Mass Ventilation

Abstract

Mass ventilation may be defined as the simultaneous ventilation of a surge of patients in varying degrees of respiratory failure who would overwhelm the normal ventilation capability of a medical service. Starting with the Copenhagen poliomyelitis epidemic in 1952 and subsequent events such as the SARS epidemic in 2004 and notably the SARSCoV2 pandemic in 2020, has led to much discussion about procurement of suitable equipment for mass ventilation and importantly who is available to operate it. The debate has been fuelled not only by fears of a new flu epidemic and COVID19 but also by the continuing threat from terrorism, starting with the sarin attacks in Matsumoto and Tokyo in 1994 and 1995. Given the limited availability of high specification ICU ventilators and the skilled personnel required to operate them, many countries are opting for mass procurement of simple gas powered ventilators which can provide basic support. These can then be supplemented in complicated cases by more complex machines in hospital and by electronically controlled transport ventilators which are more complex to operate but less expensive than ICU machines (See Chaps. 8 and 11).

There is no one single solution that will be appropriate for the management of mass ventilation in different parts of the world. A flexible solution will be required to match the number of cases requiring ventilation with the setting, the available equipment and staff who are able to operate. With the extensive development of portable ventilators over the past years there is now a wide range of options available. If ventilators are stockpiled for national emergencies it is essential that they be of a type that is familiar from everyday medical use and that the equipment should be carefully maintained on a regular basis.