EMCrit Wee – Alternatives to Vent Splitting and the Safest Vent Splitting Methods in COVID19

This Post will be updated as new-information arises

Hospital Non-Invasive Machines can be Adapted for Invasive Ventilation

Issues:

Most machines are single tube circuits that allow exhalation from a vented mask. If hooked up to an ETT, you need an exhalation port and it must be proximal to a viral filter. Many of the companies sell circuits purpose-built for this, for example:

Respironic's Version

If not, items can be adapted to this use by Respiratory Therapy. Key is anything venting to the environment is filtered

Home BiPAP/CPAP Machines

* Same deal as above

* Sinai's Research Page on Adapting Home CPAP Machines

* Adapting the V60

Back-Up Ventilators

Many chronically vented patients have their primary ventilator and a back-up in their homes. If they want to help, their community, a loan of these back-up ventilators would be helpful.

Oxygen Powered Commercial CPAP Devices

Like the Boussignac device, Pulmodyne Go-PAP,

and similar devices

Intensive Blog's take on NHS Guidance on CPAP

Anesthesia Machines

* APSFASA Anesthesia Machines as ICU Ventilators

Oxylator

See the EMCrit Post

With a PEEP cap in place, these will replace a ventilator

EMCrit CPAP Set-Up

can be used for invasive CPAP through an ETT for patients who are awake and spontaneously breathing freeing up the ICU ventilators for patients requiring mandatory breaths.

see video describing set-up on EMCrit COVID Airway Post

This will not be as comfortable as a legit machine, but it should get the job done

Vortran Garbage Disaster Vents

* Instructional Video

Splitting Non-Invasive CPAP

Listen to the Wee below for more on this...

Should work on invasive CPAP as well

Helmet CPAP

* Helmet-Based Ventilation

Splitting Ventilators

This seems absolutely a last resort situation. SCCM has released a guidance document saying the same:

* SCCM Statement on Vent Splitting

* PULMCrit Retort to the SCCM Statement

* Read Jack Iwashyna take on the issue

* <a href="https://www.gnyha.org/wp-content/uploads/2020/03/Ventilator-Sharing-Protocol-Dual-Patient-Ventilation-with-a-Single-Mechanical-Ventilator-for-Use-during-Critical-Ventilator-Sho...