Coronavirus: Elon Musk praises doctor who rigged ventilator to treat 9 instead of 1 using online tutorial
This could prevent a worst-case scenario in which doctors have to choose between patients, condemning those who don't get access to a ventilator to die
Dr. Alain Gauthier, an anesthetist at the Perth and Smiths Falls District Hospital in Ontario, Canada, decided to make better use of in-demand ventilators during the on-going coronavirus pandemic. Using DIY mechanics learned through a video tutorial made by two Detroit doctors, he rigged one ventilator to treat nine patients instead of one.
In basic terms, Dr. Gauthier's rig involves pairing patients of similar size and lung capacity, and running two hoses from one ventilator running at double power. His innovation came about because he was worried that the high-risk population that his hospital serves may be in greater need of ventilators than what was available for use. The Canadian Press reported that Dr. Gauthier had said that the idea has been studied in theory and tried once before, for people injured in a mass shooting in Las Vegas.
The solution engineered is not perfect, Dr. Gauthier has warned. But it could prevent a worst-case scenario in which doctors have to choose between patients, condemning those who don't get access to a ventilator to die.
This is already a reality in Italy where the toll has now risen to 4,032 deaths and more than 47,000 cases. Ventilators are key to the battle against COVID-19 because, with no treatment or vaccine, the mechanical breathing machines are the main supportive treatment for patients with the most severe symptoms until they recover.
Dr. Gauthier's colleague, Dr. Alan Drummond, shared photos of the rigged ventilator on Twitter, calling Dr. Gauthier, "with a PhD in diaphragmatic mechanics", an "evil genius" for single-handedly increasing their rural hospital's ventilator capacity. His post was noticed by Elon Musk who posted "Interesting thread" in reply to Dr. Drummond's post and later posted about on a continued discussion on how to replicate it in other settings. He wrote: "A single computer, pump & pressure accumulator would be fine for many patients, but ideally individual valves per patient to personalize care & avoid cross-flow risk."
Dr. Gauthier first learned about the ventilator adaptation by watching a YouTube video put out by an emergency physician, Dr. Charlene Babcock Irvin, from Detroit. The video was based on an earlier feasibility study she did with Dr. Gerry Irvin Neyman. Las Vegas emergency physician Dr. Kevin Menes remembered this study when he was faced with a shortage of ventilators after the 2017 mass shooting in Las Vegas that killed 58 people and wounded 413. He improvised with a y-tube and hooked two of the injured people up to a single ventilator, saving both of their lives.
The knowledge on how to stretch medical resources is key to handling the coronavirus crisis, especially in smaller hospitals, like in Perth, where Gauthier works as an anesthetist and general practitioner. Therefore his DIY efforts are not an isolated phenomenon. Doctors are trying similar DIY techniques to stretch resources like crafting masks from office supplies because of the shortage of protective gear.
“We have to prepare ourselves for all the intensive care units in the province to be swamped. So we have to become more comfortable with things we don’t usually do as often,” said Gauthier.
“We are planning for the worst-case scenario, having to put two people or four people on one ventilator.” Gauthier acknowledged it was a “crazy plan,” but said his hospital had to prepare for the possibility now and not ten days from now.