Evaluating the Reusability of Disposable Ventilator Components
Jenna Hines, Mary Beth Reno, Shiv Patel, Marketa Marcanikova, Mark Livingstone, Manuel Gutierrez, Dr. Melinda Harman
Abstract
Ventilators are a necessary medical instrument, especially with the current COVID-19 pandemic. Consumable supplies used with ventilators include nasal masks that go over the nose and mouth and polymer tubes that go down the throat, aided by use of a laryngoscope instrument. Excessive demand has led to inadequate ventilator instruments and supplies and increased the challenges of cleaning these instruments and supplies, both domestically and abroad. Defining and validating protocols for reusing consumable ventilator devices could extend resources and help save lives. A risk assessment was performed on the ventilator components to find the most at risk components, and current protocols were researched to determine an effective reprocessing method. Overall, the mask and tubing contain the highest risk, and there are current cleaning methods that could be used in COVID-19 cases to reuse these components
Introduction
Throughout 2020, the COVID-19 pandemic has affected both people and healthcare systems, putting both to the limits in not only the United States, but globally as well. Specifically, the amount of ventilators available to combat the high number of cases has been in high demand. Ventilators have many components, which can be either disposable and able to be thrown away or reused after each patient, or can be capital and used from patient to patient. In order to allow ventilators to be readily available for patients in need without excessively high costs, it would be beneficial to reuse the disposable ventilator components.
Materials and Methods
- The components of mechanical ventilators, both reusable and disposable
- Risk assessment to determine high inherent risk of each component and ability to be cleaned
- Evaluation of current protocols for cleaning and reprocessing
- The application of cleaning protocols in low resource settings
Results
- The components of highest risk: facial mask and tubing, and the laryngoscope, the instrument used to intubate a patient, were the components with the highest risk
- The risk assessment looked at the risk of containing COVID-19 and who would be in contact with this equipment
- World Health Organization (WHO) guidelines for cleaning can be used as a basis for COVID-19-specific reprocessing procedure definition
Conclusions
Based on the risk assessment, disposable components have the highest risk, and should be focused on for reuse. The current WHO guidelines state these components should be cleaned and disinfected before reuse.
Next steps and future work:
- Evaluation of the clinical limitations for reuse in low resource settings
- Discussion with ventilator manufacturers to inform them on the risk assessment
- Analysis of the role of human factors in ventilator reprocessing
References
BBC News, 2020, Coronavirus: What are Ventilators and Why are they important?, https://www.bbc.com/news/health-52036948, June 10, 2020
Bound Tree. VividTrac VideoLaryngoscopes, https://www.boundtree.com/Airway-Oxygen-Delivery/Video-Laryngoscopes/VividTrac-Video-Laryngoscopes/p/group003889, June 16, 2020.
Indiamart. Patient Circuit. https://www.indiamart.com/proddetail/patient-circuit-20295422912.html, June 16, 2020.
JedMed, 2020. Hollinger Laryngoscope, https://www.jedmed.com/products/hollinger-laryngoscope, June 16, 2020