Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

The U.S. tried to build a new fleet of ventilators

nytimes.com

Post reply on HN
Print view View original

101–110 of 355 posts

Re: The U.S. tried to build a new fleet of ventilators

#101

Post by 14 »

oefrha wrote: post #30

I find it strange that all we hear about these days is the shortage of ventilators (okay, PPE too), as if it’s the only bottleneck. The reality is ventilators are useless without intensivists to operate them, and you need anesthesiologists and probably other skilled personnel too. I learned through a personal connection who was actually on the ground in Hubei (but not Wuhan) caring for serious but non-ICU patients th…

Documentation will be one of the biggest bottle necks. You can not do anything in the system without documenting every single item you used or action you have taken. It takes huge amounts of time. These doctors could increase the patients they see I would guess 10 fold if they didn’t have to document every detail. But it would be hard to bill without the details and for some things documentation is critical and important. In a triage situation however a lot of stuff could be ignored completely and focus solely on critical elements like lab values not that you used 12 pieces of cotton so bill that.

Re: The U.S. tried to build a new fleet of ventilators

#102

Post by relativitypro »

oefrha wrote: post #30

I find it strange that all we hear about these days is the shortage of ventilators (okay, PPE too), as if it’s the only bottleneck. The reality is ventilators are useless without intensivists to operate them, and you need anesthesiologists and probably other skilled personnel too. I learned through a personal connection who was actually on the ground in Hubei (but not Wuhan) caring for serious but non-ICU patients th…

Saying it is easy to ramp up machinery implies that it actually is... while your point that human capital is more valuable than tools is correct, ask yourself why a sophisticated pump costs 10k$ and requires a medically trained person to operate it.

There is a lot of money to be made by keeping these barriers in place, through legal, technical means and by limiting people’s access to “experts” that know what to do with them.

Re: The U.S. tried to build a new fleet of ventilators

#103

Post by saurik »

SkyPuncher wrote: post #97
oefrha wrote: post #30

I find it strange that all we hear about these days is the shortage of ventilators (okay, PPE too), as if it’s the only bottleneck. The reality is ventilators are useless without intensivists to operate them, and you need anesthesiologists and probably other skilled personnel too. I learned through a personal connection who was actually on the ground in Hubei (but not Wuhan) caring for serious but non-ICU patients th…

> It’s much harder to ramp up production of medical professionals. I have a mixed opinion on this. In particular, I don't think we really need to create more skilled medical professionals, we just need to change the way they work. Most of doctors have exposure to the basics of intubating and ventilation through medical school. Those without direct critical care experience would likely be absolutely terrible at it. Ho…

I now don't remember where I saw this, nor can I find it... but I swear I had seen something in the past week or two comparing how much retraining different medical professions needed to quickly get useful for staffing ventilator technology, and veterinarians came out on top; so like, people are (unless I dreamth this?!) looking into reusing people.

Re: The U.S. tried to build a new fleet of ventilators

#104

Post by joe_the_user »

oefrha wrote: post #30

I find it strange that all we hear about these days is the shortage of ventilators (okay, PPE too), as if it’s the only bottleneck. The reality is ventilators are useless without intensivists to operate them, and you need anesthesiologists and probably other skilled personnel too. I learned through a personal connection who was actually on the ground in Hubei (but not Wuhan) caring for serious but non-ICU patients th…

If only there were a nation, so far unaffected by the virus, with a large number of skilled medical professionals willing to travel to other countries and help. I'm sure if such a place existed, the US would be negotiating right now to get a supply of such medical professionals. And certainly wouldn't be sabotaging that country's ability to aid other countries /s.

https://en.wikipedia.org/wiki/Healthcare_in_Cuba

Re: The U.S. tried to build a new fleet of ventilators

#105

Post by chinathrow »

joe_the_user wrote: post #104
oefrha wrote: post #30

I find it strange that all we hear about these days is the shortage of ventilators (okay, PPE too), as if it’s the only bottleneck. The reality is ventilators are useless without intensivists to operate them, and you need anesthesiologists and probably other skilled personnel too. I learned through a personal connection who was actually on the ground in Hubei (but not Wuhan) caring for serious but non-ICU patients th…

If only there were a nation, so far unaffected by the virus, with a large number of skilled medical professionals willing to travel to other countries and help. I'm sure if such a place existed, the US would be negotiating right now to get a supply of such medical professionals. And certainly wouldn't be sabotaging that country's ability to aid other countries /s. https://en.wikipedia.org/wiki/Healthcare_in_Cuba

