# Prioritizing who gets ventilators question



## Em in Ohio (Mar 26, 2020)

I'm old.  If there is only one available ventilator and a younger person needs one, I think they should have priority over me.  Thoughts?


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## Aunt Bea (Mar 26, 2020)

For me, the simple answer is yes.

I think other factors should enter into the decision.  If the older person could survive with immediate attention and the younger stronger person could fight off the effects of the virus for a few days they might be able to save both with the same ventilator.

This is one area that I have been having trouble understanding.  The governor of New York has said repeatedly that he needs 40,000 ventilators and has only been able to locate approx. 4,000.  The thing that I don't understand does New York need 40,000 all at once or over the duration of the epidemic could he get by with the 4,000  or some other number used several times over the course of several weeks. 

It's hard and frustrating to get past the fear and the sensational soundbites in the news.

The best thing that any of us old folks can do is stay out of the way and not contribute to the problem.


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## old medic (Mar 26, 2020)

In NC we have a MOST form you can complete, other states have similar... 
Unlike a DNR it covers ventilators, fluid or feeding tubes antibiotics ECT... 
But their overall health and condition should also play in... 
Why take a 50 year old genetic scientist of the only vent to put it on a 24 year old gang banger crack head?
Unfortunately, it will come down to this in some places...


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## Em in Ohio (Mar 26, 2020)

old medic said:


> In NC we have a MOST form you can complete, other states have similar...
> Unlike a DNR it covers ventilators, fluid or feeding tubes antibiotics ECT...
> But their overall health and condition should also play in...
> Why take a 50 year old genetic scientist of the only vent to put it on a 24 year old gang banger crack head?
> Unfortunately, it will come down to this in some places...


I realize that we have a different definition of old.  I am 70.  I am unemployed.  Nobody depends on me.  So, yes - save the 50 year old.  I do understand your thinking about the "24 year old gang banger crack head."  They weren't likely to live long lives anyway.  

I have a DNR order that specifies that I don't want anything that "prolongs my death."  Give us pain relief, a euphoria drug, a fatal dose of sedative (I also stated that if this should be an option in my state, this is my request.)

I do foresee this as a need.  Sorry to get real, but...


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## Em in Ohio (Mar 26, 2020)

Aunt Bea said:


> For me, the simple answer is yes.
> 
> I think other factors should enter into the decision.  If the older person could survive with immediate attention and the younger stronger person could fight off the effects of the virus for a few days they might be able to save both with the same ventilator.
> 
> ...



Just lost my response.  But, I didn't mean this as an absolute, young over old.  The medic is right.  And, old is relative.  I don't consider 50 old.  I'm 70 - I consider myself old.  Also, yes - with the limited number of ventilators nationwide, it would be ideal to get them to where they are needed when they are needed.  Now, pharmacists report doctors trying to stockpile possible treatments for family and friends... disgusting.  Oaths seem to mean little in some people.


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## Gaer (Mar 26, 2020)

Wow Empty, This is RAW!  To give your life for another, a stranger, wow!  Your soul will be glorified in the Heavens!  I guess if it came down to it though, I'd do the same.  Actually, I'm kinda anxious to get to the other side.  Life goes on and on into eternity so whether I live out this life or another, better life in another place is of no concern.  Oh! You must have such a beautiful soul!


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## Em in Ohio (Mar 26, 2020)

Gaer said:


> Wow Empty, This is RAW!  To give your life for another, a stranger, wow!  Your soul will be glorified in the Heavens!  I guess if it came down to it though, I'd do the same.  Actually, I'm kinda anxious to get to the other side.  Life goes on and on into eternity so whether I live out this life or another, better life in another place is of no concern.  Oh! You must have such a beautiful soul!


Don't know about my soul - probably depends on who you ask.  But, I feel this makes sense.  When I was in high school, they had _some_ of us do a "Who lives, who dies" disaster scenario.  (I remember a lot of parents pissed off at this writing assignment.)  I never thought as hard about anything.  Wish I had kept it.  My logic skills were much greater then.  But, I think my major conclusions/rationale stayed with me. Horrible to think about.  But reality happens.  I hope to always deal with it rationally - see the big picture, not the personal/emotional/knee-jerk-reaction view.  (But, thanks for the positive note)


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## Gaer (Mar 26, 2020)

You are in a deep place today.


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## bingo (Mar 26, 2020)

Aunt Bea said:


> For me, the simple answer is yes.
> 
> I think other factors should enter into the decision.  If the older person could survive with immediate attention and the younger stronger person could fight off the effects of the virus for a few days they might be able to save both with the same ventilator.
> 
> ...


he's basing it on the numbers he sees now....since the people coming into hospitals...needing ventilation....have had the virus already two weeks....before we started "social distancing ".....
maybe....hopefully those numbers won't be as high


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## C'est Moi (Mar 26, 2020)

Think positive and stay at home.  I don't plan on needing a ventilator.


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## Pepper (Mar 26, 2020)

Sounds like some of us are tired of living even without coronavirus.


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## jujube (Mar 26, 2020)

I just read that in Italy now they aren't intubating anyone over 60.  Cripes, that's young!


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## fmdog44 (Mar 26, 2020)

Doctors will soon have to make those decisions.


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## Pepper (Mar 26, 2020)

NY State:  2 patients can share a ventilator simultaneously.  Not ideal, but can do.


