this hospital, to ensure that when we reach this point, so is each individual doctor has not only the support of other clinicians in the workshop, but also from another group of senior doctors and the doctors in The Hospital ," Debbie Horner.

"in Addition, There is also discussion on the regional and national ethics committees, the support of the individual hospitals, the decision-making process, so that all of these decisions with the same frame. "

This is new territory for us. There is a feeling of fear is the fact that potentially replicate some of the decisions that have been made in Italy.

Hopefully it will not reach that point.

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respiratory diseases, coronavirus pandemic, nhs, ventilators, oxygen, bradford

Source of news: bbc.com