Cuba is already supporting Italy at this time.

https://www.youtube.com/watch?v=n-93Uhrpam4

Re: The U.S. tried to build a new fleet of ventilators

#106

Post by AlexCoventry »

joe_the_user wrote: post #104
oefrha wrote: post #30

I find it strange that all we hear about these days is the shortage of ventilators (okay, PPE too), as if it’s the only bottleneck. The reality is ventilators are useless without intensivists to operate them, and you need anesthesiologists and probably other skilled personnel too. I learned through a personal connection who was actually on the ground in Hubei (but not Wuhan) caring for serious but non-ICU patients th…

If only there were a nation, so far unaffected by the virus, with a large number of skilled medical professionals willing to travel to other countries and help. I'm sure if such a place existed, the US would be negotiating right now to get a supply of such medical professionals. And certainly wouldn't be sabotaging that country's ability to aid other countries /s. https://en.wikipedia.org/wiki/Healthcare_in_Cuba

Where can I read more about those sabotage attempts?

Re: The U.S. tried to build a new fleet of ventilators

#107

Post by 14 »

ALittleLight wrote: post #74
cycrutchfield wrote: post #65

Earlier quoted context omitted.

Ask any doc if they want 4th year medical students to help in the ICU with COVID-19 patients and they will say “No, they would most likely be a hindrance rather than help”. If a 4th year medical student can’t help, then why do you suppose somebody with zero training would?

I'm not saying "zero training". I'm suggesting the minimum training necessary to run a ventilator. That way doctors or nurses could simply hand off care to ventilator-operators who could contact the doctor or nurses if things got out of control. This wouldn't be as high quality care as people would usually get, but hopefully it would be better than nothing. Regarding whether doctors would want undertrained help - tha…

I have been nursing for years and the battle of skills has never stopped. Only doctors can do A B or C. Then at some point the registered nurses start doing it and then eventually the licensed practical nurses get to do it. The shift in skill set is always happening and often fought from the top ie doctors fighting to keep the skill to theirselves. You are absolutely right there are plenty of people who could efficiently watch the ventilator patients and report back the important facts. And you are also right they don’t need to do a perfect job only better then just letting people die with no chance. That is what triage is all about. All hands on deck. It is just really hard to start giving extra direction and have new people on the ward when the shit is hitting the fan and that alone can fluster staff. But in a pinch we won’t have enough staff so other rolls need to be taken or people will die.

Re: The U.S. tried to build a new fleet of ventilators

#108

Post by cycrutchfield »

joe_the_user wrote: post #99
cycrutchfield wrote: post #65

Earlier quoted context omitted.

Ask any doc if they want 4th year medical students to help in the ICU with COVID-19 patients and they will say “No, they would most likely be a hindrance rather than help”. If a 4th year medical student can’t help, then why do you suppose somebody with zero training would?

It seems like you've outlined a situation that could well be true. The US indeed has a training process that only generates useful competence with a full 8-12 year apprenticeship of hazing and theory. Of course, it flies in the face of a common sense view that someone careful, able to follow orders, just hold things or press button etc would provide some use in a world where the doctors are fundamentally limited. It…

Imagine thinking that the role of a medical professional in the ICU is to just sit around and “press buttons”.

Re: The U.S. tried to build a new fleet of ventilators

#109

Post by [deleted] »

romanows wrote: post #41
oefrha wrote: post #30

I find it strange that all we hear about these days is the shortage of ventilators (okay, PPE too), as if it’s the only bottleneck. The reality is ventilators are useless without intensivists to operate them, and you need anesthesiologists and probably other skilled personnel too. I learned through a personal connection who was actually on the ground in Hubei (but not Wuhan) caring for serious but non-ICU patients th…

I wonder how long it would take to teach someone to be more help than harm? After 30 intensive days of training, what would candidates lack?

[deleted]

Re: The U.S. tried to build a new fleet of ventilators

#110

Post by baybal2 »

oefrha wrote: post #30

I find it strange that all we hear about these days is the shortage of ventilators (okay, PPE too), as if it’s the only bottleneck. The reality is ventilators are useless without intensivists to operate them, and you need anesthesiologists and probably other skilled personnel too. I learned through a personal connection who was actually on the ground in Hubei (but not Wuhan) caring for serious but non-ICU patients th…

> The reality is ventilators are useless without intensivists to operate them,

Get guard reservists and order them to squeeze the airbag by hand if 5 million American health professionals are not up to task

Post reply on HN