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## Aunt Bea (Mar 26, 2020)

This option was mentioned on tonight's federal coronavirus update.

https://www.wsj.com/articles/lacking-ventilators-hospitals-seek-out-alternative-device-11585154579


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## old medic (Mar 27, 2020)

It's unfortunately a reality at this point. Our son 34 has serious heath history, and afraid this will kill him should he catch it...
I have been in the position a few times in my career that I had to choose who to treat. 
Pepper, theres work in NC on 4 on one vent...


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## Lee (Mar 27, 2020)

What if it was a person 65 who was sole caregiver for someone 85 and absolutely no one else who could replace them in the role of caregiver?

If the 65 year old dies then the 85 year old is forced into a nursing home and there is a shortage of nursing homes


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## garyt1957 (Mar 27, 2020)

Pepper said:


> NY State:  2 patients can share a ventilator simultaneously.  Not ideal, but can do.



 There was a Dr. here in Mi who had a set up where 4 people could use one ventilator. It was all over the news here but haven't seen anything of it since. She may even have a youtube video.But man, would that help.


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## old medic (Mar 27, 2020)

Its an interesting set up... but kinda complicated...
there are multiple settings on a vent, and each Patient has specific requirements...
With sharing a vent every Pt must have the same requirements...


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## Pepper (Mar 27, 2020)

old medic said:


> Its an interesting set up... but kinda complicated...
> *there are multiple settings on a vent, and each Patient has specific requirements...*
> With sharing a vent every Pt must have the same requirements...


Yes, I know, unfortunately having been on ventilators.  Notice the plural.


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## old medic (Mar 27, 2020)

We have simple transport vents, but cant be used long term in the hospital..


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## garyt1957 (Mar 27, 2020)

Maybe in general yes, the younger person would get it. But here in MI I've just seen video on the news of a certain segment of Detroiters jamming parks, having BBQ's, playing basketball and football and just large gatherings in spite of a shut down order saying no gatherings of 10 people, (it might actually be 2 people now). When one of these A-holes get sick, should they take a ventilator from someone older who isolated but got the virus on a necessary trip to the grocery store? Not in my book. Of course, there's no way to enforce this.


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## AnnieA (Mar 27, 2020)

I think priority should be healthcare workers that know how to intubate and manage ventilators.  Then parents or guardians rearing children.

Sounds harsh, but I also think treatment should be merit based.  There's a patient I know with Covid-19 who is on a vent in the Memphis metro area. She has diabetes with complications that she's made no attempt to manage over the years. Up until she fell ill, she had been running around town doing her regular daily shopping,  eating out up until restuarants went to take out only etc. Pisses me off royally when I think of the medical team wearing themselves out and exposing themselves caring for someone like her who has never taken care of herself.


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## JB in SC (Mar 27, 2020)

One of our local doctors has invented and produced an FDA approved device that can supply four people with one ventilator. Her husband is a software engineer that 3D printed the device.


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## terry123 (Mar 27, 2020)

Like I have said before, a vent saved my life when  was 50.  At my age now, just let me go to be with my Lord. I have always felt I was an old soul and I am ready to pass on.  Use the vent for some one younger.


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## Em in Ohio (Mar 28, 2020)

garyt1957 said:


> Maybe in general yes, the younger person would get it. But here in MI I've just seen video on the news of a certain segment of Detroiters jamming parks, having BBQ's, playing basketball and football and just large gatherings in spite of a shut down order saying no gatherings of 10 people, (it might actually be 2 people now). When one of these A-holes get sick, should they take a ventilator from someone older who isolated but got the virus on a necessary trip to the grocery store? Not in my book. Of course, there's no way to enforce this.


Stupid may be harder to cure than this virus.


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## Em in Ohio (Mar 28, 2020)

AnnieA said:


> I think priority should be healthcare workers that know how to intubate and manage ventilators.  Then parents or guardians rearing children.
> 
> Sounds harsh, but I also think treatment should be merit based.  There's a patient I know with Covid-19 who is on a vent in the Memphis metro area. She has diabetes with complications that she's made no attempt to manage over the years. Up until she fell ill, she had been running around town doing her regular daily shopping,  eating out up until restuarants went to take out only etc. Pisses me off royally when I think of the medical team wearing themselves out and exposing themselves caring for someone like her who has never taken care of herself.


Unfortunately, in this situation, I don't think that medical staff have time to debate individual merit, unlike organ transplants.  Life expectancy based on age, likeliness of recovery, and then value to society...  Definitely agree that healthcare workers should have priority in this crisis, if they can be saved and brought back into the fight.


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## Aneeda72 (Mar 28, 2020)

I am 73.  Yes, give my vent to the 23 year homeless crack head or the 68 year old grandmother. Give it to anyone but me.  If God wants me to survive, I will.  But I will not end up for months on a vent, not the way I want to die.


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## WhatInThe (Mar 28, 2020)

I see why many might need a ventilator but the last person/senior over 80 I know treated in the hospital for pneumonia was treated with humidified oxygen, antibiotics and diuretics. Showed improvement in 24 hours. O2 levels  to normal with in 3 days. They even wanted to release them with a low grade fever. This before covid19.  O2 normal plus by end of week at home.

For now I'd say first come first serve as really needed, not for somekind of precaution. Use should be the last resort.


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