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High profile incidences over recent years, such as Coronavirus (COVID-19), 9/11, the Moscow theatre siege, severe acute respiratory syndrome, H1N1, and the avian flu have raised awareness of the acute problem entailed in handling mass casualty situations caused by terror, accidents, pandemics or natural disasters. As increasing numbers of people gather in shopping centers and stadia, on public transportation and in high-rise buildings, the likelihood of large-scale mass casualty disasters has dramatically risen.
Ventilators are at the center of the preparedness planning and emergency response debate. Man-made, natural disasters or pandemics could create a large number of victims who require ventilation. Until now, there has been no viable way to adequately ventilate mass casualties.
During a severe disaster such as a pandemic or chemical attack, many patients with respiratory failure who are able to receive mechanical ventilation may survive, while patients with respiratory failure who do not receive mechanical ventilation are likely to die. The Center for Disease Control (CDC) assumes that ventilators will be in short supply in many communities prior to or during the peak of a severe influenza or Coronavirus pandemic if something is not done.
In a recent report, the Center for Health Security at Johns Hopkins estimated the United States of America has a total of 160,000 ventilators available for patient. This leaves more than 99% of the United States population without any available form of ventilation in the event of a pandemic outbreak, such as coronavirus. Current ventilator capacity and usage in the United States is about 75% to 95% utilized with existing cases (COPD, elderly, accident victims, trauma, post surgical, cardiac, etc).
A study run by the federal government in 2005 estimated that if the United States of America were hit with a moderate pandemic like the influenza of 1957, the country would need more than 60,000 ventilators. If the United States were struck with a severe pandemic like the Spanish flu of 1918, it is estimated we would need more than 740,000 ventilators — many times more than are available.
The solution is Biphasic Cuirass Ventilation. Biphasic Cuirass Ventilation does not require skilled medical professionals, and almost anyone can apply BCV to a patient with minimal training.
Currently, Endotracheal (ET) intubation is utilized in conjunction with positive pressure ventilation for respiratory support in patients with cardiac or respiratory arrest during emergent situations. Coupled with the shortage of qualified clinicians capable of managing endotracheal intubation, even with a stockpile of positive pressure ventilators, only a very limited number of patients can be treated. Using simple calculations, 1 study found that the limiting factor during a pandemic-level crisis, such as coronavirus would be the number of respiratory therapists rather than ventilators.
Medical emergency experts are seeking more feasible methods on how to treat large groups of people requiring immediate life saving ventilation. According to The U.S. Department of Health and Human Services (HHS) and the Biomedical Advanced Research and Development Authority (BARDA), there is a need for a ventilator that is portable, low-cost, user-friendly and flexible in a pandemic situation or other public health emergency. An affordable portable ventilator will help meet the needs of patients, especially those that are critically ill during a public health emergency whether from a natural pandemic or an act of chemical or biological attack.
A ventilator such as the Hayek MRTX delivers a comprehensive and effective solution to this problem by providing complete and non-invasive ventilation.
The MRTX utilizing Biphasic Cuirass Ventilation, or BCV, can be applied very easily and with an incredibly short learning time for the end user. Clinical studies have shown that the application of BCV with the Hayek MRTX can be taught in as little as 5 minutes, or simply by watching a short instructional video by virtually anyone. Most importantly, in the unlikely event of misapplication of the Hayek MRTX, Biphasic Cuirass Ventilation carries absolutely no risk to the patient, unlike positive pressure ventilation, which may prove fatal.
The innovative MRTX leverages advanced technology, while designed in a way that doctors, nurses, health professionals and even non-clinical personnel can operate quickly without any special training. This makes it ideal for personnel providing rapid treatment at the scene of an emergency, while avoiding the difficulties and complication that will likely arise with invasive ventilation.
Biphasic Cuirass Ventilators, such as the Hayek MRTX are easily portable, are extremely lightweight, with a ruggedized case for outdoor use. The rechargeable battery of the Hayek MRTX provides full ventilation for up to 6 hours and can also run on 12 and 24 volts, as well as on mains power allowing the Hayek MRTX to be used for routine care as well. Preset ventilation parameters based on patient dimensions, eliminate any setting concerns.
