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Sharing some details about “oxygen rationing”. The municipal corporation collects data on oxygen beds and ICU beds, and allocates 5 lit/min/patient for oxygen bed and 20 lit/min/patient for ICU bed. The total estimated consumption in 24 hours is your hospital’s allocation. 1/n https://twitter.com/KetPan/status/1391314138924609544
This sounds reasonable and logical to an average person, doesn’t it. Equitable distribution based on needs. But to doctors this makes very little sense, because they know that the requirements of a COVID patient can change from 5Lit/min to 15Lit/min within hours. 2/n
The average consumption of an ICU COVID patient on BIPAP or NIV is 30-40 lit/min. On HFNC, it is 80-100 Lit/min. So how do authorities solve this? By declaring HFNC a waste of oxygen and banning its use. Despite the fact that HFNC reduces the need for ventilation by over 50%. 3/n
In effect, the “oxygen rationing” policy actively discourages the treatment of the sickest patients who need higher oxygen flows to survive. A hospital manager would think he can’t waste 3-4 patients oxygen quota on a single patient, and naturally avoid taking such patients. 4/n
On the other hand, hospitals would be more than happy to take in stable patients because they will have better outcomes and can be given adequate treatment. Win-win for stable patients and hospitals, but losing proposition for the most seriously ill patients. 5/n
Effectively, oxygen rationing works in favour of stable patients and against seriously ill patients. Equitable distribution destroys those who need the resource the most. There is no alternative to providing enough oxygen and some more, rationing is counterproductive. END. 6/6
