Anaesthetic machines boost ventilator capacity

NHS staff have helped boost the stock of ventilators, crucial for the care of those suffering from coronavirus (COVID-19), by repurposing more than 200 anaesthetic machines.

These machines, normally used in operating theatres outwith intensive care units (ICU), will supplement the stock of specialised ICU ventilators.

NHS boards will deploy them as an interim measure with staff currently being retrained to use them in this way.

The use of repurposed machines increases ICU bed availability to more than 500. More ventilators for the NHS in Scotland have been ordered from a range of manufacturers and these will arrive in the coming weeks.

First Minister Nicola Sturgeon said:

“Expert NHS clinicians, medical physicists and technicians have worked tirelessly, particularly over the last few days, to increase the ventilation capacity in our NHS by repurposing anaesthetic machines in response to COVID-19. 

“Their remarkable work means our NHS has not just doubled ICU capacity, but has tripled it, ahead of the arrival of the additional ventilators we have ordered.

“We are now working to quadruple ICU capacity for COVID-19 patients to beyond 700 ICU beds, as soon as that can be achieved.

“These measures are part of our concerted and sustained response to an unprecedented health emergency. I am deeply grateful to our NHS staff for their ongoing commitment, expertise and bravery during this outbreak.”

Consultant Intensive Care Anaesthetist and Scottish Critical Care Clinical Lead Dr Rory Mackenzie said:

“Over the last month ICU clinicians across Scotland have been fully committed to delivering detailed plans to increase the number of ventilator beds to meet the anticipated demand due to COVID-19.

“These plans include expanding into new spaces not normally used for critical care and repurposing anaesthetic machine ventilators, normally used in the operating theatre environment, to supplement specialised ICU ventilators.

“Most importantly, staff with previous ICU experience and others released from elective care programmes have gone through additional training. 

“This is to ensure they can provide essential support and assistance to core critical care staff in the delivery of invasive ventilation, within these significantly enlarged units, to the sickest patients for whom this treatment provides a realistic prospect of survival.”

Scottish Government Senior Medical Advisor and Consultant Intensive Care Anaesthetist Dr John Colvin said:

“From working collaboratively with clinical and technical staff across NHS Scotland, we are now confident that we are able to provide more than three times the normal number of ICU beds, and are on course to quadruple Intensive Care Capacity.

“A key advantage is that the extra medical and nursing staff from anaesthetics who will be contributing to the ICU escalation care will be familiar and confident with this equipment. ”

Background

Most modern anaesthetic machines have ventilators within them, and as a result the majority can be used with or without some modification to ventilate patients requiring intensive care.

Modifications of anaesthetic machines for this purpose includes converting from oxygen to air to power the ventilator or software adaption.  

A large number of anaesthetic ventilators in NHS Scotland do not require any modification to run for the much longer period required in ICU, compared with their usual intermittent operating theatre use.

Medical and nursing staff from anaesthetics who will be contributing to the ICU escalation care will be familiar and confident with this equipment.