title: Assessing the Capacity of the US Health Care System to Use Additional Mechanical Ventilators During a Large-Scale Public Health Emergency.
abstract: OBJECTIVE
  A large-scale public health emergency, such as a severe influenza pandemic, can generate large numbers of critically ill patients in a short time. We modeled the number of mechanical ventilators that could be used in addition to the number of hospital-based ventilators currently in use.
  
  
  METHODS
  We identified key components of the health care system needed to deliver ventilation therapy, quantified the maximum number of additional ventilators that each key component could support at various capacity levels (ie, conventional, contingency, and crisis), and determined the constraining key component at each capacity level.
  
  
  RESULTS
  Our study results showed that US hospitals could absorb between 26,200 and 56,300 additional ventilators at the peak of a national influenza pandemic outbreak with robust pre-pandemic planning.
  
  
  CONCLUSIONS
  The current US health care system may have limited capacity to use additional mechanical ventilators during a large-scale public health emergency. Emergency planners need to understand their health care systems' capability to absorb additional resources and expand care. This methodology could be adapted by emergency planners to determine stockpiling goals for critical resources or to identify alternatives to manage overwhelming critical care need.
authors.affiliation: 1Food and Drug Administration,Silver Spring,Maryland.
authors.forename: Adebola
authors.initials: A
authors.lastname: Ajao
authors.affiliation: 2Department of Health and Human Services,Assistant Secretary for Preparedness and Response,Washington,DC.
authors.forename: Scott V
authors.initials: SV
authors.lastname: Nystrom
authors.affiliation: 3Centers for Disease Control and Prevention,Atlanta,Georgia.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Koonin
authors.affiliation: 3Centers for Disease Control and Prevention,Atlanta,Georgia.
authors.forename: Anita
authors.initials: A
authors.lastname: Patel
authors.affiliation: 2Department of Health and Human Services,Assistant Secretary for Preparedness and Response,Washington,DC.
authors.forename: David R
authors.initials: DR
authors.lastname: Howell
authors.affiliation: 4IEM Inc,Morrisville,North Carolina.
authors.forename: Prasith
authors.initials: P
authors.lastname: Baccam
authors.affiliation: 2Department of Health and Human Services,Assistant Secretary for Preparedness and Response,Washington,DC.
authors.forename: Tim
authors.initials: T
authors.lastname: Lant
authors.affiliation: 3Centers for Disease Control and Prevention,Atlanta,Georgia.
authors.forename: Eileen
authors.initials: E
authors.lastname: Malatino
authors.affiliation: 5Pardee Rand Graduate School,Santa Monica,California.
authors.forename: Margaret
authors.initials: M
authors.lastname: Chamberlin
authors.affiliation: 3Centers for Disease Control and Prevention,Atlanta,Georgia.
authors.forename: Martin I
authors.initials: MI
authors.lastname: Meltzer
mesh_terms: D003695:Delivery of Health Care / Q000592:standards; D004189:Disaster Planning / Q000379:methods / Q000592:standards; D006295:Health Resources / Q000706:statistics & numerical data; D006801:Humans; D054527:Mass Casualty Incidents; D011634:Public Health / Q000295:instrumentation*; D055872:Surge Capacity / Q000706:statistics & numerical data*; D012122:Ventilators, Mechanical / Q000706:statistics & numerical data*
keywords: mechanical ventilators; model; pandemic; public health emergency; surge capacity