The Government has promised that the first batch of new ventilators made by UK manufacturers will be in hospitals in early April.

The announcement represents a significant boost for the NHS, which currently has 8,000 ventilators. But what are they and why are they important in the fight against coronavirus?

What is a ventilator?

A ventilator, formerly known as a respirator, is a machine designed to help move breathable air in and out of the lungs in the event that a person is unable to breathe by themselves or their lungs are not operating at full capacity.

If the patient only needs the ventilator for a portion of the time, such as while sleeping, they would usually inhale air through a nasal mask. However, if a patient needs long-term ventilator dependence, they will usually receive a tracheotomy cannula; a small slit in the throat that a tube is fed through. 


Ventilators help to force oxygen into the lungs of patients who are struggling to get enough


Credit: Wikimedia Commons

How do ventilators work?

Modern ventilators are computerised and feature a compressible air reservoir or turbine, air and oxygen supplies, and a set of valves and tubes connected to the patient. The air is pneumatically compressed several times a minute to force oxygen into the lungs, which expand and take it in thanks to their natural elasticity.

How many ventilators are in the UK?

There are 8,000 ventilators currently in the NHS, but it is understood that an order of ventilators from China is needed to top up supplies before the British-made machines roll off the production line.

Which companies are making ventilators?

Ventilator Challenge UK, a consortium of British engineering firms including Airbus, Rolls-Royce and BAE Systems, secured an order for 10,000 of two types of machine currently produced by Smiths Medical of Luton and an Oxfordshire-based firm called Penlon.

A reservation for 5,000 machines has also been placed with Smiths, on top of a further order for 10,000 from the vacuum cleaner manufacturer Dyson. 

Praising the “ingenuity” of major UK firms and manufacturers, including Airbus, Dyson, Ford, McLaren and Rolls Royce, Michael Gove said the the first tranche would be produced in early April and then “rapidly distributed”.

“Before the epidemic struck, we had very little domestic manufacture of ventilators,” Mr Gove said.

“But now, thanks to the dedication of existing medical supply companies and ingenuity of our existing manufacturing base, we have existing models being produced in significantly greater numbers, and new models coming on stream.

 


Mercedes is one of the companies making ventilators


Credit: JAMES TYE/AFP/GETTY IMAGES

How likely is it that you’ll need to be on one if you get Covid-19? 

Most people who end up contracting Covid-19 will suffer only very minor symptoms similar to a flu: a dry cough, fever, and shortness of breath. However, in some cases, particularly among elderly or immuno-compromised people, the illness can lead to respiratory troubles, pneumonia, and multiple organ failure as the virus attacks the lungs. 

To this end, hospitals have been desperately trying to source additional ventilators to help treat those most badly affected by the disease. 

Even if you are in hospital with Covid-19, it is unlikely you will need to be put on a ventilator. A New England Journal of Medicine study of 1,099 patients in China hospitalised with coronavirus found that 41.3 per cent of people need supplemental oxygen, ie a ventilator. On top of that, only 2.3 per cent needed invasive mechanical ventilation with a tracheotomy. The average period of hospitalisation was 12 days. 


The Government says thousands of ventilators will soon be ready for hospitals


Credit: Stefan Rousseau/REUTERS

Why is the government trying to increase manufacturing of ventilators? 

According to the projected number of coronavirus cases, the UK is unprepared for the amount of ventilator usage that it will need. 

Worst-case forecasts suggest that 7.9 million Britons could end up requiring hospitalisation, and 41.3 per cent of those will require 12 days on a ventilator, meaning that 8,000 units will not be close to enough. Mr Hancock has admitted as much, explaining that the country would need “many times more than that”. 

What does it feel like to be on a ventilator? 

The bad news for those who end up having to use a ventilator is that it is not a comfortable experience. 

The only significant study into the feeling was conducted by doctoral student Veronika Karlsson at the University of Gothenburg’s Sahlgrenska Academy in 2012. Resulting from interviews with 14 patients who were on ventilators for between two and 88 days, she revealed that lying fully conscious on a mechanical ventilator is a traumatic experience for all. 

“The studies show that many people who are conscious while on ventilator treatment experience feelings of panic,” noted Karlsson. “Many describe being breathless, and pain from the tube and probes makes it hard for them to relax and sleep.


Ventilators can be uncomfortable for many patients


Credit: JERRY LAMPEN/EPA

“After breathing, the most difficult thing was not being able to talk. All of the patients who were interviewed communicated by nodding or shaking their head, but also developed individual communication patterns using facial expressions, looks and body language to express their suffering.”

However, the study did find that most patients preferred to remain conscious and that having attentive carers with them did help boost people’s perceptions of being on a ventilator, so depending on the level of care, it might not be such a bad experience. Either way, if being on a ventilator prevents deaths it will be a price most people are willing to pay.

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