Mass Casualty Respiratory Failure and Mechanical Ventilation

About This Course

Over the last two decades AARC has partnered with the Centers for Disease Control and Administration for Strategic Preparedness and Response to train clinicians on the role of the respiratory therapist in mass casualty care and the ventilators in the strategic national stockpile. All in anticipation of a mass respiratory failure event.  COVID-19 tested this preparation and challenged the worlds health care system.  Shortages of staff, PPE, ICU beds and ventilators strained even the most prepared institutions.  Hospitals were required to improvise on the fly.  Staffing models were created and the use of travelers became routine.  The use of PPE amongst shortages placed caregivers at risk, challenging the duty to work paradigm. The role of the respiratory therapist evolved.  New treatments were devised, tested and either adopted or abandoned.

There were 3 types of ventilators in the stockpile (a total of approximately 14,000 ventilators).  During the COVID pandemic, this number ballooned, with the addition of approximately 150,000 ventilators (over a dozen new models- 2 of the 3 original devices were scrapped).  These challenges and the responses as well as future planning will be discussed in this symposium.

You can find information for all 15 mechanical ventilators in the SNS here: https://www.aarc.org/resource/strategic-national-stockpile-ventilator-training-program/

This on demand course contains four modules and awards 3 hours of CRCE.

Modules

Mass Casualty Respiratory Failure: Etiologies and Surge Capacity Considerations

Various infections and man-made and natural disasters can result in many people requiring respiratory support. COVID-19 is the most recent experience where large numbers of people required a myriad of ventilatory support.  This session will describe events that may lead to mass respiratory failure incidents and the types of injury and respiratory failure patterns based on natural and man-made disaster events. We will also discuss the implementation of mass respiratory failure care outside of conventional hospital settings, California’s response to oxygen and ancillary equipment supply demands during COVID-19, and briefly mention staffing and triage issues associated with mass care of patients.

Speaker Information

• Asha Devereaux, MD, MPH

Strategic National Stockpile Ventilator Program

This presentation will provide a brief overview of SNS response capabilities to help state and local partners with emergency response and preparedness planning. Details will also be provided on the medical asset request process, ventilator allocations, and how SNS ventilators are stored and maintained to ensure they will work properly once deployed. Since training is essential for SNS-held ventilator models, links to vital training and resources will be provided to prepare clinicians for the use of SNS ventilator models.

Speaker Information

• Catherine Mitchell MSN, BSN, RN / Health Scientist

The Role of the Respiratory Therapist in Mass Respiratory Failure

Respiratory therapists are essential personnel in a mass casualty respiratory failure event. From triage in the emergency department to care of the ventilated patient in the ICU, the respiratory therapist plays a critical role in the allocation of therapy and equipment as well as patient care. The COVID-19 pandemic revealed the issues related to staffing and staff burn out as well as how management can impact these concerns. Therapists provided early oxygen therapy and awake prone positioning as well as invasive ventilation and rescue therapies. The individual therapist and the RT department need to be prepared through education and training.

Speaker Information

• Carolyn J. La Vita, MHA, RRT, RRT-ACCS, RRT-NPS

The SNS: A Clinicians Perspective

Over the last two decades, AARC has partnered with the Centers for Disease Control and Administration for Strategic Preparedness and Response to train clinicians on the respiratory therapist’s role in mass casualty care and the ventilators in the strategic national stockpile. All in anticipation of a mass respiratory failure event. COVID-19 was the first event which resulted in wide dissemination of the SNS ventilators.  In the midst of the crisis, there were 3 types of ventilators in stockpile (a total of » 14,000 ventilators).  Use of these ventilators in patients with ARDS and viral sepsis was met with variable success. During the COVID pandemic, this number ballooned, with the addition of  » 150,000 ventilators (over a dozen new models- 2 of the 3 original devices were scrapped).  The ventilators currently available in the SNS will be discussed with regard to functionality and utility.  The characteristics of patients cared for during COVID-19 will be discussed and the essential requirements of the ventilators will be reviewed.

Speaker Information

• Richard D. Branson MSc, RRT, FAARC, FCCM