With BCV, the goal of increasing the number of individuals trained or cross-trained to manage ventilator-dependent patients is easily achieved with the Hayek MRTX. The Hayek MRTX does not require skilled medical personnel.
Click here to learn about the application of Biphasic Cuirass Ventilation by Gear-Protected Physicians
Click here to learn Biphasic Cuirass Ventilation for pandemic A (H1N1) influenza virus.
The cuirass is applied to the patient’s chest. Its disposable seal allows for a comfortable, but airtight fit. The flexible transparent plastic cuirass is available in 12 sizes, chosen according to patient weight and body size, fitting anyone from neonates to adults.The attached power unit actively controls both the inspiratory and expiratory phases of the respiratory cycle. Biphasic Cuirass Ventilation works physiologically. It operates externally by creating negative chamber pressure on the entire chest area. This causes the lungs to expand, and for inhalation to occur. Using positive pressure in the cuirass, it then creates an expiratory phase, exhalation.
BCV is easy to apply using the Hayek MRTX, even when cumbersome protective gear is worn; making it possible for one person to treat several patients. This is especially important where large numbers of people require emergency treatment.
The patented technology used in the Hayek MRTX greatly increases minute ventilation and enabling effective ventilation in both normal and injured lungs. Additional benefits of BCV include the facilitation of secretion clearance and improvement in cardiac output during ventilation.
The Hayek MRTX utilizing BCV is the only viable solution for providing ventilation in mass casualty situations.The Hayek MRTX was designed to be manufactured very quickly in the event of a surge in the number of patients requiring ventilation.
With the appropriate cuirass shell, BCV can be used on anyone.
Positive pressure ventilation techniques, as well as invasive mechanical ventilation, have a lengthy list of adverse effects, which BCV does not. Some potential adverse physiologic effects of positive pressure ventilation (PPV) are:
Perhaps the most feared complications occurring during mechanical ventilation include:
The use of positive pressure ventilation can lead to barotrauma, volutrama and possible development of a pneumothorax. These complications can be entirely avoided with the use of BCV.
BCV offers effective, even and natural ventilation without risk to the patient and can be applied by virtually anyone with minimal training.
BCV will also facilitate the clearance of secretions in contrasts to PPV, which compounds secretions.
BCV provides the only real solution to the complexities encountered in delivering life saving ventilation in such mass events.
Standard positive pressure ventilators require intensive training, clinical personnel to provide application, and are generally time consuming to apply. Combitube intubation is used for airway control and ventilation. Unfortunately, combitube intubation requires a skilled provider who performs this procedure on a frequent basis. During an emergency situation, ventilating patients quickly and effectively is key. In the event of a mass casualty scenario, such as a pandemic, this simply isn’t feasible. There are neither the facilities, nor the skilled personnel required for this to be achieved. With the Hayek MRTX, this is easily achieved.
In a mass casualty situation, persons of little medical skill will be required to care for patients. Biphasic Cuirass Ventilation does not require skilled medical professionals, and almost anyone can apply BCV to a patient with minimal training. BCV minimizes risks and complications, leading to significantly better patient outcomes during emergencies, including pandemics.
A comparison of the Hayek MRTX versus SNS/portable ventilators:
|Hayek MRTX||LP10||LTV 1200||Eagle Univent|
||Mandatory controlled, Continuous Negative, Triggered, or Secretion Clearance||SIMV or Assist Control – Volume||SIMV or Assist Control – Volume or Pressure||SIMV or Assist Control – Volume|
|How to ventilate?
||Non-invasive cuirass shell||Combitube intubation||Combitube intubation||Combitube intubation|
||Neonates to adults||Pediatrics to adults||Patients 5kg to adults||Pediatrics to adults|
||Nasal cannula or traditional oxygen delivery without interfering with vent settings.||Bleed in front of vent. Set liter flow and analyze on vent. Turn liter flow up or down to adjust FiO2.||If using high pressure oxygen source, set control on vent. If using low pressure oxygen source, set liter flow and analyze. Turn liter flow up or down to adjust FiO2.||Set by control on ventilator. Read FiO2 on LED above control.|
|Internal Battery||Up to 6 hours of operation||Up to 1 hour operation||Up to 1 hour operation||Up to 3 hours of operation|