Working Protocol for Supporting Two Patients with a Single Ventilator

March 26, 2020

The attached document, Ventilator Sharing Protocol: Dual-Patient Ventilation with a Single Mechanical Ventilator for Use during Critical Ventilator Shortages, was developed by NewYork-Presbyterian Hospital.

I am sharing this important protocol with all GNYHA member hospitals and health systems for possible use in your institutions. I am deeply grateful to NewYork-Presbyterian Hospital President and CEO Steven J. Corwin, MD, and his team of expert engineers and clinical caregivers for developing this outstanding work at this crucial time.

Quoting from the protocol’s “Administrative and Ethical Considerations,” the following guidance should be noted:

“Hospital administration should approve the protocol before use, acknowledging the unique ethical considerations. This protocol is only appropriate for consideration when (i) crisis standards have been instituted, (ii) there are not enough ventilators to meet demand for single-patient ventilation, and (iii) multiple patients are present for whom invasive ventilation has a reasonable probability of being life-saving.”

“Ethically, it must be recognized that dual-patient ventilation is not the usual standard of care. However, in the setting of a mass crisis, such as the COVID19 pandemic, the number of potentially rescuable patients may exceed the number of ventilators to support them. With the above safety measures, we believe this approach offers the best chance at saving the most lives. The use of dual-patient ventilation should be discontinued as soon as a sufficient supply of ventilators becomes available.”

Please direct questions about the protocol to Dr. Corwin’s Chief of Staff, Kerry S. DeWitt. She will forward your questions to the appropriate experts at NewYork-Presbyterian Hospital.

As always, thank you for your support, and for the extraordinary work of you, your leadership team, and your entire workforce in responding to this great challenge.

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