Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

The hidden ventilators in America

Ian M. Kahane, MD
Conditions
April 25, 2020
Share
Tweet
Share

Your town has more than enough ventilators if you know where to find them. Tens to hundreds of vents are sitting in almost every neighborhood in America, but are being utilized incorrectly.  Throughout the nation, there are facilities known as LTACs, which stands for long term acute care facility. These facilities are utilized for a broad array of patient care, but almost everyone falls into three categories: the first patient is someone who requires a long term ICU stay. These patients will usually recover, but they may require 30 to 120 days on a ventilator.

The second and third patients are where our resources are being wasted.  The second patient is someone who has had a stroke or another catastrophic injury and has not woken up in months. The family adamantly refuses to turn off the ventilator, even though their loved one is deceased by any objective measure, due to religious reasons. The third patient had the same type of catastrophic injury but now remains hopelessly on a ventilator because their family has a dispute on disconnecting the vent, and the patient had no advanced directive or living will. The family cannot decide what to do, so their loved one just wastes away in an LTAC. All across America, there are people who are 78 years old, had a stroke four years ago and have remained on a vent in an LTAC for three years, five years, or even longer.

It is important to highlight these LTACs for two main reasons. First off, if you have a family member who has been unresponsive on a vent for years or even decades, now is the time to turn the vent off. I am genuinely sorry that you will have to let your loved one go, however in the coming weeks, a 16 year old who vapes is going to need that vent just to survive. They may have decades of fruitful life ahead of them, so please think about them. You have the power to make a life-saving resource immediately available.

Second, most government officials have no idea how many Medicare dollars are spent in these facilities each year and how easy it would be to convert them to COVID-19 battlegrounds. Our government officials should seriously entertain placing a limit on how long LTACs can keep a person unresponsive. We needn’t be cruel; we can pick an absurdly long period of time, be it 90 days or even 180 (even though after 14 days if you do not respond, your likelihood of doing so is essentially zero). At some point, the government should force the vent to be turned off.  We are going to need these vents in April. They are just sitting and being wasted in LTACs all across the nation. They are already in your town, and they could be altered to actually save lives. This may seem unfair, but in the coming weeks, we are going to have to choose between the 78-year-old unresponsive stroke patient and the previously healthy 16-year-old kid.

Ian M. Kahane is an internal medicine physician.

Image credit: Shutterstock.com 

Prev

Is asking for hazard pay "not becoming of a compassionate and caring physician"?

April 24, 2020 Kevin 2
…
Next

The immense kindness and humanity surfacing from the pandemic

April 25, 2020 Kevin 0
…

Tagged as: COVID, Critical Care, Infectious Disease

Post navigation

< Previous Post
Is asking for hazard pay "not becoming of a compassionate and caring physician"?
Next Post >
The immense kindness and humanity surfacing from the pandemic

ADVERTISEMENT

More by Ian M. Kahane, MD

  • A more scientific jump-start to the economy

    Ian M. Kahane, MD

Related Posts

  • America’s inadequate LGBTQ medical education

    Haidn Foster
  • Gun violence in America is a national emergency

    Hussain Lalani, MD and Justin Lowenthal 
  • The hidden work of primary care

    Michelle Nall, MPH, ANP-BC
  • The hidden curriculum of medicine

    Errin Weisman, DO
  • The hidden threat of the 80-hour resident workweek 

    Anonymous
  • Making America great again with harm reduction

    Mark Leeds, DO

More in Conditions

  • Why PSA levels alone shouldn’t define your prostate cancer risk

    Martina Ambardjieva, MD, PhD
  • Reframing chronic pain and dignity: What a pain clinic teaches us about MAiD and chronic suffering

    Olumuyiwa Bamgbade, MD
  • America’s ER crisis: Why the system is collapsing from within

    Kristen Cline, BSN, RN
  • Why timing, not surgery, determines patient survival

    Michael Karch, MD
  • Why psychotherapy works and why psychotherapy fails

    Peggy A. Rothbaum, PhD
  • How oral health silently affects your heart, brain, and body

    Charles Reinertsen, DMD
  • Most Popular

  • Past Week

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why timing, not surgery, determines patient survival

      Michael Karch, MD | Conditions
    • Why health care leaders fail at execution—and how to fix it

      Dave Cummings, RN | Policy
    • How digital tools are reshaping the doctor-patient relationship

      Vineet Vishwanath | Tech
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
  • Recent Posts

    • Why point-of-care ultrasound belongs in every emergency department triage [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why PSA levels alone shouldn’t define your prostate cancer risk

      Martina Ambardjieva, MD, PhD | Conditions
    • How to handle chronically late patients in your medical practice

      Neil Baum, MD | Physician
    • Reframing chronic pain and dignity: What a pain clinic teaches us about MAiD and chronic suffering

      Olumuyiwa Bamgbade, MD | Conditions
    • How early meetings and after-hours events penalize physician-mothers

      Samira Jeimy, MD, PhD and Menaka Pai, MD | Physician
    • Why medicine must evolve to support modern physicians

      Ryan Nadelson, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 1 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why timing, not surgery, determines patient survival

      Michael Karch, MD | Conditions
    • Why health care leaders fail at execution—and how to fix it

      Dave Cummings, RN | Policy
    • How digital tools are reshaping the doctor-patient relationship

      Vineet Vishwanath | Tech
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • The hidden health risks in the One Big Beautiful Bill Act

      Trevor Lyford, MPH | Policy
  • Recent Posts

    • Why point-of-care ultrasound belongs in every emergency department triage [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why PSA levels alone shouldn’t define your prostate cancer risk

      Martina Ambardjieva, MD, PhD | Conditions
    • How to handle chronically late patients in your medical practice

      Neil Baum, MD | Physician
    • Reframing chronic pain and dignity: What a pain clinic teaches us about MAiD and chronic suffering

      Olumuyiwa Bamgbade, MD | Conditions
    • How early meetings and after-hours events penalize physician-mothers

      Samira Jeimy, MD, PhD and Menaka Pai, MD | Physician
    • Why medicine must evolve to support modern physicians

      Ryan Nadelson, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

The hidden ventilators in America
1 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...