How are decisions on sharing of ventilators made and how can risks of doing so be mitigated?

Question

My wife is a respiratory therapist working in an academic medical center in the USA. She works daily with Covid 19 patients performing roles such ventilator management or assisting with intubation.

As a result of the rapid rise in hospitalizations due to the highly contagious delta variant of the covid virus, ventilators are quickly becoming strained and hospital management has stated that coventilating multiple patients on a single ventilator may be necessary if situation worsens. Per a joint recommendation from organizations representing anesthesiologists , critical care physicians, and respiratory therapists last March, shared ventilation should not be done due to such practice being unsafe.

I am trying to help my wife with this stress with the following questions. When I asked the work aspects of this question on The Workplace SE, majority of the answers stated that hospital administration most likely accepted already the risks of shared ventilation so my wife's chances of change are limited.

1. If shared ventilation becomes necessary, how is it decided which patients are selected to share a ventilator?

2. How are the risks of doing do mitigated other than by not sharing a ventilator?

Answer 1

Placing bacteria filters on the tubing would be my go-to practice (I am a retired RT) but that seems ineffective since Viral load is much smaller than the sub-micro bacterial load the filters are designed for.

It’s a wet sloppy job ~ I had 35 years experience and I won’t gloss it over.

Sorry, I have no practical advice for front-line workers beyond good PPE, FULL VACCINATION/Booster and the other measures we employ, other than removing herself from her high-risk work environment. There are other related occupations, like Classroom Teaching in this field, being a Rep for Mech vent companies/Drug Rep, developing On-Line CE courses, Home Health, a lateral move to Management in another non-direct patient interfacing position come to mind.

My Best Wishes to your Heroic Wife. Cherish that.