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It is Crunch Time on Ventilators

If it is war, I think of ventilators as tanks.

Every infantryman is happy to see tanks (friendly tanks) show up on the battlefield. The pack a punch and are the best defense against enemy tanks. In the crisis we are in that is being called a war, I see the ventilators as the "tanks" in the battle hospitals are in. This looks to be a good assessment of where we are nationally on ventilators today:

States demand ventilators as feds ration limited supply

Here is a copy of the language from FEMA on what they are asking for before they will ship ventilators:

FEMA Advisory

Coronavirus (COVID-19) Pandemic - Ventilator Request

Given the scarcity of the ventilators in the Strategic National Stockpile (SNS) and the current capacity of the private sector to meet the demand, the federal government has adopted the process below to manage federal ventilator resources to ensure the ventilators are shipped to the states in the amount needed to manage the immediate crisis. In the case of ventilators, immediate is defined as requirements necessary to sustain life within a 72-hour window.

To submit a request, states and tribes will work through their FEMA/ HHS regional leadership. In order for a request to be processed, the state/tribe must provide detailed responses to the following five questions:

    1. How many usable ventilators, ICU beds, and convertible ventilators are currently available within the state or tribe?
    2. What is the current hospital bed and ICU bed occupancy rate in the state/tribe?
    3. How many new ICU beds does the state/tribe estimate it can stand-up and the number of ventilators, or FDA-approved ventilator alternatives, it can or is standing up?
    4. What is the decompression ability of hospitals in the state/tribe (i.e.: are there currently field hospitals or alternate care facilities established)?
    5. How many anesthesia machines are in the state/tribe and have they been converted?
Once the requesting state or tribe provides the FEMA/ HHS Region with the answers to these five questions, then the requirement is validated at the Regional level and forwarded to FEMA’s National Response Coordination Center (NRCC) for processing.

At present, the federal government has 10,469 total ventilators available, which includes 9,404 [updated number is 7,000] in the Strategic National Stockpile and 1,065 available from the Department of Defense.

In addition to submitting requests through this process, state, and tribal officials are encouraged to share the FDA’s Emergency Use Authorization (EUA) for Ventilators issued on March 24. The EUA allows anesthesia gas machines and positive pressure breathing devices to be modified for use as ventilators. The EUA also provides guidance to assist health care personnel on use of other ventilators like CPAP devices for sleep apnea, with COVID-19 patients in respiratory distress, as well as on shelf life of existing ventilators. 

If you have any questions, please contact the National Business Emergency Operations Center at NBEOC@max.gov.

Eric Holdeman is a contributing writer for Emergency Management magazine and is the former director of the King County, Wash., Office of Emergency Management.